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

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

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Samenvatting

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.

Abstract

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.

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Notes

  1. Vertaling van ‘Relaxed but not stoned’, ondertitel in artikel in online tijdschrift The Conversation (Grimison 2016).

Literatuur

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Alexander, S. P. (2016). Therapeutic potential of cannabis-related drugs. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 157–166.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Becker, H. S. (1974). Consciousness, power and drug effects. Journal of Psychedelic Drugs, 6(1), 67–76.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Chapkis, W. (2007). Cannabis, consciousness, and healing. Contemporary Justice Review, 10, 443–460.

    Article  Google Scholar 

  • Chapkis, W., & Webb, R. J. (2008). Dying to get high: marijuana as medicine. New York: NYU Press.

    Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Coomber, R., Oliver, M., & Morris, C. (2003). Using cannabis therapeutically in the UK: a qualitative analysis. Journal of Drug Issues, 33(2), 325–356.

    Article  Google Scholar 

  • 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 

  • 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 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  CAS  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Grimison, P. (2016). Could a cannabis pill reduce chemotherapy-induced nausea and vomiting? Here’s how we find out. The conversation. https://theconversation.com/could-a-cannabis-pill-reduce-chemotherapy-induced-nausea-and-vomiting-heres-how-we-find-out-66774 (Gecreëerd: 5 dec 2016). Geraadpleegd op: 17 maart 2017.

    Google Scholar 

  • Grinspoon, L. (2003). The medical marijuana problem. Journal of Cognitive Liberties, 4, 63–81.

    Google Scholar 

  • Grotenhermen, F., & Schnelle, M. (2003). Survey on the medical use of cannabis and THC in Germany. Journal of Cannabis Therapeutics, 3(2), 17–40.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Gruber, A. J., Pope, H. G., & Brown, M. E. (1996). Do patients use marijuana as an antidepressant? Depression, 4(2), 77–80.

    Article  CAS  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • Holt, M., & Treloar, C. (2008). Pleasure and drugs. International Journal of Drug Policy, 19(5), 349–352.

    Article  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Keane, H. (2008). Pleasure and discipline in the uses of ritalin. International Journal of Drug Policy, 19(5), 401–409.

    Article  PubMed  Google Scholar 

  • 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 

  • 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 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    CAS  PubMed  Google Scholar 

  • Mechoulam, R. (2017). Cannabis and epilepsy. Epilepsy and Behavior, 70(Pt B), 278–279.

    Article  CAS  PubMed  Google Scholar 

  • Mechoulam, R., & Parker, L. A. (2013). The endocannabinoid system and the brain. Annual Review of Psychology, 64, 21–47.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • Mosher, C. J., & Akins, S. (2006). Drugs and drug policy: the control of consciousness alteration. Thousand Oaks: SAGE.

    Google Scholar 

  • Nolf, M. (2004). Medisch gebruik van cannabis: exploratief empirisch onderzoek bij geneesheren. Panoptican, 25, 135–154.

    Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Pedersen, W. (2015). From badness to illness: medical cannabis and self-diagnosed attention deficit hyperactivity disorder. Addiction Research and Theory, 23(3), 177–186.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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 paper

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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 

  • Russo, E. B. (2011). Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344–1364.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schmitz, A. (2016). Benzodiazepine use, misuse, and abuse: a review. Mental Health Clinician, 6(3), 120–126.

    Article  Google Scholar 

  • Swift, W., Gates, P., & Dillon, P. (2005). Survey of Australians using cannabis for medical purposes. Harm Reduction Journal, 2, 18. https://doi.org/10.1186/1477-7517-2-18.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tart, C. T. (1971). On being stoned. Palo Alto: Science and Behavior Books.

    Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • United Nations Office on Drugs and Crime (2016). World drug report. Vienna: Author.

    Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Zinberg, N. E. (1984). Drug, set and setting. New Haven: Yale University.

    Google Scholar 

  • Zuardi, A. W. (2006). History of cannabis as a medicine: a review. Revista Brasileira de Psiquiatría, 28(2), 153–157.

    Article  PubMed  Google Scholar 

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  1. Gent, België

    Frédérique Bawin

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Bawin, F. Medisch gebruik van cannabis en zijn psychoactieve werking: een paradox?. Verslaving 14, 3–15 (2018). https://doi.org/10.1007/s12501-018-0155-0

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