, Volume 14, Issue 1, pp 3–15 | Cite as

Medisch gebruik van cannabis en zijn psychoactieve werking: een paradox?

  • Frédérique Bawin


Cannabis wordt momenteel niet langer uitsluitend gezien als een roesmiddel waar gebruikers high van worden, het wordt tevens steeds vaker erkend als een middel met medische toepassingen. Het feit dat cannabis zowel voor medische doeleinden als in de vrijetijdssfeer wordt gebruikt, zorgt ervoor dat zijn psychoactieve werking een delicate positie inneemt binnen de medische context. Tot op heden is de roesverwekkende werking van cannabis binnen medisch gebruik weinig onderzocht. Aan de hand van de literatuur bekijken de auteurs vanuit verschillende invalshoeken welke plaats de psychoactieve eigenschappen van cannabis binnen de medische context innemen. In dit artikel gaan zij na of een eenzijdige negatieve benadering van de high niet om meer nuancering vraagt. Het is van belang dat de bezorgdheid om de psychoactieve werking van cannabis geen negatieve impact heeft op de ontwikkeling van cannabis en zijn afgeleiden tot volwaardige therapeutische middelen.

The medical use of cannabis and its psychoactive activity: a paradox?


Today, cannabis is no longer considered solely as an intoxicating substance that gets users high. There is an increasing recognition that the plant also has therapeutic uses. Because cannabis is used for medical as well as recreational purposes, its psychoactivity is a sensitive issue in the medical context. To date, very little research is performed into the intoxicating effects of cannabis within medical cannabis use. Based on a literature review, the authors look from various perspectives to the position of cannabis’ psychoactivity within the medical context. In this article they ask themselves whether the one-sided negative approach of the high does not ask for a more nuanced approach. It is important that the anxiety towards the intoxicating effects of cannabis does not impede the development of cannabis and its derivatives into full therapeutic agents.


  1. Aggarwal, S. K., Carter, G. T., Sullivan, M. D., ZumBrunnen, C., Morrill, R., & Mayer, J. D. (2009). Characteristics of patients with chronic pain accessing treatment with medical cannabis in Washington State. Journal of Opioid Management, 5(5), 257–286.CrossRefPubMedGoogle Scholar
  2. Aggarwal, S. K., Carter, G. T., Sullivan, M. D., ZumBrunnen, C., Morrill, R., & Mayer, J. D. (2013). Prospectively surveying health-related quality of life and symptom relief in a lot-based sample of medical cannabis-using patients in urban Washington State reveals managed chronic illness and debility. American Journal of Hospice and Palliative Medicine, 30(6), 523–531.CrossRefPubMedGoogle Scholar
  3. Alexander, S. P. (2016). Therapeutic potential of cannabis-related drugs. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 157–166.CrossRefPubMedGoogle Scholar
  4. Andrzejewski, K., Barbano, R., & Mink, J. (2016). Cannabinoids in the treatment of movement disorders: a systematic review of case series and clinical trials. Basal Ganglia, 6(3), 173–181.CrossRefGoogle Scholar
  5. Bambico, F. R., Katz, N., Debonnel, G., & Gobbi, G. (2007). Cannabinoids elicit antidepressant-like behavior and activate serotonergic neurons through the medial prefrontal cortex. Journal of Neuroscience, 27(43), 11700–11711.CrossRefPubMedGoogle Scholar
  6. Becker, H. S. (1974). Consciousness, power and drug effects. Journal of Psychedelic Drugs, 6(1), 67–76.CrossRefGoogle Scholar
  7. Belle-Isle, L., Walsh, Z., Callaway, R., Lucas, P., Capler, R., Kay, R., & Holtzman, S. (2014). Barriers to access for Canadians who use cannabis for therapeutic purposes. International Journal of Drug Policy, 25(4), 691–699.CrossRefPubMedGoogle Scholar
  8. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Bonn-Miller, M. O., Boden, M. T., Bucossi, M. M., & Babson, K. A. (2014). Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. American Journal of Drug and Alcohol Abuse, 40(1), 23–30.CrossRefPubMedGoogle Scholar
  10. Bottorff, J. L., Johnson, J. L., Moffat, B. M., & Mulvogue, T. (2009). Relief-oriented use of marijuana by teens. Substance Abuse Treatment, Prevention, and Policy, 4(1), 1.CrossRefGoogle Scholar
  11. Chapkis, W. (2007). Cannabis, consciousness, and healing. Contemporary Justice Review, 10, 443–460.CrossRefGoogle Scholar
  12. Chapkis, W., & Webb, R. J. (2008). Dying to get high: marijuana as medicine. New York: NYU Press.Google Scholar
  13. Clark, A. J., Ware, M. A., Yazer, E., Murray, T. J., & Lynch, M. E. (2004). Patterns of cannabis use among patients with multiple sclerosis. Neurology, 62(11), 2098–2100.CrossRefPubMedGoogle Scholar
  14. Coomber, R., Oliver, M., & Morris, C. (2003). Using cannabis therapeutically in the UK: a qualitative analysis. Journal of Drug Issues, 33(2), 325–356.CrossRefGoogle Scholar
  15. Crowther, S. M., Reynolds, L. A., & Tansey, E. M. (red.). (2010). The medicalization of cannabis. Transcript of a witness seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, on 24 March 2009. Londen: Trustee of the Wellcome Trust.Google Scholar
  16. Dahl, H., & Frank, V. A. (2011). Medical marijuana: exploring the concept in relation to small scale cannabis growers in Denmark. In T. Decorte, G. Potter & M. Bouchard (red.), World wide weed. Global trends in cannabis cultivation and its control (pag. 116–141). Farnham: Ashgate.Google Scholar
  17. Devinsky, O., Marsh, E., Friedman, D., Thiele, E., Laux, L., Sullivan, J., & Wong, M. (2016). Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurology, 15(3), 270–278.CrossRefPubMedGoogle Scholar
  18. Ebert, T., Zolotov, Y., Eliav, S., Ginzburg, O., Shapira, I., & Magnezi, R. (2015). Assessment of Israeli Physicians’ knowledge, experience and attitudes towards medical cannabis: a pilot study. Israel Medical Association Journal, 17(7), 437.PubMedGoogle Scholar
  19. El-Alfy, A. T., Ivey, K., Robinson, K., Ahmed, S., Radwan, M., Slade, D., et al. (2010). Antidepressant-like effect of ∆9-tetrahydrocannabinol and other cannabinoids isolated from Cannabis sativa L. Pharmacology Biochemistry and Behavior, 95(4), 434–442.CrossRefGoogle Scholar
  20. Gandhi, S., Vasisth, G., & Kapoor, A. (2017). Systematic review of the potential role of cannabinoids as antiproliferative agents for urological cancers. Canadian Urological Association Journal, 11(3), 138–142.CrossRefGoogle Scholar
  21. Green, B. O. B., Kavanagh, D., & Young, R. (2003). Being stoned: a review of self-reported cannabis effects. Drug and Alcohol Review, 22(4), 453–460.CrossRefPubMedGoogle Scholar
  22. Grella, C. E., Rodriguez, L., & Kim, T. (2014). Patterns of medical marijuana use among individuals sampled from medical marijuana dispensaries in Los Angeles. Journal of Psychoactive Drugs, 46(4), 263–272.CrossRefGoogle Scholar
  23. Grimison, P. (2016). Could a cannabis pill reduce chemotherapy-induced nausea and vomiting? Here’s how we find out. The conversation. (Gecreëerd: 5 dec 2016). Geraadpleegd op: 17 maart 2017.Google Scholar
  24. Grinspoon, L. (2003). The medical marijuana problem. Journal of Cognitive Liberties, 4, 63–81.Google Scholar
  25. Grotenhermen, F., & Schnelle, M. (2003). Survey on the medical use of cannabis and THC in Germany. Journal of Cannabis Therapeutics, 3(2), 17–40.CrossRefGoogle Scholar
  26. Growing, L. R., Ali, R. L., Christie, P., & White, J. M. (1998). Therapeutic use of cannabis: clarifying the debate. Drug and Alcohol Review, 17, 445–452.CrossRefGoogle Scholar
  27. Gruber, A. J., Pope, H. G., & Brown, M. E. (1996). Do patients use marijuana as an antidepressant? Depression, 4(2), 77–80.CrossRefPubMedGoogle Scholar
  28. Hazekamp, A., Sijrier, P., Verpoorte, R., Bender, J., & Van Bakel, N. (2005). Cannabis uit de apotheek is beter. Pharmaceutisch Weekblad, 140(12), 402–405.Google Scholar
  29. Hazekamp, A., Ware, M. A., Muller-Vahl, K. R., Abrams, D., & Grotenhermen, F. (2013). The medicinal use of cannabis and cannabinoids: an international cross-sectional survey on administration forms. Journal of Psychoactive Drugs, 45(3), 1–12.CrossRefGoogle Scholar
  30. Holt, M., & Treloar, C. (2008). Pleasure and drugs. International Journal of Drug Policy, 19(5), 349–352.CrossRefPubMedGoogle Scholar
  31. Izzo, A. A., Borrelli, F., Capasso, R., Di Marzo, V., & Mechoulam, R. (2009). Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb. Trends in Pharmacological Sciences, 30(10), 515–527.CrossRefPubMedGoogle Scholar
  32. Keane, H. (2008). Pleasure and discipline in the uses of ritalin. International Journal of Drug Policy, 19(5), 401–409.CrossRefPubMedGoogle Scholar
  33. Kowal, M. A., Hazekamp, A., & Grotenhermen, F. (2016). Review on clinical studies with cannabis and cannabinoids 2010–2014. Multiple Sclerosis, 11(special issue), 1–18.Google Scholar
  34. Lucas, P. (2012). It can’t hurt to ask; a patient-centered quality of service assessment of health canada’s medical cannabis policy and program. Harm Reduction Journal, 9(2), 1–11.Google Scholar
  35. Malan, T. P., Ibrahim, M. M., Lai, J., Vanderah, T. W., Makriyannis, A., & Porreca, F. (2003). CB 2 cannabinoid receptor agonists: pain relief without psychoactive effects? Current Opinion in Pharmacology, 3(1), 62–67.CrossRefPubMedGoogle Scholar
  36. McPartland, J. M., & Pruitt, P. L. (1999). Side effects of pharmaceuticals not elicited by comparable herbal medicines: the case of tetrahydrocannabinol and marijuana. Alternative Therapies in Health and Medicine, 5(4), 57.PubMedGoogle Scholar
  37. Mechoulam, R. (2017). Cannabis and epilepsy. Epilepsy and Behavior, 70(Pt B), 278–279.CrossRefPubMedGoogle Scholar
  38. Mechoulam, R., & Parker, L. A. (2013). The endocannabinoid system and the brain. Annual Review of Psychology, 64, 21–47.CrossRefPubMedGoogle Scholar
  39. Moran, T. J. (2010). Just a little bit of history repeating: the California model of marijuana legalization and how it might affect racial and ethnic minorities. Washington and Lee Journal of Civil Rights and Social Justice, 17, 557.Google Scholar
  40. Morgan, C. J., Schafer, G., Freeman, T. P., & Curran, H. V. (2010). Impact of cannabidiol on the acute memory and psychotomimetic effects of smoked cannabis: naturalistic study. British Journal of Psychiatry, 197(4), 285–290.CrossRefPubMedGoogle Scholar
  41. Mosher, C. J., & Akins, S. (2006). Drugs and drug policy: the control of consciousness alteration. Thousand Oaks: SAGE.Google Scholar
  42. Nolf, M. (2004). Medisch gebruik van cannabis: exploratief empirisch onderzoek bij geneesheren. Panoptican, 25, 135–154.Google Scholar
  43. Ogborne, A. C., Smart, R. G., Weber, T., & Birchmore-Timney, C. (2000). Who is Using cannabis as a medicine and why: an exploratory study. Journal of Psychoactive Drugs, 32(4), 435–443.CrossRefPubMedGoogle Scholar
  44. Pedersen, W. (2015). From badness to illness: medical cannabis and self-diagnosed attention deficit hyperactivity disorder. Addiction Research and Theory, 23(3), 177–186.CrossRefGoogle Scholar
  45. Pedersen, W., & Sandberg, S. (2013). The medicalisation of revolt: a sociological analysis of medical cannabis users. Sociology of Health and Illness, 35(1), 17–32.CrossRefPubMedGoogle Scholar
  46. Prentiss, D., Power, R., Balmas, G., Tzuang, G., & Isreaelski, D. M. (2004). Patterns of marijuana use among patients with hiv/aids followed in a public health care setting. Journal of Acquired Immune Deficiency Syndromes, 35(1), 38–45.CrossRefPubMedGoogle Scholar
  47. Quintero, G. (2009). Rx for a party: a qualitative analysis of recreational pharmaceutical use in a collegiate setting. Journal of American College Health, 58(1), 64–72.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Ransom, J. (1999). ‘Anslingerian’ politics: the history of anti-marijuana sentiment in federal law and how Harry Anslinger’s anti-marijuana politics continue to prevent the FDA and other medical experts from studying marijuana’s medical utility. Harvard: DASH. Third year paperGoogle Scholar
  49. Reinarman, C., Nunberg, H., Lanthier, F., & Heddleston, T. (2011). Who are medical marijuana patients? Population characteristics from nine California assessment clinics. Journal of Psychoactive Drugs, 43(2), 129–135.CrossRefGoogle Scholar
  50. Roitman, P., Mechoulam, R., Cooper-Kazaz, R., & Shalev, A. (2014). Preliminary, open-label, pilot study of add-on oral ∆9-tetrahydrocannabinol in chronic post-traumatic stress disorder. Clinical Drug Investigation, 34(8), 587–591.CrossRefPubMedGoogle Scholar
  51. Russo, E. (2007). The solution to the medicinal cannabis problem. In M. E. Schatman (red.), Ethical issues in chronic pain management (pag. 165–194). New York: Informa Healthcare.Google Scholar
  52. Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344–1364.CrossRefPubMedPubMedCentralGoogle Scholar
  53. Schmitz, A. (2016). Benzodiazepine use, misuse, and abuse: a review. Mental Health Clinician, 6(3), 120–126.CrossRefGoogle Scholar
  54. Swift, W., Gates, P., & Dillon, P. (2005). Survey of Australians using cannabis for medical purposes. Harm Reduction Journal, 2, 18. Scholar
  55. Tart, C. T. (1971). On being stoned. Palo Alto: Science and Behavior Books.Google Scholar
  56. Tramèr, M. R., Carroll, D., Campbell, F. A., Reynolds, D. J. M., Moore, R. A., & McQuay, H. J. (2001). Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ, 323(7303), 16.CrossRefPubMedPubMedCentralGoogle Scholar
  57. United Nations Office on Drugs and Crime (2016). World drug report. Vienna: Author.Google Scholar
  58. Velasco, G., Hernández-Tiedra, S., Dávila, D., & Lorente, M. (2016). The use of cannabinoids as anticancer agents. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 259–266.CrossRefPubMedGoogle Scholar
  59. Walsh, Z., Callaway, R., Belle-Isle, L., Capler, R., Kay, R., Lucas, P., & Holtzman, S. (2013). Cannabis for therapeutic purposes: patient characteristics, access, and reasons for use. International Journal of Drug Policy, 24(6), 511–516.CrossRefPubMedGoogle Scholar
  60. Ware, M. A., Rueda, S., Singer, J., & Kilby, D. (2003). Cannabis use by persons living with hiv/aids: patterns and prevalence of use. Journal of Cannabis: Therapeutics, 3, 3–15.CrossRefGoogle Scholar
  61. Ware, M. A., Wang, T., Shapiro, S., Robinson, A., Ducruet, T., Huynh, T., & Collet, J. P. (2010). Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. Canadian Medical Association Journal, 182(14), E694–E701.CrossRefPubMedPubMedCentralGoogle Scholar
  62. Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., & Schmidlkofer, S. (2015). Cannabinoids for medical use: a systematic review and meta-analysis. JAMA, 313(24), 2456–2473.CrossRefPubMedGoogle Scholar
  63. Wilsey, B., Marcotte, T., Deutsch, R., Gouaux, B., Sakai, S., & Donaghe, H. (2013). Low-dose vaporized cannabis significantly improves neuropathic pain. Journal of Pain, 14(2), 136–148.CrossRefPubMedGoogle Scholar
  64. Zinberg, N. E. (1984). Drug, set and setting. New Haven: Yale University.Google Scholar
  65. Zuardi, A. W. (2006). History of cannabis as a medicine: a review. Revista Brasileira de Psiquiatría, 28(2), 153–157.CrossRefPubMedGoogle Scholar

Copyright information

© Bohn Stafleu van Loghum is een imprint van Springer Media B.V., onderdeel van Springer Nature 2018

Authors and Affiliations

  1. 1.GentBelgië

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