What You Need to Know About Medical Marijuana

What You Need to Know About Medical Marijuana

Are proponents or detractors just blowing smoke?

Depending on whom you talk to, medical marijuana (also known as cannabis) is either a panacea for everything from cancer, to chronic pain, to epilepsy or it’s a dangerous and illegal drug with no place in medicine. 

A study published in July 2016 in the journal Health Affairs found that Medicare Part D spending decreased by approximately $165.2 million between 2010 and 2013 in the 17 states (plus Washington D.C.) that allowed for medical marijuana in 2013. The researchers found that prescriptions for drugs used to treat anxiety, depression, nausea, pain, psychosis, seizures and sleep disorders also declined in states with medical marijuana laws. Another 2014 study published in JAMA Internal Medicine found a nearly 25 percent reduction in prescription drug overdose death in states with medical marijuana laws. 

Can marijuana really treat so many conditions? Read on to find out more about what medical marijuana can—and can’t—do. 

Marijuana’s murky legalities 
As of April 2017, 29 states allow medical marijuana and another 17 allow limited access to cannabis derivatives. Marijuana is currently classified as a Schedule I drug under the Controlled Substances Act, along with drugs such as mescaline and MDMA (ecstasy). That means the federal government has found it to have a high potential for abuse, has no medical use and is unsafe. Marijuana’s status as a Schedule I drug makes getting funding for research into its medical benefits difficult, says Keith Roach, MD, Sharecare’s chief medical officer.

“I think it should be reclassified because there’s potential for marijuana to be used in other conditions,” says Dr. Roach. “Saying it has no medical validity is a mistake. Let’s study it.” 

Doctors are not allowed to write prescriptions for medical marijuana; they can only recommend going to a marijuana dispensary. Roach says the future of medical marijuana research “depends entirely on the federal government and what they choose to do. Right now, it’s very difficult for researchers to do any kind of good research.” 

Elements of marijuana
There are a number of active compounds, called cannabinoids, found in marijuana. The main compound is called delta-9-tetrahydrocannabinol (THC) and is responsible for the “high” that marijuana causes.

Another compound some researchers believe has medical uses is called cannabidiol, CBD for short, which does not have psychoactive properties. In November 2017, the World Health Organization (WHO) published a report stating that CBD in its pure form is safe, with little potential for substance abuse and no evidence of harm to public health.

According to the report, not only is CBD considered safe, but it has potential health benefits, too. It can be used to treat epilepsy in both children and adults, and may benefit those with Alzheimer’s disease, Parkinson’s disease and some cancers. The federal government still classifies CBD as a Schedule 1 controlled substance, restricting its use and research. The WHO began a larger review in May 2018.

The effectiveness of certain compounds found in marijuana are no longer in question, says Roach. “But it’s still controversial because marijuana itself has a lot of different substances in it. We try to isolate one substance and say ‘This is what’s important,’ when it may be several things acting in concert. It’s very difficult to study.

What marijuana can (and can’t) help 
According to Roach, a marijuana derivative—a form of THC called dronabinol—has been used to treat chemotherapy-induced nausea for decades, and has the added benefit of often stimulating appetite. 

Roach believes medical marijuana also has the potential to treat refractory epilepsy, or epilepsy that hasn’t responded to other drugs. A 2012 review of studies could not find reliable data on whether marijuana helps with epilepsy; however, a study presented at the American Academy of Neurology’s 2015 meeting that had no placebo control, found seizures decreased by an average of 54 percent in people who took CBD oil for 12 weeks. 

Cancer, unfortunately, can’t be helped by medical marijuana. “People still ask me all the time if marijuana helps with cancer,” he says. “It really doesn’t.” The authors of a 2016 review of literature published in JAMA Oncology suggest that marijuana can help with chemotherapy-induced nausea and vomiting, pain from cancer and may slow the growth of tumors. However, they note that much of the research is outdated and based on either animal or small human studies, and that more research is needed. 

The American Academy of Neurology has stated that marijuana can ease some symptoms of multiple sclerosis. A meta-analysis published in June of 2015 in JAMA found moderate-quality evidence that marijuana helps in chronic pain and spasticity.  Other conditions that have been studied, but deemed inconclusive include schizophrenia and bipolar disorder. 

Responsible use 
Marijuana is the same whether you get it from a state-licensed dispensary or on the black market, according to Roach, but if you’re using marijuana for medical purposes, you need to obtain it through the proper channels. In the past, black market marijuana has been laced with other substances such as PCP. “You’re certainly better off getting something sold out in the open that has some guarantee of what it is rather than buying it on the street,” says Roach.  

Marijuana impairs driving, according to the National Institute on Drug Abuse, so if you’re taking medical marijuana it’s best not to get behind the wheel. It is also particularly detrimental to teenagers’ developing brains, impairing thinking and memory for days after use.  

Roach also says that more accessible marijuana may reduce instances of alcohol abuse. “It’s not clear yet, but there’s the potential that someone can take a few hits rather than drink a six pack,” he says. “In my opinion, harm from alcohol is worse.” 

Medically reviewed in January 2019.

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