The main difference between therapeutic and compassionate use lies in the context in which cannabis is used for its medicinal properties. Broadly speaking, we can define the therapeutic use of cannabis as use supported by medical prescription for diseases with accepted and proven indications, and involving approved products, either certified medical marijuana, standardised extracts, or capsules containing THC or its derivatives, provided these are produced and obtained under controlled conditions.
Two sides of the same coin
The way things are going with regard to the issue of medical cannabis, it seems opportune to devote an article to two closely related yet distinct notions, namely, therapeutic and compassionate use.
The differences between the therapeutic and compassionate use of cannabis
The main difference between therapeutic and compassionate use lies in the context in which cannabis is used for its medicinal properties.
Broadly speaking, we can define the therapeutic use of cannabis as use supported by medical prescription for diseases with accepted and proven indications, and involving approved products, either certified medical marijuana, standardised extracts, or capsules containing THC or its derivatives, provided these are produced and obtained under controlled conditions.
Although in medical jargon compassionate use is normally associated with terminal illnesses, in this case it apples to use by patients who either suffer from diseases for which the effectiveness of cannabis has not yet been proven in a rigorous manner (which does not mean it is not effective), or who use non-standardised products (mainly self-grown cannabis).
It seems obvious then that when we use the expression therapeutic use, we are referring to cannabis use in hospitals or, otherwise, its use at home in accordance with a medical prescription. Compassionate use, however, does not require medical supervision, as patients monitor their own symptoms themselves and bear these in mind when using cannabis for medical purposes.
These patients have a good level of support from cannabis users’ clubs, where there are experienced growers who can easily provide advice on certain varieties and introduce patients to self-cultivation as a satisfying pursuit.
Cannabis-derived products, which at present are considered to be of therapeutic use include THC capsules from the THC-Pharm company, Dronabinol, Dutch marijuana called Bedrocan, and the British-made THC and CBD sublingual spray Sativex®.
If, on the one hand, the therapeutic use of cannabis has several limitations placed on it with regard to the appropriate application, compassionate use, on the other hand, is a less restrictive option, as products for this type of use do not need to be standardised. Thus, the range of diseases for which compassionate use can be applied is much greater than that for therapeutic use. Additionally, patients are not required to undergo a compulsory follow-up by a healthcare professional, although this would be preferable.
When I say healthcare professionals, I am referring not only to doctors, but also nurses and pharmacists, provided all three groups are equipped with up-to-date knowledge in this field. I do not remember having received training on the therapeutic use of cannabis in medical school, although things have surely changed by now.
As is discussed above, cannabis clubs are the best option for patients for whom there are no formal treatments that include the use of cannabis and its derivatives, but who obtain relief from their symptoms with cannabis products.
Alternatives for progress in medicinal use
The collection of statistical data by cannabis clubs would undoubtedly be an effective means of speeding up the process of normalising the therapeutic use of cannabis for other diseases. It could also increase the number of products used at present, which is clearly insufficient, both with regard to their number as well as the composition of their active ingredients.
However, many users’ clubs have problems differentiating between recreational users and compassionate users and it would be helpful to have some guidelines in these clubs to eliminate interpretation errors in future.
It is precisely these errors of interpretation which prohibitionists take advantage of to reinforce the notion that medical cannabis is just an excuse for recreational users to justify their consumption. Of course, the notion that there is no such thing as a “therapeutic joint” has, over the years, been debunked by scientific evidence, although with the exception of the Netherlands (Bedrocan), other European countries seem to have allowed themselves to be dictated to by market forces. This has resulted in further delays for patients seeking access to standardised products.
If users’ clubs were to have the support of a healthcare professional, at least to assess new users, the fundamental errors which underlie these issues would be eliminated. As a result, society would avoid confusing recreational use with medicinal use, which includes therapeutic as well as compassionate use.
The need for change
Time and again we are faced with the same paradigm. When drugs were legal (they all were legal once), the problems associated with their use were minimal, and their medicinal application was at its height. When the marijuana prohibition began, followed by other repressive measures, humanity was deprived of its unrestricted access to a natural pain reliever. All of us who want drugs to be considered medicine once again (which they are, after all), are confronted daily with the complex web of misinformation that has been entrenched over the years by the prohibitionist machine.
In my humble opinion, the thorny subject of the medicinal use of cannabis is the Achilles’ heel of this power-hungry prohibitionist apparatus. Keeping a cool head and an active mind is of vital importance. The prohibition of medicinal plants is just another strategy with which individuals can be controlled. The intent is to irrationally impose consumer guidelines under the false pretext of public health, when in reality, the sole underlying rationale is financial gain. This method of control is so ridiculous and simultaneously so opaque that the prohibitionist machine has failed to see that this stance only earns them millions of new enemies, including herbalists, small businesses, families who earn their living through growing medicinal plants, and so on.
Author: Javier Pedraza