MEDICAL CANNABIS USE AND EFFECTS

Medical Cannabis Use and Effects

INTRODUCTION TO MEDICAL CANNABIS

Medical cannabis, also known as medical marijuana, refers to the use of the Cannabis sativa or Cannabis indica plant and its cannabinoids—particularly tetrahydrocannabinol (THC) and cannabidiol (CBD)—for treating disease or alleviating symptoms. Unlike recreational cannabis, medical cannabis is used under physician supervision and often regulated by government agencies.

While it remains controversial in some regions, medical cannabis is gaining recognition globally for its potential therapeutic benefits in managing chronic pain, epilepsy, and other health conditions.

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CANNABINOIDS: THE ACTIVE COMPOUNDS

THC (TETRAHYDROCANNABINOL)

THC is the main psychoactive compound in cannabis. It binds to CB1 receptors in the brain and nervous system, producing effects such as euphoria, altered sensory perception, and pain relief. Its medical benefits include:

Pain management

Muscle spasticity reduction

Appetite stimulation

Nausea and vomiting suppression

CBD (CANNABIDIOL)

CBD is non-psychoactive and has become widely popular for its potential medicinal effects without inducing a “high.” It interacts with various receptors in the body and brain but doesn’t strongly bind to CB1 or CB2 receptors. Medical uses include:

Anti-inflammatory and analgesic effects

Anxiety and depression management

Seizure control

Neuroprotective properties

 

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MEDICAL CONDITIONS TREATED WITH CANNABIS

CHRONIC PAIN

One of the most common reasons for prescribing medical cannabis is for chronic pain, especially neuropathic pain. Studies suggest cannabis can be an effective alternative to opioids with a lower risk of addiction.

EPILEPSY

CBD-based medications, such as Epidiolex, are FDA-approved for treating rare forms of epilepsy like Dravet syndrome and Lennox-Gastaut syndrome. These patients often show a significant reduction in seizure frequency.

MULTIPLE SCLEROSIS (MS)

Cannabis can help reduce muscle spasticity and nerve pain in MS patients. Nabiximols (Sativex), a mouth spray combining THC and CBD, is approved in several countries for this purpose.

CANCER-RELATED SYMPTOMS

Medical cannabis helps cancer patients by:

Reducing chemotherapy-induced nausea and vomiting

Stimulating appetite (especially THC)

Managing cancer-related pain

MENTAL HEALTH DISORDERS

CBD has shown promise in treating anxiety disorders, PTSD, and insomnia, although more clinical research is needed. Caution is advised as high THC levels may worsen psychiatric conditions in vulnerable individuals.

GLAUCOMA

Cannabis can lower intraocular pressure, a key factor in glaucoma. However, the effect is temporary, and better treatment options are available, limiting its long-term use.

INFLAMMATORY BOWEL DISEASE (IBD)

Some patients with Crohn’s disease or ulcerative colitis report symptom relief with cannabis use. However, evidence is mixed and further studies are ongoing.

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MODES OF ADMINISTRATION

INHALATION (SMOKING/VAPORIZING)

Onset: 1–10 minutes

Duration: 2–4 hours

Advantages: Fast relief

Risks: Respiratory irritation (especially with smoking)

ORAL CONSUMPTION (EDIBLES, CAPSULES, TINCTURES)

Onset: 30–90 minutes

Duration: 6–8 hours

Advantages: Long-lasting effects

Risks: Delayed onset may lead to overconsumption

SUBLINGUAL (UNDER THE TONGUE)

Onset: 15–45 minutes

Duration: 4–6 hours

Advantages: Bypasses digestive system, more consistent absorption

TOPICAL APPLICATIONS

Used for localized pain or inflammation

No psychoactive effects as it doesn’t enter the bloodstream significantly

 

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MEDICAL CANNABIS VS. RECREATIONAL CANNABIS

PURPOSE

Medical: Symptom relief under medical supervision

Recreational: Psychoactive effects for personal enjoyment

COMPOSITION

Medical cannabis often has a higher CBD-to-THC ratio to reduce psychoactive effects.

Recreational strains tend to prioritize high THC content.

REGULATION

Medical cannabis is more strictly regulated with quality controls, dosage guidance, and labeling standards.

 

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POTENTIAL SIDE EFFECTS AND RISKS

SHORT-TERM SIDE EFFECTS

Dry mouth

Red eyes

Dizziness or lightheadedness

Short-term memory impairment

Anxiety or paranoia (especially at high THC doses)

LONG-TERM RISKS

Cognitive impairment, particularly with frequent use starting in adolescence

Cannabis use disorder (CUD)

Dependency or tolerance

Lung damage (if smoked regularly)

INTERACTIONS WITH OTHER MEDICATIONS

Cannabis can interact with other drugs metabolized in the liver, such as:

Blood thinners (e.g., warfarin)

Anti-seizure medications

Antidepressants

Patients should always disclose cannabis use to healthcare providers.

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LEGAL AND ETHICAL CONSIDERATIONS

LEGAL STATUS BY REGION

United States: Legal in many states for medical use, but still illegal federally

Canada: Fully legal for medical and recreational use

Europe: Mixed regulations; medical cannabis is legal in countries like Germany and the Netherlands

Asia: Highly restricted, with exceptions like Thailand and Israel allowing limited medical use

ETHICAL ISSUES

Access disparities due to cost, location, or stigma

Pharmaceutical vs. natural cannabis debate

Clinical evidence gaps affecting physician willingness to prescribe

 

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RESEARCH AND EVIDENCE

While anecdotal support for medical cannabis is strong, randomized controlled trials (RCTs) are limited. This is due to:

Historical legal restrictions

Challenges in standardizing plant-based compounds

Regulatory hurdles in funding and conducting cannabis research

However, areas with promising evidence include:

Chronic pain

Chemotherapy-induced nausea

Epilepsy in children (CBD)

Multiple sclerosis spasticity

Ongoing research aims to explore cannabis for:

Alzheimer’s disease

Parkinson’s disease

PTSD

Opioid withdrawal

 

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DOSING AND PHYSICIAN GUIDANCE

START LOW, GO SLOW

Because of variability in individual responses, doctors usually recommend a “start low and go slow” approach, particularly for:

THC-heavy formulations

Elderly or cannabis-naïve patients

INDIVIDUALIZED TREATMENT PLANS

Factors affecting dosage and strain choice include:

Patient age and weight

Medical condition

Previous cannabis experience

Mode of administration

Monitoring for effectiveness and side effects is crucial. Frequent reassessment helps optimize therapeutic outcomes.

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FUTURE OF MEDICAL CANNABIS

PHARMACEUTICAL DEVELOPMENT

Cannabis-based medications are entering mainstream medicine, including:

Epidiolex (CBD) for epilepsy

Marinol and Syndros (synthetic THC) for appetite loss and nausea

Sativex (THC+CBD spray) for MS

Future formulations aim for: