Inauguration and the start The Medical Marijuana seminar was held at Yenepoya University on 26th April, 2017. It was organized by Yenepoya Narcotics Educational Foundation of India (YNEFI), Mangaluru, was inaugurated by Mr. Mohammed Nazir, Mangaluru city corporation commissioner at auditorium of Yenepoya Dental College. Dr. Anil Kakunje Associate professor of Psychiatry and Deputy CEO of YNEFI welcomed, Dr. M Vijayakumar, Vice- Chancellor of Yenepoya University presided over the function, and Dr. Shemjaz Arakkal Deputy CEO of YNEFI proposed a vote of thanks.
Medicinal use of cannabis across different cultures by Dr. G Shreekumar Menon. Presently, cannabis is banned almost throughout the world. Being known as the 'Poor man's Heaven', every part of this plant is in use. It is also known as the Indian Hemp, which points out to its Indian origin. According to the Hindu mythology, cannabis is Lord Shiva's favourite food and thus He is known as the 'Lord of Bhang'. Atharvaveda mentions the cannabis plant among the 5 kingdom of herbs that free people from anxiety. It is also referred to in the Old Testament as 'Honey wood' by Samuel. Cannabis is cultivated mainly for three purposes, for human consumption, for synthesising fibres for ropes and as a commercial substitute for linseed oil. Speaking of the Historical aspect of cannabis, it is considered as one of the seven sacred plants in India. There are also groups like the Aghoris and Yogis who practice the religious use of cannabis. In the Chinese medicine, it is one of the 50 fundamental herbs. The Chinese history also reveals that it was Hua Tuo who first used cannabis as an anaesthetic. Interestingly, it is said that Gautam Buddha, in his penance of 6 years ate one cannabis seed per day. There is difference of opinion on the cannabis plant in the different denominations of Christianity. Some Sufi Masters like Sheikh Haydar advocated the use of cannabis. However, religions like Islam, Budhism and Bahai completely prohibit the use of cannabis. Some Sufi Masters like Sheikh Haydar advocated the use of cannabis. In the period between 1850-1937, cannabis was considered the prime medicine for than a 100 separate diseases. But in 1912, the Harrison's Act called for a complete ban on all intoxicating substances. This caused many countries to declare a ban on the cannabis. Hence, no much research was done. Well, now, the interest seems to have revived and some US states have begun to legalise it for medicinal purposes.
Medical marijuana could be of therapeutic use in conditions like Alzheimer's, Hepatitis C, ALS, Multiple sclerosis and epilepsy. It could also be used to reduce seizures, chemotherapy induced nausea, reduce pressure in glaucoma and relieve pain,tremors and spasms. But, it comes with adverse effects like structural changes in the brain, risk of heart attacks, impairment of memory and balance and potential addiction. Marijuana also seems to have a lot of commercial potential in the textile industry, for paper, building materials etc. Presently, Israel is the world leader in the cultivation and exportation of cannabis with an income of about 1 billion US dollars a year. This has lead them to conduct numerous researches on it. About 76% of doctors approve the use of medical marijuana. This proves the need of the authorities to legalise the medicinal use of marijuana to further the researches and ultimately bring benefit to the suffering patients.
Marijuana in homeopathy by Dr. Madona Joseph, Prof. & HoD, Dept. of Forensic Medicine, Father Muller Homeopathy Medical College, Mangaluru. In homeopathy, it is said 'like cure like'. The cannabinoids are also called 'the drug of happiness' or a 'social drug' because its intake removed feelings of loneliness and boredom. The plant cannabis belongs to the vegetable kingdom. It is believed that the cannabinoids could be used in conditions like phobias, hallucinations and other neurological disorders like epilepsy, manias and delirium.
On the contrary, Cannabinoid users are also expected to be dealing with absent mindedness, nightmares, feeling exaggerated emotions and feel like time passes too slowly. They also inhibit higher mental functions and stimulate imagination to a remarkable degree. As to conclude, it is possible that this drug could be a potential medicine to some of the disease if a dose is prepared keeping the holistic approach in mind. After all, it is said, 'One man's food is another man's poison.
Cannabinoids are used in medicine to treat a variety of symptoms, but their efficacy for specific indications is not yet clear. It is believed that it could be used to treat conditions like epilepsy, multiple sclerosis, Alzheimer's, Huntington's disease , Osteoporosis, Incontinence, nausea and vomiting due to chemotherapy, glaucoma etc. A total of 7 relevant studies have been done on HIV infections. Dronobinol was administered for their appetite stimulation. It proved of some help for the treatment of AIDS associated anorexia, but the evidence for its safety and efficacy are still lacking. About 18 RCTs with 20-419 sample sizes were conducted in painful conditions and some relief was noticed in conditions like peripheral neuropathy and multiple sclerosis. Cannabinoids have also proven to reduce insomnia, incidence of nightmares and increase sleep quality. They have shown to reduce pain and thus could be used in palliative care. But, several adverse effects like dizziness, nausea, fatigue, somnolence, euphoria, hallucinations etc have been reported from about 79 clinical trials.
Rimanaband, a cannabinoid receptor blocker was found useful to treat dyslipidemia but it was removed in 2010 as it showed suicidal tendencies and depression. Cannabinoids are also believed to be of use in osteoporosis, breast cancer, prostatic cancer, skin cancer, lung cancer, oral cancer and pancreatic cancer. Even if they could not provide complete cure, it could be combined with chemotherapy as an adjuvant to reduce toxicity. The conclusion drawn is that cannabinoids may not be an answer for pain relief or palliative care, but maybe of use in advanced cancerous conditions, so the best thing to do is to stimulate endogenous cannabinoids through yoga, exercise, meditation and other enjoyable activities.
Marijuana in Ayurvedic Medicine by Dr. Krishnamurthy, Alvas Ayurveda Medical College, Mangalore. The plant 'Bhang' had been regarded as a semi poisonous drug since olden days. Unlike the common man's belief, not every plant that grows in nature is necessarily safe or without side effects. In the Ayurvedic literature, the Bhang has been used to treat a variety of diseases like skin diseases, diarrhoea, psychological disorders, etc. It is described as an appetiser, absorbent, digestive, carminative, confusing, hallucinatory, causing sluggish speech and sedative drug. But like any other thing, it is the proper amount, time and duration of use that decides whether it is a nectar or a poison. The dosage of Bhang in Ayurveda is 65-125mg of purified Bhang leaf powder. The adverse reactions noticed are vertigo, fatigue, confusion and tremors. The antidote to its overdose it Cow's ghee and milk. The dose should only be consumed after the classical method of purification is done and the formulations rightly prepared. Its uses are numerous. It is an analgesic, anticonvulsant, appetiser and sexual stimulant to name a few. The scientific evaluation of the therapeutic actions of Bhang and its utility is lagging due to a number of reasons like insufficient data, hindrance in motivation, its effect on other classical products and because it is a non-profit business to Pharmaceutical companies. To answer the question whether Bhang is a boon or bane, the answer is to prepare classical formulations with suitable vehicle in specific doses. The studies in this matter are to be encouraged in the light of research so that the needy patients are benefitted out of it.
Neuroscience perspective on the Cannabinoids by Dr. Raghavendra B.S, First Neuro Brain & Spine Super Speciality Hospital, Mangalore Speaking of the 'weed of madness', there was a time in 1763 in the US when anybody could be jailed for not growing the cannabis plant because it was a war crop at that time. The cannabinoid receptors in the body are the CB1 in the nervous system and CB2 receptors in the immune system. CB1 receptors are located in the presynaptic nerve terminal. The stress responsive Anandamide acts on CB1 and decreases the GABA mediated transmission. This is responsible for actions such as hyperactivity, analgesic action and so on.
Panel Discussion The discussion emphasised that the cannabinoids could be a potential answer to diseases like epilepsy, ALS, multiple sclerosis, Gonorrhoea, palliative treatment of non-curable cancer, autism and others. The ethical side of it much is still unknown. The addiction factor that causes the psychological dependence makes the limitation of the drug usage. The answer to this may lie in all branches of medicine working together to bring out a formulation that can benefit the patient. The procedure to conduct a research on the drug was also discussed by the medical ethics representative. The discussion concluded with the decision that a collaborative effort from all fields of medicine may reveal the wonders of Medical Marijuana. The addiction potential of cannabinoids when compared to nicotine, heroine, alcohol and the like are comparatively very less(of about 9%). Medical marijuana could be made use of in fertility regulation, appetite regulation, reduction of inflammation, euphoria and to increase the blood supply to the brain. The question posed is' Is cannabis safe?' and the answer is that no drug is totally safe. And without a doubt, it is relatively much safer than other drugs that are used to treat epilepsy. Cannabinoids could be helpful in headaches, cancer, multiple sclerosis, neuropathic pain, and movement disorders, anorexia associated with AIDS and cancer and in reducing spasticity. To end with a quote, as the Father of Neurology said, “There is nothing either good or bad, but the thinking makes it so."
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