Cannabis and Marinol are both possible treatments for the side effects
of chemotherapy and the symptoms of AIDS. Each option has its own
benefits and drawbacks. However, cannabis may be a more effective
treatment for many patients, as it has extra therapeutic properties
compared to Marinol.
What is Marinol?
Marinol is a synthetic form of THC, one of the main psychoactive
components of cannabis. In May 1985, the FDA approved Marinol as a
prescription medication for the treatment of nausea and vomiting caused
by chemotherapy. It can also stimulate
appetite, which led to the FDA
extending the approval to AIDS patients suffering from anorexia and
weight loss.
How Does Marinol Differ From Cannabis?
The active ingredient of Marinol is dronabinol, which is a synthetic
form of THC. Marijuana contains many active compounds in addition to
THC. These include cannabidol (CBD), cannabinol, cannabichromine,
cannabigerol, terpenoids, flavonoids, phenols, and various oils.
Research has identified 66 naturally occurring chemical
compounds
in cannabis, many of which are known as cannabinoids.
CBD has many potentially beneficial effects, which are not provided by
Marinol. CBD has anticonvulsant, antispasmodic, and anti-inflammatory
properties. It also reduces anxiety and tackles psychosis, as well as
suppressing the growth of
tumors in some situations.
Cannabinol is also an anticonvulsant, while cannabichromine acts as an
antidepressant. Both these compounds can reduce inflammation, as can
many of the flavonoids, oils, and phenols found in cannabis.
Is Cannabis or Marinol More Effective?
Both cannabis and Marinol bring benefits to some people. However,
Marinol has some key downsides compared to marijuana. Firstly, Marinol
is more expensive than medical marijuana, which puts it out of reach of
many patients. More importantly, Marinol also causes unwanted side
effects for many users, while offering only limited benefits compared to
the natural plant. The side effects of
Marinol include
drowsiness, dizziness, nausea, vomiting, clumsiness and trouble thinking
clearly.
THC is the main psychoactive component of cannabis. Therefore, users of
Marinol, which is a pure synthetic form of THC, often experience a
“high” feeling when taking the drug. While feeling high is also a
well-known effect of taking cannabis, the other cannabinoids in
marijuana temper the effects of the THC, reducing negative psychological
side effects such as anxiety. Therefore, the psychological experience is
often better for people who take natural marijuana than for those who
take synthetic THC.
The other benefit of marijuana is that patients can
consume
it in a variety of ways, including inhalation, oral ingestion,
vaporization, or in a cream or oil. In contrast, Marinol is only
currently available in the form of gelatin capsules, which come in
dosages of 2.5 mg, 5 mg or 10 mg. Each oral pill can take up to an hour
to have an effect, which means that it can be difficult for patients to
determine the right dosage. Vaporization of medical marijuana has an
immediate effect, helping patients to get quick relief from their
symptoms without the risk of taking a dose that is too strong. The fact
that the drug doesn’t have to be swallowed is also an important benefit
for patients who are struggling with nausea or vomiting.
The oral administration of Marinol poses further problems. After passing
through the digestive system, Marinol absorbs into the bloodstream and
passes to the liver. The liver metabolizes Marinol into a plethora of
other chemicals, including
11-hydroxy-THC,
which is four or five times as strong as natural THC. This could explain
why so many Marinol users report that its psychoactive effects are much
greater than those of natural cannabis. The lack of CBD, which reduces
anxiety, could also contribute to the problem.
What is Marinol Used For?
The
FDA
has approved Marinol as a treatment for lack of appetite and weight loss
in patients with AIDS. The drug is also approved as a treatment for
nausea and vomiting caused by chemotherapy, but only for cancer patients
who have not responded to conventional anti-nausea treatments.
There are many situations in which the FDA advises against the use of
Marinol. For example, Marinol must be used with caution in patients who
have heart disorders, as well as those with depression, mania,
schizophrenia or a history of substance abuse. There are also possible
interactions with many other drugs, including alcohol and
benzodiazepines, which can make Marinol unsuitable for some patients.
Marinol or Marijuana?
There is increasing evidence that marijuana is a more effective
treatment than Marinol for a range of conditions, including the side
effects of chemotherapy and the symptoms of AIDS. The other compounds in
marijuana, such as cannabidol, cannabinol, and terpenoids, offer
benefits that extend far beyond those offered by THC, including pain
relief and a decrease in anxiety. Cancer and AIDS patients often
experience pain, in addition to the nausea and anorexia that THC can
treat.
Perhaps the most important argument for using marijuana rather than
Marinol is that the natural plant often causes far fewer side effects,
particularly psychoactive side effects such as anxiety. FDA approval for
medical marijuana could allow sufferers of cancer and AIDS to benefit
from the entourage effect of cannabis, where the various compounds in
cannabis work together to create an overall beneficial effect.
Photo by Anna Shvets
