Friday, February 11, 2011

The Reasons Marinol (Doesn't) Work

Dronabinol (which is sold under the name Marinol) is a cannabinoid prescribed to treat nausea and vomiting induced by chemotherapy and to treat appetite loss in AIDS patients who have developed wasting syndrome. Unfortunately for them, this FDA-approved drug is actually a counterfeit, and the side effects from the drug may be worse than the symptoms it is meant to treat.

Dronabinol is synthetic 9-delta-tetrahydracannabinol (THC), produced in laboratories with machinery and chemicals, which is meant to mimic the effects of cannabis intoxication. The drug came onto the scene in 1985 when Unimed Pharmaceuticals bought the patent for dronabinol from the National Cancer Institute and began mass-producing the drug for commercial sale. Using a process known as liquid chromatography, Unimed produces nearly pure THC from a substance known as termpene olivitol, combines the THC with sesame oil, and sells the pill in doses of 2.5, 5, and 10 mg.

This entire process verifies the healing effects of THC, which is the main psychoactive ingredient in cannabis. However, what drug companies fail to realize is that THC isn't acting alone to produce the “high” that users feel when smoking or ingesting marijuana; it is instead working with several other cannabinoids present in the plant, including cannabidiol (which relieves convulsion, inflammation, anxiety, and nausea, as well as limiting THC-induced short-term memory loss), 9-delta-tetrahydrocannabivarin (which limits the psychoactive effects of THC), and cannabichromene (which is believed to contribute to the anti-inflammatory and analgesic effects of marijuana). This harmony of cannabinoids produces the “high” that cannabis users are familiar with; dronabinol, on the other hand, contains only one cannabinoid, and its effects on the user are quite different from smoked or ingested marijuana.

This is no subtle difference. Cannabis contains over seventy phytocannabinoids which interact in a complex manner, producing a unique sense of being alert and relaxed, while dronabinol, on the other hand, induces reactions in patients quite different from cannabis users. When a patient takes a Marinol, he or she is ingesting pure THC, which without antagonizing cannabinoids produces powerful hallucinations, including one where a girl who took Marinol saw the angel of death when she looked at her mother. 

Medicinal marijuana has other advantages over Marinol. Cannabis does not contain common allergens, whilst dronabinol contains inactive ingredients including sesame oil that some patients might have an adverse reaction to. Cannabis is also cheaper, with stronger strains (which is known colloquially as “chronic”) selling for $8.57 per low dose (500 mg), while dronabinol sells for $9.05 per low dose (which is only 5 mg); medical marijuana is a tenth of the cost. For patients with health insurance, Marinol may cost less as it is a Schedule III drug covered by several insurance companies, but for those without, it may cost over $200 a month.

The matter is simple: dronabinol is synthesized in the laboratory using an artificial chemical process. The result is a drug containing 99% THC, which, without the aid of other cannabinoids, will induce adverse effects in users that could be properly treated with medicinal marijuana. Cannabis contains all the necessary cannabinoids, produces more favorable effects, and can be purchased at a much lower price than dronabinol because it is more easily produced (and if it was legal, it could be grown for free in your own garden).

The one health risk that cannabis poses is the potential danger from inhaling combusted plant matter. However, it is far less carcinogenic than tobacco smoke, and as cannabis users smoke less often than do tobacco smokers, they are exposed to far less smoke (and it is interesting to note that there are no recorded instances of marijuana-only smokers developing black lung or lung cancer). In addition, the plant can also be vaporized, which removes harmful substances from the smoke, or it can be ingested orally, the exact ingestion method employed to take dronabinol.

In light of this information, think about our society from an economic perspective. Should the government allow us to grow and possess a plant that contains powerful drugs capable of relieving pain and inflammation and stimulating appetite, or should it continue to outlaw this plant in favor of an inferior and artificially-produced medicine that sells at a higher price and fills the coffers of Unimed Pharmaceuticals?

Expensive medicine, or a plant that grows in the ground and does the job better? You decide.

-John D.. McGaughey

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