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Medical marijuana – who would have believed it? Should marijuana be legalised? My answer when I graduated from pharmacy school would have been a resounding no. However, times have changed and we have to change with the times. Although I may still agree with my original thought, here is some further information for those who may consider that marijuana should indeed be legalised. Marijuana in various forms has been used for medicinal, religious, ceremonial and recreational purposes for thousands of years. Marijuana has been cultivated since the dawn of agriculture 10 000 years ago. The pharmacopeia of Chinese emperor Shen Nung who lived in 2700 BC recommends it to treat more than 100 ailments. In October 2013, medical marijuana was legalised in 20 American states with more states considering following suit. In August 2013, Sanjay Gupta, chief medical correspondent for CNN said that many clinical studies had established that marijuana has “very legitimate medical applications”. He added that marijuana “doesn’t have a high potential for abuse”. Some of the medical benefits which he outlined from reliable scientific studies proved that marijuana can: • Alleviate chronic pain, especially nerve pain caused by diabetes, amputation, HIV, multiple sclerosis and hepatitis. • Lower eye pressure caused by glaucoma (when used as an eye drop). • Relax muscle tension, decreasing muscle spasms and reducing shaking caused by multiple sclerosis and other neuromuscular diseases. • Act as an anti-vomiting agent, especially in people receiving chemotherapy (cancer therapy). • Stimulate appetite in people with AIDS, cancer and eating disorders. • Relieve acute anxiety, insomnia and other sleep disorders. For those keen on legalising it, research also shows that in chronic users, marijuana impacts learning and memory, long after the acute effects of the drug wear off and the effects may persist for years. It may also seriously impair judgment and motor coordination, contributing to accidents while driving. The combination of marijuana and alcohol is worse than either substance alone, with respect to driving impairment. A number of studies have shown an association between chronic marijuana use and mental illness, such as personality disturbances and schizophrenia. To be considered a legitimate medicine, a substance must have well-defined and measureable ingredients that are consistent from one dose (tablet, capsule or injection) to the next. The consistency allows doctors to determine the dose and frequency of dosing. Since the marijuana plant contains approximately 400 ingredients (chemical compounds) that may vary from plant to plant, its use as a medicine is truly difficult to evaluate. What’s the best advice? Who knows?