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Alcohol & Other Drugs

The Health Effects of Medical Marijuana Project (HEMMP)

Lynda G. Balneaves, Joan L. Bottorff, H. Bindy K. Kang, Rielle Capler and the HEMPP Research Team

Reprinted from "Cannabis" issue of Visions Journal, 2009, 5 (4), p. 27

A growing number of people with chronic illnesses use marijuana to help them cope with their symptoms. In fact, it is estimated that up to one million Canadians use marijuana for its medicinal effects.1 There are a limited number of clinical trials supporting the effectiveness and safety of marijuana. However, observational studies2-5 and other personal observations suggest that marijuana helps people cope with a number of symptoms, including pain, nausea, muscle spasms, depression and anxiety. In addition, marijuana may improve sleep and appetite.

Today, there is access to marijuana for medical purposes through Health Canada’s Marihuana Medical Access Division (MMAD). MMAD is the government office that approves access to medical marijuana for people who are eligible under the Marihuana Medical Access Regulations (MMAR). People living with specified chronic diseases no longer need to fear legal penalties associated with marijuana use, if they are approved by MMAD. Those who are approved can purchase marijuana grown for MMAD. They may also be allowed to grow a limited number of plants for their own use (depending on their daily dose requirements),6 or they can designate another person to grow marijuana for them.

To date, only 2,812 Canadians are registered through MMAD.7 Community-based compassion clubs also provide non-legal marijuana to thousands of Canadians with or without a MMAD licence. Although, MMAD’s authorizations to possess marijuana have steadily increased from 2003, the onerous 33-page application and the reluctance of the Canadian medical community to support the therapeutic use of marijuana continue to serve as barriers for compassionate access.8

Understanding the health effects from the point of view of users

More people are turning to marijuana for medical purposes. This has created a need to develop better resources to provide information about the health benefits and risks of marijuana use. In order to develop a toolkit for better practices, the UBC School of Nursing undertook a research study: the Health Effects of Medical Marijuana Project (HEMMP).

The objectives of the project are to:

  1. understand the health and social effects for individuals who use marijuana for medical purposes, and
  2. examine how the social and political context around marijuana influences people’s decisions to use it. This includes exploring issues such as the stigma around marijuana use and its continued illegal status beyond the Health Canada program.

Since 2007, the HEMMP study has interviewed 25 people who obtained marijuana for medical use as members of a compassion club or as holders of MMAD authorization. The sample includes men, women and transgendered individuals ranging in age from 20 to 69. This study includes people living with a wide range of debilitating illnesses, including HIV/AIDS, cancer, hepatitis C and irritable bowel syndrome. Fourteen of our participants also reported using marijuana for mental health issues, including anxiety disorders and depression.

The stories of people taking part in the study reflect the importance of marijuana use in the lives of ordinary people as they deal with a complex range of symptoms. For many, marijuana was a last resort after other prescription drugs and therapies proved unsuccessful. Marijuana helped individuals take part in everyday activities, such as going to work, shopping or simply getting out of bed, and it provided them with a way to feel normal.

Alia’s story

Alia is a woman in her 50s living with arthritis and chronic pain. She doesn’t sleep well and lacks the energy she needs to carry out normal everyday activities. Over the years, she tried various medications and supplements to deal with her sleep problems and pain, but found nothing really helped.

She started using marijuana at the suggestion of a friend. She found that one particular strain of marijuana, available through a local compassion club, improved her sleep immensely and decreased her pain. Alia smokes marijuana once a day in the evening. She has been using marijuana for 14 years. For her, the health and social risks of marijuana use are few and hold little importance when compared to the benefits she receives.

“It reduces the pain enough that I can get through the next few hours without worrying about how I’m going to do what I’m doing. So I don’t have to make so many concessions . . . and that’s a really big plus. Because then I can get three or four hours worth of stuff done and not worry about how tired or sore I’m going to be afterwards . . .”

John's story

John, a 38-year old man, has been living with multiple diagnoses, including fibromyalgia and chronic pain syndrome. For over a decade, he has been seeking help from specialists—trying to find relief from the intense pain he experiences, with little success. His family does not support his use of medical marijuana. So, for a period of time, John “gave up” marijuana.  

“I quit and started pursuing much more rigorously the medical aspect of it. I went through all the medications they said should work, might work, never did work and I gave them a full shot at it . . .”

John later returned to using marijuana and found instant relief.

“Having one short toke was enough to make my muscles all relax . . . It has a dramatic effect on muscle pain, stiffness, aches and pain.”

Marijuana as a lifeline

Alia and John are like many of our participants who found prescribed drugs and other medical therapies to be largely ineffective. Many of our participants believe that marijuana is a “lifeline” for them and that they couldn’t function without it.

Almost all of our participants shared concerns about using marijuana. As an illegal substance, marijuana continues to be identified as a potentially dangerous product that there should be limited access to. Many of our participants shared concerns about disclosing their medical use to work colleagues, neighbours, acquaintances, healthcare professionals, law enforcement staff, family and friends. They worried about consequences of disclosure such as losing their jobs, being evicted from their homes, being ‘fired’ by their physicians, being targeted as a ‘criminal’, and social isolation. They were also worried about the influence of their marijuana use on children in their social circles. Some individuals also expressed concern about possible health-related side effects, such as the effect on their lung health. Despite these concerns, participants were very clear that the benefits of marijuana far outweighed the risks or concerns they had.

The HEMMP research study is now in its second year. With interviews now complete, data analysis is underway and reports are being prepared to submit for publication this fall. If you would like more information about the study, contact co-principal investigator Dr. Lynda Balneaves at 604-822-7679 or at [email protected].

 
About the author

Dr. Balneaves is an Associate Professor with the School of Nursing at the University of British Columbia, as well as a Lead Investigator with the NEXUS research unit. She holds a CIHR New Investigator award

Dr. Bottorff is a Professor and Director of the Institute of Healthy Living and Chronic Disease Prevention at the University of British Columbia Okanagan.

Ms. Kang is a Project Director with the School of Nursing’s Centre for Nursing & Research Behaviour Unit at the University of British Columbia and a Cross Cultural Mental Health Worker with Vancouver Coastal Health.

Ms. Capler worked eight years as a Policy Analyst and Research Coordinator with the BC Compassion Club Society. She was a Research Associate at the Centre for Addictions Research of BC (CARBC) and is currently an Associate Researcher at the Centre for Applied Research in Mental Health and Addiction at SFU

Footnotes:
  1. Ogborne, A.C., Smart, R.G. & Adlaf, E. (2000). Self-reported medical use of marijuana: A survey of the general population. Canadian Medical Association Journal, 162(12),1685-1686.

  2. de Jong, B.C., Prentiss, D., McFarland, W. et al. (2005). Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. Journal of Acquired Immune Deficiency Syndrome, 38(1), 43-46.

  3. Campbell, F., Tramèr, M.R., Carroll, D. et al. (2001). Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review. British Medical Journal, 323(7303), 13-16.

  4. Page, S.A., Verhoef, M.J., Stebbins, R.A. et al. (2003). Cannabis use as described by people with multiple sclerosis. Canadian Journal of Neurological Sciences, 30(3), 201-205.

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

  6. Health Canada. (2008). Fact sheet—Medical access to marihuana. www.hc-sc.gc.ca/dhp-mps/marihuana/law-loi/fact_sheet-infofiche-eng.php.

  7. Health Canada. (2009). Marihuana for Medical Purposes Statistics (July 4, 2008). www.hc-sc.gc.ca/dhp-mps/marihuana/stat/_2008/july-juillet-eng.php.

  8. Lucas, P.G. (2008). Regulating compassion: An overview of Canada’s federal medical cannabis policy and practice. Harm Reduction Journal, 5:5. doi: 10.1186/1477-7517-5-5.

 

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