Also known as Dronabinol, Marinol is a lab-developed form of THC, the well-known psychoactive compound found in the cannabis plant. Along with a variety of similar products, Marinol was created as a means of finding a way around the legal restrictions surrounding marijuana. While it is no longer as popular a medication as it once was, it still enjoys booming sales in states where medicinal marijuana is not yet legal.
What is Marinol?
Marinol is a synthetic form of THC, but while it shares the same chemical formula as the THC in marijuana, the elements are arranged differently within the molecule. It consists of pure THC which is dissolved in sesame oil and comes in pill form. Rather than ingesting THC from the cannabis plant, patients who consume Marinol are taking THC that has been synthesized in a lab.
THC was first isolated by Raphael Mechoulam and Yechiel Gaoni in Israel in 1964. In 1978, New Mexico became the first state in America to pass a law recognizing the medical value of marijuana. In 1980, the National Cancer Institute (NCI) started experimenting with a new drug it called Marinol. The NCI tested the drug on cancer patients in San Francisco. What happened next arguably changed the course of medical marijuana’s history.
While NCI studies found that some patients responded well to Marinol, six states conducted studies of their own on marijuana. They discovered that patients found the THC in natural marijuana safer and more effective than the synthetic version yet incredibly, the government decided to proceed with Marinol.
In 1981, the United States Government sold the Marinol patent to Unimed who in turn applied to the FDA for permission to market the new drug as an anti-nausea treatment. The FDA initially denied the request in November 1984 because the clinical trial results were not promising. However, Unimed quickly changed matters and provided further data which prompted the FDA to give its approval in June 1985.
In December 1992, the FDA approved Marinol for anorexia treatment in patients with AIDS, and in July 1999, Unimed was successful in petitioning the DEA to move Marinol’s classification from Schedule II to Schedule III to ensure greater availability.
What is Marinol Used For?
It is best known for its use as a treatment for the vomiting and nausea caused by chemotherapy. It is only used when other drugs have failed in their task. Marinol is also used to treat weight loss and loss of appetite associated with HIV, also known as Wasting Syndrome.
The dosage depends on what you are using Marinol for. Patients using it for appetite loss should take it twice a day (once before lunch and once before dinner.) If you are using it to treat nausea and vomiting, take it 4-6 times a day.
Although Marinol was approved for use back in 1985, the best evidence surrounding its efficacy has only come to light in recent years, well over a decade after its initial sale. A 2001 study by Carroll et al. found that the drug was an effective treatment for the nausea and vomiting caused by chemotherapy.
However, a 2016 study by May and Glode concluded that there was “insufficient data to support the use of dronabinol as an antiemetic in all chemotherapeutic regimens” although they did concede that it has some “beneficial effects.”
A 1995 study by Beal et al. looked at Marinol as a treatment for anorexia in AIDS patients suffering from weight loss. The study involved 139 patients who received either 2.5mg of Marinol twice a day or a placebo. Those who took Marinol had a 38% increase in their appetite above the baseline compared to 8% for those who took the placebo.
Marinol Side Effects
There is a long list of possible side effects associated with Marinol including:
- Feeling ‘high.’
- Stomach pain
It is important to go to a doctor immediately if you faint, experience a rapid increase in your heart rate or a significant change in your mental state.
Is Marinol Better Than Marijuana?
Although usage of Marinol is on the wane in the United States (it was discontinued in Canada), it still has its proponents. Yet it is crucial to note that while Marinol contains THC, it is nothing like the THC found naturally. Marinol does not contain the hundreds of compounds found in cannabis.
Why is this important? It is likely that the cannabinoids and terpenes found in marijuana reduce the negative effects associated with THC such as anxiety and dizziness. Certainly, CBD (cannabidiol) helps reduce the psychoactive high you get from THC.
In 2001, Lester Grinspoon, Professor of Psychiatry at Harvard Medical School, said he had yet to find a patient that found Marinol more useful than natural marijuana. He asserted that if marijuana were legal, few patients would choose Marinol.
In 1999, the Institute of Medicine said that Marinol isn’t effective because taking it orally slows the absorption rate and prevents patients from having control over dosing. In 2002, Andrew Weil from the University of Arizona’s School of Medicine condemned Marinol by saying it simply isn’t effective enough. He spoke to numerous patients, and all of them said the pill didn’t work as well as natural herb and it resulted in even greater intoxication.
In 2002, Robert L DuPont, the President of the Institute for Behavior and Health led the rebuttals by claiming that plants are “unstable mixtures of different chemicals” and should not be used for medical treatment. DuPont said that no plant should ever be allowed as a medicinal treatment because they can’t be used directly to provide a specific dosage of any one chemical.
In contrast, Marinol provides a pre-measured dose of THC which he believes is a much better option. It was interesting to read that DuPont used the FDA’s approval of Marinol in 1985 as proof that it was a better option than natural marijuana. This is in spite of several state studies which clearly showed that patients not only preferred natural THC but claimed it was more effective.
In 2006, the Office of National Drug Control Policy (ONDCP) cited the 1970 Drug Abuse Prevention and Control Act which classified marijuana as a Schedule I drug with no recognized medical value. The ONDCP described Marinol as a “safe and legal version of medical marijuana” and claimed that smoking marijuana was likely to harm your health.
Final Thoughts on Marinol
Marinol continues to be a financial success, but much of this can be attributed to the extremely limited availability of THC from its natural source. A 2013 study by Hazekamp et al. asked 953 people to complete a survey and answer whether they preferred synthetic THC or ‘the real thing.’ Fewer than 2% of respondents said they preferred synthetic THC which suggests that Marinol is only popular because of the existing laws.
The fact of the matter is that an increasing number of studies are conclusively proving that medical marijuana is a vastly superior treatment to pharmaceutical drugs for dozens of conditions ranging from PTSD to chronic pain. Marinol’s impact is relatively limited, and it carries a number of side effects.
Also, it is extremely difficult for patients to self-adjust their dosage since Marinol comes in pill form and takes much longer to become effective than smoked marijuana. Many of the side effects associated with Marinol don’t occur in natural marijuana because its additional compounds counteract many of the negative effects of THC. Marinol will continue to sell well, but it is clear that patients prefer natural THC, just like they did in 1980.