Many Dutch people have sometimes smoked a joint, or eaten spacecake.
But in addition to recreational use of cannabis, its medicinal use has grown explosively in recent years.
Medicinal cannabis seems to have a lot of potential, as science also sees.
And certain forms of medicinal cannabis that were only available on prescription at first, can already be easily purchased at a simple drugstore.
Is the medicinal use of cannabis not growing too fast?
And what are the risks? Scientias.nl spoke about this with Dr. Arno Hazekamp.
He obtained his doctorate in the field of pharmaceutical research into medicinal cannabis and is founder of a consultancy firm for the cannabis industry, regulators and medical professionals: Hazekamp Herbal Consulting .
If we look at the potential of medicinal cannabis, there are currently fairly strong indications for various disorders that cannabis seems to offer a real solution.
Hazekamp says: “There are a number of things that cannabis can do well.
In some disorders cannabidiol (CBD, see box) works well, with other tetrahydrocannabinol (THC, see box).
If we look at what THC does, then we are talking about reducing chronic pain complaints and delivering palliative care to people who are very seriously ill.
Think of patients with AIDS or cancer. THC ensures, for example, that these patients sleep better, have more appetite and less vomiting.
So it really reduces the peripheral symptoms and symptoms of their illness that they feel really bad about.
These are really two things that have been shown to be very strong THC can do this.
Scientists are currently also investigating the potential of CBD against epileptic seizures.
CBD seems to work reasonably well in certain forms of epilepsy in children.
The combination of THC and CBD together is particularly suitable for reducing spasms in patients with multiple sclerosis (MS).
This has been described very well in the scientific literature. “Medical cannabis certainly has potential.
After these disorders, which have been shown to be very strong in helping medical cannabis, there is a whole list of disorders that are claimed to help cannabis.
But there is still a strong scientific basis for this at the moment.
So there is still plenty to do.
Recreational vs. medicinal
But there are also a lot of people who use cannabis for recreational purposes. Hazekamp explains that every cannabis plant can possibly be medicinal, as well as the species that are used for recreational purposes.
He says: “Cannabis is a plant with a medicinal effect, but there are countless types of cannabis.
And so you have to find out which specific cannabis plant benefits from which disease. ”
There is therefore no difference between a cannabis plant for recreational use and a cannabis plant for medicinal use.
But there is a big difference in the way recreational and medicinal cannabis is processed.
He explains that a lot is involved in the production of medicinal cannabis.
“For the development of medicinal cannabis, it is not so much just about the cannabis plant itself, but also about the quality.
In the Netherlands we grow cannabis for medicinal purposes in a way that there is no mess, such as pesticides, fungi or heavy metals.
Unfortunately, illegal cannabis growers sometimes use that kind of junk to speed up the growth of cannabis plants as quickly as possible.
In the Netherlands we grow medicinal cannabis in a controlled area, where they control the quality of the plants and also use a standardized processing process, “says Hazekamp.
In the lab it is all about quality and standardization, and these are the two most important basic requirements for making medicines.
When you have been prescribed a medicine, or you buy yourself in the pharmacy, you want to be sure every time that the medicine works the same.
This is precisely why laboratories check the composition of medicines and use standardized methods to produce them.
And it is precisely those aspects that are missing when you buy a cannabis plant in a coffee shop, for example, instead of in a prescription pharmacy.
Hazekamp says: “When you go to a coffee shop, it is actually a kind of Russian roulette.
You do not know exactly what you get and that brings risks with it.
The quality can vary and therefore the effects can always turn out differently. ”
But apart from the processing, a lot of different products fall under the term medicinal cannabis.
Several manufacturers, pharmacists and even people at home make everything from cannabis.
And all these products must be used in a different way. When we talk about medicinal cannabis, it is therefore important to know which product we are talking about and how we use that product exactly.
We must prevent that we throw the effects of all these different products into one big heap under the heading of medicinal cannabis.
These effects can vary greatly.
At first it was popular to smoke cannabis, but given the health effects of smoking, doctors and coffee shops advise against doing this.
An alternative now is to inhale the cannabis with the help of evaporators.
The advantage of this is that the active substances are absorbed directly into the blood via the lungs and therefore have a rapid effect.
In addition, people also make all kinds of skin creams of cannabis and lubricate that where they need the active substances.
But the best-known and strongest growing form of medicinal cannabis are perhaps the oils: THC oil and CBD oil.
Hazekamp says: “Such an oil you swallow and when you do that, the organs like the stomach, intestines and liver do all kinds of things with those substances in the oil.
Your metabolism ultimately determines what goes into your blood and that is something different than what you have swallowed. ”
So there are a lot of different products, each with its own working mechanism, which we all have to take into account.
And that is difficult. The market is growing like coal and sellers would like to take a piece of the hype.
Hazekamp says: “First, when it was only sold in plant form, 10,000 people went to the pharmacy to buy a cannabis plant on prescription.
In addition, people who bought a cannabis plant in a coffee shop, because a doctor did not want to prescribe it, or because they did not know it was available on prescription, or because they simply did not want to talk about cannabis with a doctor.
We do not really know how many medical users there are of that group. Now with CBD oil the market has grown much more.
When you go around asking around, you are probably never more than two people away from a bottle of CBD oil. ”
At present there is no clear legislation and manufacturers make full use of this.
There are also scammers who simply want to make money from the hype.
Hazekamp found in his studies that there is less CBD in some CBD oils than indicated on the packaging, or that they sometimes do not contain CBD at all.
Actually you only know in the pharmacy where you are right, although certain manufacturers can now also deliver better quality.
The CBD oil is now incredibly popular, but Hazekamp stresses that we should not see it as a simple nutritional supplement.
The fact that it has been placed rigorously on the market does not mean that it is entirely without risks.
“Because CBD oil is in a shiny jar with a nice sticker in the store, people think that unfortunately soon.
They think right that it is good for them.
Whether the large use of CBD oil under the category ‘does not benefit, it does not harm’, is something that we do not know about for years.
We can not say at the same time on the one hand that it is innocent and therefore sell as a self-care product and on the other hand say that it is a very heavy drug that works when no other medicine works. ”
The composition of the medicinal cannabis that is available in the pharmacy is fully controlled and is not contaminated with pesticides, fungi or heavy metals.
The pharmacy checks this itself and independent laboratories also check this once again by sampling.
The government ensures that the medical cannabis available in the pharmacy is safe.
That is not the cannabis from the coffee shop, or other sources. Hazekamp says: “In that cannabis or in those processed products, anything and everything can be.
For growing cannabis, growers in many cases use all kinds of chemicals to keep away animals and fungi.
With THC oil it is even worse. The legislation on CBD oil is vague, but making THC oil is illegal.
This is why all growers secretly do that in back rooms. Nobody looks at that.
The quality of these products can not be guaranteed and safety has not been checked. ”
Fortunately, more and more manufacturers of CBD oil are aware of these issues.
The government is also starting to see that clear rules are needed, both in the Netherlands and abroad.
In addition, the use of medicinal cannabis is not entirely without risk.
Hazekamp says: “CBD is not addictive, but THC can certainly be addictive.
You have more and more forms of addiction, such as physical and mental addiction.
But you can also be addicted to Facebook, for example, which was unthinkable ten years ago.
You can even measure that in the brain, the chemistry of your brain then changes.
Something similar happens with THC. You have slight dependency, or a heavier addiction. ”
Medicinal cannabis products containing THC could therefore cause addiction.
So we have to be a bit worried about that.
And multiple use, such as an addiction, can cause very unpleasant side effects.
An unpleasant side effect, for example, is vomiting vigorously. Hazekamp explains that something goes wrong in the brain and that it causes severe vomiting.
But he also says that large users can become irritated or suffer from sleep problems.
These side effects may seem relatively harmless, but there are also more serious side effects.
“Sometimes severe side effects occur, such as psychosis or other psychological problems.
It is therefore advisable to have a doctor watch in some cases.
In addition, interactions may occur with other medications.
People who are seriously chronically ill sometimes mix countless different medications and we do not know what happens when we also add cannabis to them.
It is almost impossible to assess all interactions between these means, but it is not always good. ”
But due to the oil hype we have become accustomed to medicinal cannabis. That leads among other things to the cautious use of CBD oil, but this could have consequences.
CBD works in our body because of our endocannabinoid system
This system plays an important role in all kinds of body processes, such as the development of our brain.
And you do not want to mess up these processes. But you may run that risk if you use a lot of CBD oil for something that has not yet been strongly demonstrated to help.
It is therefore never wrong to use certain forms of medicinal cannabis, such as CBD oil, under the supervision of a doctor.
A doctor can think along with you about what might be best at a certain moment in a certain stage of a disorder.
Hazekamp says: “I do think that forms of medicinal cannabis are increasingly shifting from last-resort means to trying medicinal cannabis forms before, and in some cases even first.
But of course that is only safe if cannabis knows how to behave as a modern medicine.
We still know too little now.
Which plant do you need?
Which substances do you need and in which proportion?
What is the appropriate dosage?
How does it behave in combination with other medications?
And that’s what we need to find out for countless different disorders.
That is difficult. But of course it is not surprising that patients who are sick now do not want to wait for that. So it is a difficult situation. ”
Cannabis has an effect on our body, because of our endocannabinoid system.
An additional worrying point is that parents increasingly give CBD oil to their children when they suffer from epilepsy or cancer.
Previously parents tried this as a last resort, but because of the many positive messages on the internet, some parents want to give their children the means and not try other proven safe medication first.
Hazekamp says: “The endocannabinoid system is especially deeply ingrained in your brain and determines how brains develop in children.
Our endocannabinoid system controls how our brains build up and thus determines the architecture of our brains.
So I also have a hard time believing that children who get a lot of CBD will not experience any effects on the development of their brain.
These children are not yet mature, only then can we see their effects.
In about ten years we will see how these children ended up. It’s a bit of a time bomb and I hope it goes well, but let’s not be too light about it. ”
So much more research is needed.
An important part of this research is the determination of the mechanisms of action of the substances in the cannabis plant in the human body.
Hazekamp says: “That way we have also learned from opium.
It was first a gigantic social problem with nasty addictions.
But when we found out how the mechanism of action worked, we found out that opium can work analgesic.
And we now have our strongest painkillers such as morphine.
When scientists started researching why people feel high about cannabis, they found out that it affected our endocannabinoid system.
We have now discovered that we can manipulate this system with substances from the cannabis plant that can stimulate appetite in patients with AIDS, stimulate bone growth and reduce chronic pain.
When we learn more about the mechanisms of action of different substances in the cannabis plant, we can develop more targeted treatments based on the cannabis plant.
The beginning has been made here, but at the moment it is still like shooting with hail and trying to hit something.
That can and should of course be better. ”
All in all, cannabis seems to actually offer a solution for serious diseases, such as MS, cancer and AIDS, and this seems to be the case for epilepsy.
Yet we should not be too frivolous as far as the use of medical cannabis is concerned.
Cannabis plants and processed cannabis products that do not come from the pharmacy can be contaminated with chemicals, pesticides, fungi and heavy metals.
Production is also not standardized, which means that the composition and thus the effects can differ again and again.
In addition, medicinal cannabis can affect our endocannabinoid system.
This can affect various body processes that you do not want to confuse.
But research into the mechanisms of action of substances in cannabis plants can provide a solution.
They can ensure that scientists can develop drugs that work very specifically and leave the rest of the endocannabinoid system alone.
But until we reach this point, it is advisable to always consult a doctor if you use or want to use cannabis medicinally.
Hazekamp says: “With my research, I hope to find out in the future which substances we need to get from which type of cannabis plant and in which form we can best administer it in different types of disorders.
But until then, let us not be too quick to seize medicinal cannabis. But you also should not completely ignore it. ”
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