The uses with the strongest evidence in the medical literature were for nausea and vomiting caused by chemotherapy and cancer pain. “I work with patients undergoing cancer therapy,” Abrams says. “I tell them, ‘Go to the dispensary, tell them what you’re trying to treat, and ask what works best.’ ”
BOTTOM LINE: Depression — mixed success; anxiety — seems to help; PTSD — seems to help
The National Academies rate scientific proof for better sleep on cannabis as only “moderate” in people with health conditions that interfere with slumber. But that’s not slowing down older users. More than 1 in 3 people in a Colorado survey tried it for sleep; 86 percent said it helped. By plugging into cannabinoid receptors on brain cells, THC and CBD could possibly team up for better sleep, at least in the short term, in people with insomnia due to pain, obstructive sleep apnea, fibromyalgia, multiple sclerosis and anxiety.
BOTTOM LINE: It seems to help
Quantity matters: A little bit (7.5 milligrams of THC, less than the content of many edibles) reduced stress in a 2017 study. But 12.5 milligrams (what you’d get from a few puffs of the popular pot strain GSC (formerly Girl Scout Cookies) increased anxiety.
So far, data for all of these mental health issues is sparse. We’ll know more soon. At least seven studies of cannabis in anxiety and/or depression are in the works in the United States and around the world. So are at least six studies for PTSD.
More than 600,000 Americans turn to cannabis for relief from chronic pain — and the scientific evidence for its effectiveness is substantial. In gold-standard randomized clinical trials of people who had agonizing health concerns — peripheral neuropathy (nerve pain from diabetes), spinal cord injury, HIV or complex regional pain syndrome, cancer, chemotherapy, muscle and joint problems, rheumatoid arthritis and multiple sclerosis — cannabis reduced pain by 40 percent, according to the 2017 NASEM report.
The picture looks brighter for anxiety — if you choose your cannabis carefully. In a 2018 study, volunteers who used cannabis reduced their use of commonly prescribed anxiety-reducing benzodiazepines by 47 percent. Users are enthusiastic. “Anxiety can really increase as you get older,” notes Barbara Blaser, 73, a nurse navigator who helps teach older cannabis users at Magnolia Wellness dispensary in Oakland, California. “Your kids are far away, your friends are passing away, you don’t know what will happen next in your life. A small amount of cannabis can help you feel better. Right now, I’m using a gel pen that delivers a tiny dab to my skin. It sinks in and I relax.”
Many patients find themselves in the situation of wanting to learn more about medical marijuana, but feel embarrassed to bring this up with their doctor. This is in part because the medical community has been, as a whole, overly dismissive of this issue. Doctors are now playing catch-up and trying to keep ahead of their patients’ knowledge on this issue. Other patients are already using medical marijuana, but don’t know how to tell their doctors about this for fear of being chided or criticized.
This is not intended to be an inclusive list, but rather to give a brief survey of the types of conditions for which medical marijuana can provide relief. As with all remedies, claims of effectiveness should be critically evaluated and treated with caution.
Least controversial is the extract from the hemp plant known as CBD (which stands for cannabidiol) because this component of marijuana has little, if any, intoxicating properties. Marijuana itself has more than 100 active components. THC (which stands for tetrahydrocannabinol) is the chemical that causes the “high” that goes along with marijuana consumption. CBD-dominant strains have little or no THC, so patients report very little if any alteration in consciousness.
Uses of medical marijuana
Along these lines, marijuana is said to be a fantastic muscle relaxant, and people swear by its ability to lessen tremors in Parkinson’s disease. I have also heard of its use quite successfully for fibromyalgia, endometriosis, interstitial cystitis, and most other conditions where the final common pathway is chronic pain.
The most common use for medical marijuana in the United States is for pain control. While marijuana isn’t strong enough for severe pain (for example, post-surgical pain or a broken bone), it is quite effective for the chronic pain that plagues millions of Americans, especially as they age. Part of its allure is that it is clearly safer than opiates (it is impossible to overdose on and far less addictive) and it can take the place of NSAIDs such as Advil or Aleve, if people can’t take them due to problems with their kidneys or ulcers or GERD.
Marijuana is currently legal, on the state level, in 29 states, and in Washington, DC. It is still illegal from the federal government’s perspective. The Obama administration did not make prosecuting medical marijuana even a minor priority. President Donald Trump promised not to interfere with people who use medical marijuana, though his administration is currently threatening to reverse this policy. About 85% of Americans support legalizing medical marijuana, and it is estimated that at least several million Americans currently use it.
Marijuana is also used to manage nausea and weight loss and can be used to treat glaucoma. A highly promising area of research is its use for PTSD in veterans who are returning from combat zones. Many veterans and their therapists report drastic improvement and clamor for more studies, and for a loosening of governmental restrictions on its study. Medical marijuana is also reported to help patients suffering from pain and wasting syndrome associated with HIV, as well as irritable bowel syndrome and Crohn’s disease.
The drug can also affect judgment and coordination, which could lead to accidents and injuries. When used during the teenage years when the brain is still developing, marijuana might affect IQ and mental function.
The agency did, however, agree to support additional research on marijuana and make the process easier for researchers. “Research is critically needed, because we have to be able to advise patients and doctors on the safe and effective use of cannabis,” Bonn-Miller says.
The marijuana plant contains more than 100 different chemicals called cannabinoids. Each one has a different effect on the body. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the main chemicals used in medicine. THC also produces the “high” people feel when they smoke marijuana or eat foods containing it.
Has the FDA approved medical marijuana?
Limited research suggests cannabinoids might:
Cannabinoids — the active chemicals in medical marijuana — are similar to chemicals the body makes that are involved in appetite, memory, movement, and pain.
Medical marijuana received a lot of attention a few years ago when parents said that a special form of the drug helped control seizures in their children. The FDA recently approved Epidiolex, which is made from CBD, as a therapy for people with very severe or hard-to-treat seizures. In studies, some people had a dramatic drop in seizures after taking this drug.
Because marijuana contains some of the same chemicals found in tobacco, there have been concerns that smoking it could harm the lungs. The effects of inhaled marijuana on lung health aren’t clear, but there’s some evidence it might increase the risk for bronchitis and other lung problems.