MEDICAL CANNABIS, or MEDICAL MARIJUANA, is cannabis and cannabinoids
that are prescribed by doctors for their patients. The use of
cannabis as a medicine has not been rigorously tested due to
production restrictions and other governmental regulations. Limited
evidence suggests cannabis can reduce nausea and vomiting during
chemotherapy , improve appetite in people with
HIV/AIDS , and reduce
chronic pain and muscle spasms .
Short-term use increases the risk of both minor and major adverse
effects. Common side effects include dizziness, feeling tired,
vomiting, and hallucinations.
Long-term effects of cannabis are not
clear. Concerns include memory and cognition problems , risk of
addiction, schizophrenia in young people, and the risk of children
taking it by accident.
Cannabis plant has a history of medicinal use dating back
thousands of years across many cultures. The use of medical cannabis
is controversial. A number of medical organizations have requested
removal from the list of Schedule I controlled substances followed by
regulatory and scientific review. Others such as the American
Academy of Pediatrics in 2015 opposed the legalization of medical
Medical cannabis can be administered using a variety of methods,
including liquid tinctures , vaporizing or smoking dried buds, eating
cannabis edibles , taking capsules, using lozenges, dermal patches or
Synthetic cannabinoids are available as
prescription drugs in some countries; examples include: dronabinol and
nabilone . Recreational use of cannabis is illegal in most parts of
the world, but the medical use of cannabis is legal in certain
countries, including Austria, Canada, Czech Republic, Finland,
Germany, Israel, Italy, the Netherlands (where it is also legal
recreationally ), Portugal and Spain. Australia has passed laws to
allow the use of marijuana for medical and scientific purposes in some
states. In the
United States , 29 states and the District of
Columbia have passed legislation permitting the possession, use, and
distribution of medical cannabis in some form. Although cannabis
remains prohibited for any use at the federal level, the
Rohrabacher–Farr amendment was enacted in December 2014, limiting
the ability of federal law to be enforced in states where medical
cannabis has been legalized.
* 1 Classification
* 2 Medical uses
* 2.1 Nausea and vomiting
* 2.3 Pain
* 2.4 Neurological problems
Posttraumatic stress disorder
Posttraumatic stress disorder
* 3 Adverse effects
* 3.1 Medical use
* 3.2 Recreational use
* 3.3 Cognitive effects
* 3.4 Impact on psychosis
* 3.5 Other potential long-term effects
* 4 Pharmacology
* 5 Administration
* 6 History
* 6.1 Ancient
* 6.2 Modern
* 7 Society and culture
* 7.1 Legal status
* 7.2 Economics
* 7.2.1 Distribution
* 7.2.2 Insurance
* 7.3 Positions of medical organizations
* 7.4 Recreational use
* 7.5 Brand names
* 8 Research
* 8.2 Cancer
* 8.3 Dementia
* 8.4 Diabetes
* 8.5 Epilepsy
* 8.6 Glaucoma
* 8.8 Other conditions
* 9 See also
* 10 References
* 11 Further reading
* 12 External links
Many different cannabis strains are collectively called "medical
cannabis." Since many varieties of the cannabis plant and plant
derivatives all share the same name, the term "medical cannabis" is
ambiguous and can be misunderstood. A
Cannabis plant includes more
than 400 different chemicals, of which about 70 are cannabinoids . In
comparison, typical government-approved medications contain only 1 or
2 chemicals. The number of active chemicals in cannabis is one reason
why treatment with cannabis is difficult to classify and study.
A 2014 review stated that the variations in ratio of CBD-to-
botanical and pharmaceutical preparations determines the therapeutic
vs psychoactive effects (CBD attenuates THC's psychoactive effects )
of cannabis products.
Cannabis as illustrated in Köhler's book of medicinal plants
Medical cannabis has several potential beneficial effects. Evidence
is moderate that it helps in chronic pain and muscle spasms . Low
quality evidence suggests its use for reducing nausea during
chemotherapy , improving appetite in
HIV/AIDS , improving sleep, and
improving tics in
Tourette syndrome . When usual treatments are
ineffective, cannabinoids have also been recommended for anorexia,
arthritis, migraine, and glaucoma.
It is recommended that cannabis use be stopped in pregnancy .
NAUSEA AND VOMITING
Medical cannabis is somewhat effective in chemotherapy-induced nausea
and vomiting (CINV) and may be a reasonable option in those who do
not improve following preferential treatment. Comparative studies
have found cannabinoids to be more effective than some conventional
antiemetics such as prochlorperazine , promethazine , and
metoclopramide in controlling CINV, but these are used less
frequently because of side effects including dizziness, dysphoria, and
hallucinations. Long-term cannabis use may cause nausea and
vomiting, a condition known as cannabinoid hyperemesis syndrome .
A 2016 Cochrane review said that cannabinoids were "probably
effective" in treating chemotherapy-induced nausea in children, but
with a high side effect profile (mainly drowsiness, dizziness, altered
moods, and increased appetite). Less common side effects were "occular
problems, orthostatic hypotension, muscle twitching, pruritis,
vagueness, hallucinations, lightheadedness and dry mouth".
Evidence is lacking for both efficacy and safety of cannabis and
cannabinoids in treating patients with
HIV/AIDS or for anorexia
associated with AIDS. As of 2013, current studies suffer from effects
of bias, small sample size, and lack of long-term data.
Cannabis appears to be somewhat effective for the treatment of
chronic pain , including pain caused by neuropathy and possibly that
due to fibromyalgia and rheumatoid arthritis . A 2009 review states
it was unclear if the benefits were greater than the risks, while a
2011 review considered it generally safe for this use. In palliative
care the use appears safer than that of opioids . A 2014 review found
limited and weak evidence that smoked cannabis was effective for
chronic non-cancer pain. The review recommended that it be used for
people for whom cannabinoids and other analgesics were not effective.
A 2015 review found moderate quality evidence that cannabinoids were
effective for chronic pain. A 2015 meta-analysis found that inhaled
medical cannabis was effective in reducing neuropathic pain in the
short term for one in five to six patients. Another 2015 systematic
review and meta-analysis found limited evidence that medical cannabis
was effective for neuropathic pain when combined with traditional
The efficacy of cannabis in treating neurological problems, including
multiple sclerosis (MS), epilepsy, and movement problems, is not
clear. Studies of the efficacy of cannabis for treating multiple
sclerosis have produced varying results. The combination of
Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) extracts give
subjective relief of spasticity, though objective post-treatment
assessments do not reveal significant changes. Evidence also suggests
that oral cannabis extract is effective for reducing patient-centered
measures of spasticity. A trial of cannabis is deemed to be a
reasonable option if other treatments have not been effective. Its
use for MS is approved in ten countries. A 2012 review found no
problems with tolerance, abuse or addiction.
POSTTRAUMATIC STRESS DISORDER
Further information: Posttraumatic_stress_disorder §
There is tentative evidence that medical cannabis is effective at
reducing posttraumatic stress disorder symptoms, but, as of 2015 ,
there is insufficient evidence to confirm its effectiveness for this
American medical hashish
There is insufficient data to draw strong conclusions about the
safety of medical cannabis. Typically, adverse effects of medical
cannabis use are not serious. These include: tiredness, dizziness,
cardiovascular and psychoactive effects. Tolerance to these effects
develops over a period of days or weeks. The amount of cannabis
normally used for medicinal purposes is not believed to cause any
permanent cognitive impairment in adults, though long-term treatment
in adolescents should be weighed carefully as they are more
susceptible to these impairments. Withdrawal symptoms are rarely a
problem with controlled medical administration of cannabinoids. The
ability to drive vehicle or operating machinery may be impaired until
a tolerance is developed. Although supporters of medical cannabis say
that it is safe, further research is required to assess the long-term
safety of its use.
Long-term effects of cannabis
THC , the principal psychoactive constituent of the cannabis plant,
has low toxicity while the
LD50 (dose of
THC needed to kill 50% of
tested rodents) is high. Acute effects may include anxiety and panic,
impaired attention, and memory (while intoxicated), an increased risk
of psychotic symptoms, and possibly increased risk of accidents if a
person drives a motor vehicle while intoxicated. Psychotic episodes
are well-documented and typically resolve within minutes or hours.
There have been few reports of symptoms lasting longer.
According to the
United States Department of Health and Human
Services , there were 455,000 emergency room visits associated with
cannabis use in 2011. These statistics include visits in which the
patient was treated for a condition induced by or related to recent
cannabis use. The drug use must be "implicated" in the emergency
department visit, but does not need to be the direct cause of the
visit. Most of the illicit drug emergency room visits involved
multiple drugs. In 129,000 cases, cannabis was the only implicated
Effects of chronic use may include bronchitis , a cannabis dependence
syndrome, and subtle impairments of attention and memory. These
deficits persist while chronically intoxicated. There is little
evidence that cognitive impairments persist in adult abstinent
cannabis users. Compared to non-smokers, people who smoked cannabis
regularly in adolescence exhibit reduced connectivity in specific
brain regions associated with memory, learning, alertness, and
executive function. One study suggested that sustained heavy, daily,
adolescent onset cannabis use over decades is associated with a
decline in IQ by age 38, with no effects found in those who initiated
cannabis use later, or in those who ceased use earlier in adulthood.
There has been a limited amount of studies that have looked at the
effects of smoking cannabis on the respiratory system. Chronic heavy
marijuana smoking is associated with coughing, production of sputum,
wheezing, coughing, and other symptoms of chronic bronchitis. Regular
cannabis use has not been shown to cause significant abnormalities in
Cannabis smoke contains thousands of organic and inorganic chemical
compounds. This tar is chemically similar to that found in tobacco
smoke, and over fifty known carcinogens have been identified in
cannabis smoke, including; nitrosamines, reactive aldehydes, and
polycylic hydrocarbons, including benzpyrene. Light and moderate use
of cannabis is not believed to increase risk of lung or upper airway
cancer. Evidence for causing these cancers is mixed concerning heavy,
long-term use. In general there are far lower risks of pulmonary
complications for regular cannabis smokers when compared with those of
tobacco. Combustion products are not present when using a vaporizer ,
THC in pill form, or consuming cannabis foods .
There is serious suspicion among cardiologists, spurring research but
falling short of definitive proof, that cannabis use has the potential
to contribute to cardiovascular disease.
Cannabis is believed to be
an aggravating factor in rare cases of arteritis , a serious condition
that in some cases leads to amputation. Because 97% of case-reports
also smoked tobacco, a formal association with cannabis could not be
made. If cannabis arteritis turns out to be a distinct clinical
entity, it might be the consequence of vasoconstrictor activity
observed from delta-8-
THC and delta-9-
THC . Other serious
cardiovascular events including myocardial infarction , stroke, sudden
cardiac death , and cardiomyopathy have been reported to be temporally
associated with cannabis use. Research in these events is complicated
because cannabis is often used in conjunction with tobacco, and drugs
such as alcohol and cocaine. These putative effects can be taken in
context of a wide range of cardiovascular phenomena regulated by the
endocannabinoid system and an overall role of cannabis in causing
decreased peripheral resistance and increased cardiac output , which
potentially could pose a threat to those with cardiovascular disease.
Cannabis usually causes no tolerance or withdrawal symptoms except in
heavy users. In a survey of heavy users 42.4% experienced withdrawal
symptoms when they tried to quit marijuana such as craving,
irritability, boredom, anxiety and sleep disturbances. About 9% of
those who experiment with marijuana eventually become dependent. The
rate goes up to 1 in 6 among those who begin use as adolescents, and
one-quarter to one-half of those who use it daily according to a NIDA
review. A 2013 review estimates daily use is associated with a 10-20%
rate of dependence. The highest risk of cannabis dependence is found
in those with a history of poor academic achievement, deviant behavior
in childhood and adolescence, rebelliousness, poor parental
relationships, or a parental history of drug and alcohol problems.
A 2013 literature review found that exposure to marijuana had
biologically-based physical, mental, behavioral and social health
consequences and was "associated with diseases of the liver
(particularly with co-existing hepatitis C), lungs, heart, and
A 2011 systematic review evaluated published studies of the acute and
long-term cognitive effects of cannabis.
THC intoxication is well
established to impair cognitive functioning on an acute basis,
including effects on the ability to plan, organize, solve problems,
make decisions, and control impulses. The extent of this impact may be
greater in novice users, and paradoxically, those habituated to
high-level ingestion may have reduced cognition during withdrawal.
Studies of long-term effects on cognition have provided conflicting
results, with some studies finding no difference between long-term
abstainers and never-users and others finding long-term deficits. The
discrepancies between studies may reflect greater long-term effects
among heavier users relative to occasional users, and greater duration
of effect among those with heavy use as adolescents compared to later
in life. A second systematic review focused on neuroimaging studies
found little evidence supporting an effect of cannabis use on brain
structure and function. A 2003 meta-analysis concluded that any
long-term cognitive effects were relatively modest in magnitude and
limited to certain aspects of learning and memory.
IMPACT ON PSYCHOSIS
THC can cause acute transient psychotic symptoms in
healthy individuals and people with schizophrenia.
A 2007 meta analysis concluded that cannabis use reduced the average
age of onset of psychosis by 2.7 years relative to non-cannabis use.
A 2005 meta analysis concluded that adolescent use of cannabis
increases the risk of psychosis, and that the risk is dose-related. A
2004 literature review on the subject concluded that cannabis use is
associated with a two-fold increase in the risk of psychosis, but that
cannabis use is "neither necessary nor sufficient" to cause psychosis.
A French review from 2009 came to a conclusion that cannabis use,
particularly that before age 15, was a factor in the development of
Some studies have suggested that cannabis users have a greater risk
of developing psychosis than non-users. This risk is most pronounced
in cases with an existing risk of psychotic disorder. A 2005 paper
from the Dunedin study suggested an increased risk in the development
of psychosis linked to polymorphisms in the COMT gene. However, a
more recent study cast doubt on the proposed connection between this
gene and the effects of cannabis on the development of psychosis.
A 2008 German review reported that cannabis was a causal factor in
some cases of schizophrenia and stressed the need for better education
among the public due to increasingly relaxed access to cannabis.
OTHER POTENTIAL LONG-TERM EFFECTS
National Institutes of Health
National Institutes of Health study of 19 chronic heavy
marijuana users with cardiac and cerebral abnormalities (averaging 28
g to 272 g (1 to 9+ oz) weekly) and 24 controls found elevated levels
of apolipoprotein C-III (apoC-III) in the chronic smokers. An
increase in apoC-III levels induces the development of
Cannabis contains two species which produce useful amounts
of psychoactive cannabinoids:
Cannabis indica and
Cannabis sativa ,
which are listed as Schedule I medicinal plants in the US; a third
Cannabis ruderalis , has few psychogenic properties.
Cannabis contains more than 460 compounds; at least 80 of these are
cannabinoids – chemical compounds that interact with cannabinoid
receptors in the brain. As of 2012, more than 20 cannabinoids were
being studied by the U.S. FDA.
The most psychoactive cannabinoid found in the cannabis plant is
tetrahydrocannabinol (or delta-9-tetrahydrocannabinol, commonly known
as THC). Other cannabinoids include delta-8-tetrahydrocannabinol,
cannabidiol (CBD), cannabinol (CBN), cannabicyclol (CBL),
cannabichromene (CBC) and cannabigerol (CBG); they have less
psychotropic effects than THC, but may play a role in the overall
effect of cannabis. The most studied are THC, CBD and CBN.
Some forms of medicinal cannabis.
Smoking is the means of administration of cannabis for many
consumers, and the most common method of medical cannabis consumption
in the US as of 2013. It is difficult to predict the pharmacological
response to cannabis because concentration of cannabinoids varies
widely as there are different ways of preparing cannabis for
consumption (smoked, applied as oils, eaten, infused into other foods,
or drunk) and a lack of production controls. The potential for
adverse effects from smoke inhalation makes smoking a less viable
option than oral preparations.
Cannabis vaporizers have gained popularity because of the perception
among users that less harmful chemicals are ingested when components
are inhaled via aerosol rather than smoke.
Cannabinoid medicines are available in pill form (dronabinol and
nabilone ) and liquid extracts formulated into an oromucosal spray
(nabiximols ). Oral preparations are "problematic due to the uptake
of cannabinoids into fatty tissue, from which they are released
slowly, and the significant first-pass liver metabolism, which breaks
THC and contributes further to the variability of plasma
Food and Drug Administration (FDA) has not approved smoked
cannabis for any condition or disease as it deems evidence is lacking
concerning safety and efficacy of cannabis for medical use. The FDA
issued a 2006 advisory against smoked medical cannabis stating:
"marijuana has a high potential for abuse, has no currently accepted
medical use in treatment in the United States, and has a lack of
accepted safety for use under medical supervision."
History of medical cannabis
Cannabis, called má 麻 (meaning "hemp; cannabis; numbness") or
dàmá 大麻 (with "big; great") in Chinese, was used in
fiber starting about 10,000 years ago. The botanist
Hui-lin Li wrote
that in China, "The use of
Cannabis in medicine was probably a very
early development. Since ancient humans used hemp seed as food, it was
quite natural for them to also discover the medicinal properties of
the plant." Emperor
Shen-Nung , who was also a pharmacologist, wrote
a book on treatment methods in 2737 BCE that included the medical
benefits of cannabis. He recommended the substance for many ailments,
including constipation, gout, rheumatism, and absent-mindedness.
Cannabis is one of the 50 "fundamental" herbs in traditional Chinese
Ebers Papyrus (c. 1550 BCE) from
Ancient Egypt describes medical
cannabis. The ancient Egyptians used hemp (cannabis) in suppositories
for relieving the pain of hemorrhoids .
Surviving texts from ancient
India confirm that cannabis'
psychoactive properties were recognized, and doctors used it for
treating a variety of illnesses and ailments, including insomnia,
headaches, gastrointestinal disorders, and pain, including during
Ancient Greeks used cannabis to dress wounds and sores on their
horses, and in humans, dried leaves of cannabis were used to treat
nose bleeds, and cannabis seeds were used to expel tapeworms.
In the medieval Islamic world , Arabic physicians made use of the
diuretic , antiemetic , antiepileptic , anti-inflammatory , analgesic
and antipyretic properties of
Cannabis sativa , and used it
extensively as medication from the 8th to 18th centuries.
An Irish physician, William Brooke O\'Shaughnessy , is credited with
introducing cannabis to Western medicine. O'Shaughnessy discovered
cannabis in the 1830's while living abroad in
India , where he
conducted numerous experiments investigating its medical utility.
Noting in particular its analgesic and anticonvulsant effects, he
England with a supply of cannabis in 1842, after which its
use spread through Europe and the United States.
Cannabis was entered
into the U.S. Pharmacopeia in 1850.
The use of cannabis in medicine began to decline by the end of the
19th century , due to difficulty in controlling dosages and the rise
in popularity of synthetic and opium -derived drugs. Also, the advent
of the hypodermic syringe allowed these drugs to be injected for
immediate effect, in contrast to cannabis which is not water-soluble
and therefore cannot be injected.
In the United States, the medical use of cannabis further declined
with the passage of the
Marihuana Tax Act of 1937 , which imposed new
regulations and fees on physicians prescribing cannabis.
removed from the U.S. Pharmacopeia in 1941, and officially banned for
any use with the passage of the
Controlled Substances Act of 1970.
Cannabis began to attract renewed interest as medicine in the 1970's
and 1980's, in particular due to its use by cancer and AIDS patients
who reported relief from the effects of chemotherapy and wasting
syndrome . In 1996,
California became the first U.S. state to
legalize medical cannabis in defiance of federal law. In 2001, Canada
became the first country to adopt a system regulating the medical use
The use of cannabis, at least as fiber, has been shown to go back at
least 10,000 years in
Taiwan . "Dà má" (
Pinyin pronunciation) is the
Chinese expression for cannabis, the first character meaning "big" and
the second character meaning "hemp".
Cannabis indica fluid extract, American Druggists Syndicate,
An advertisement for cannabis americana distributed by a pharmacist
in New York in 1917
Ebers Papyrus (c. 1550 BCE) from
Ancient Egypt has a prescription
for medical marijuana applied directly for inflammation.
SOCIETY AND CULTURE
Legal and medical status of cannabis ,
Cannabis in the
United Kingdom , and
Medical cannabis in the
Worldwide laws on cannabis possession for medical purposes as of 2016
Legal or essentially legal Decriminalized Illegal but often
unenforced Illegal No information
Medical use of cannabis or preparation containing
THC as the active
substance is legalized in Austria, Belgium, Canada, Chile, Colombia
Czech Republic, Finland, Israel, Netherlands, Spain, the UK and some
states in the US, although it is illegal under US federal law.
Cannabis is in Schedule IV of the United Nations' Single Convention
on Narcotic Drugs , making it subject to special restrictions. Article
2 provides for the following, in reference to Schedule IV drugs:
A Party shall, if in its opinion the prevailing conditions in its
country render it the most appropriate means of protecting the public
health and welfare, prohibit the production, manufacture, export and
import of, trade in, possession or use of any such drug except for
amounts which may be necessary for medical and scientific research
only, including clinical trials therewith to be conducted under or
subject to the direct supervision and control of the Party.
The convention thus allows countries to outlaw cannabis for all
non-research purposes but lets nations choose to allow medical and
scientific purposes if they believe total prohibition is not the most
appropriate means of protecting health and welfare. The convention
requires that states that permit the production or use of medical
cannabis must operate a licensing system for all cultivators,
manufacturers, and distributors and ensure that the total cannabis
market of the state shall not exceed that required "for medical and
As of April 2017, 29 states and the District of Columbia have
legalized the medical use of cannabis, and another 16 have passed laws
allowing the use of CBD products.
Cannabis remains illegal at the
federal level by way of the
Controlled Substances Act , under which
cannabis is classified as a Schedule I drug with a high potential for
abuse and no accepted medical use. In December 2014, however, the
Rohrabacher–Farr amendment was signed into law, prohibiting the
Justice Department from prosecuting individuals acting in accordance
with state medical cannabis laws.
Medical marijuana dispensary
The method of obtaining medical cannabis varies by region and by
legislation. In the US, most consumers grow their own or buy it from
marijuana dispensaries in the 29 states and the District of Columbia
that permit the use of medical cannabis.
Marijuana vending machines
for selling or dispensing cannabis are in use in the
United States and
are planned to be used in Canada. In 2014, the startup Meadow began
offering on-demand delivery of medical marijuana in the San Francisco
Bay Area, through their mobile app.
In the United States, health insurance companies may not pay for a
medical marijuana prescription as the Food and Drug Administration
must approve any substance for medicinal purposes. Before this can
happen, the FDA must first permit the study of the medical benefits
and drawbacks of the substance, which it has not done since it was
placed on Schedule I of the
Controlled Substances Act in 1970.
Therefore, all expenses incurred fulfilling a medical marijuana
prescription will possibly be incurred as out-of-pocket. However, the
New Mexico Court of Appeals has ruled that workers\' compensation
insurance must pay for marijuana prescribed as part of the state's
POSITIONS OF MEDICAL ORGANIZATIONS
Medical organizations that have issued statements in support of
allowing access to medical cannabis include the American Nurses
American Public Health Association
American Public Health Association , American Medical
Student Association ,
National Multiple Sclerosis Society , Epilepsy
Foundation , and Leukemia mild to moderate dizziness is common during
the first few weeks.
Relative to inhaled consumption, peak concentration of oral
delayed, and it may be difficult to determine optimal dosage because
of variability in patient absorption.
In 1964, Albert Lockhart and Manley West began studying the health
effects of traditional cannabis use in Jamaican communities. They
developed, and in 1987 gained permission to market, the pharmaceutical
"Canasol", one of the first cannabis extracts.
"Victoria", the United States' first legal medical marijuana
plant grown by The Wo/Men's Alliance for Medical Marijuana.
A 2016 review assess the current status and prospects for development
of CBD and CBD-dominant preparations for medical use in the United
States, examining its neuroprotective, antiepileptic, anxiolytic,
antipsychotic, and antiinflammatory properties.
The Schedule I classification of cannabis in the U.S. has hindered
research on medicinal uses of the drug. As of 2016, most
cannabis-related research in the
United States is on chemical
components of the cannabis plant, and not on the whole plant. To
conduct research on the whole plant, proposals must be submitted to
Food and Drug Administration and the National Institute on Drug
Abuse for approval, and a license must be obtained from the Drug
Enforcement Administration specific to conducting research on Schedule
I drugs. The FDA has 30 days to respond to proposals, while there is
no such deadline imposed on the NIDA. Prior to 2015, proposals were
also required to be submitted to the U.S. Public Health Service for
approval, with no deadline imposed on the PHS either. Some reviews
have taken years to complete as a result. Any of the involved
government agencies could halt a cannabis research project at any
time, and consequently, medical research on cannabis has not advanced
United States for many years.
Cannabinoids have been shown to exhibit some anti-cancer effects in
laboratory experiments, although there has been little research into
their use as a cancer treatment in people. Laboratory experiments
have suggested that cannabis and cannabinoids have anticarcinogenic
and antitumor effects, including a potential effect on breast- and
lung-cancer cells. The
National Cancer Institute
National Cancer Institute reports that as of
November 2013 there have been no clinical trials on the use of
cannabis to treat cancer in people, and only one small study using
THC that reported potential antitumoral activity. While
cannabis may have potential for refractory cancer pain, use as an
antiemetic, and as an antitumor agent, much of the evidence comes from
outdated or small studies, or animal experiments.
Although there is ongoing research, claims that cannabis has been
proved to cure cancer are, according to
Cancer Research UK
Cancer Research UK , both
prevalent on the internet and "highly misleading".
There is no good evidence that cannabis use helps reduce the risk of
getting cancer. Whether smoking cannabis increases cancer risk in
general is difficult to establish since it is often smoked mixed with
tobacco – a known carcinogen – and this complicates research.
Cannabis use is linked to an increased risk of a type of testicular
The association of cannabis use with head and neck carcinoma may
differ by tumor site, with both possible pro- and anticarcinogenic
effects of cannabinoids. Additional work is needed to rule out various
sources of bias, confounds and misclassification of cannabis exposure.
Cannabinoids have been proposed to have the potential for lessening
the effects of Alzheimer's disease. A 2012 review of the effect of
cannabinoids on brain ageing found that "clinical evidence regarding
their efficacy as therapeutic tools is either inconclusive or still
missing". A 2009 Cochrane review said that the "one small randomized
controlled trial assessed the efficacy of cannabinoids in the
treatment of dementia ... ... poorly presented results and did not
provide sufficient data to draw any useful conclusions".
There is emerging evidence that cannabidiol may help slow cell damage
in diabetes mellitus type 1 . There is a lack of meaningful evidence
of the effects of medical cannabis use on people with diabetes; a 2010
review concluded that "the potential risks and benefits for diabetic
patients remain unquantified at the present time".
A 2016 review in the New
England Journal of Medicine said that
although there was a lot of hype and anecdotes surrounding medical
cannabis and epilepsy, "current data from studies in humans are
extremely limited, and no conclusions can be drawn". The mechanisms
by which cannabis may be effective in the treatment of epilepsy remain
Some reasons for the lack of clinical research have been the
introduction of new synthetic and more stable pharmaceutical
anticonvulsants, the recognition of important adverse side effects,
and legal restrictions to the use of cannabis-derived medicines -
although in December 2015, the DEA (
United States Drug Enforcement
Administration) has eased some of the regulatory requirements for
conducting FDA-approved clinical trials on cannabidiol (CBD).
Epidiolex, a cannabis-based product developed by GW Pharmaceuticals
for experimental treatment of epilepsy, underwent stage-two trials in
the US in 2014.
A 2017 study found that cannabidiol decreased the rate of seizures in
Dravet syndrome but increased the rate of sleepiness and
trouble with the liver.
In 2009, the
American Glaucoma Society noted that while cannabis can
help lower intraocular pressure , it recommended against its use
because of "its side effects and short duration of action, coupled
with a lack of evidence that its use alters the course of glaucoma".
As of 2008 relatively little research had been done concerning
therapeutic effects of cannabinoids on the eyes.
A 2007 review of the history of medical cannabis said cannabinoids
showed potential therapeutic value in treating
Tourette syndrome (TS).
A 2005 review said that controlled research on treating TS with
dronabinol showed the patients taking the pill had a beneficial
response without serious adverse effects; a 2000 review said other
studies had shown that cannabis "has no effects on tics and increases
the individuals inner tension".
A 2009 Cochrane review examined the two controlled trials to date
using cannabinoids of any preparation type for the treatment of tics
or TS (Muller-Vahl 2002, and Muller-Vahl 2003). Both trials compared
delta-9-THC; 28 patients were included in the two studies (8
individuals participated in both studies). Both studies reported a
positive effect on tics, but "the improvements in tic frequency and
severity were small and were only detected by some of the outcome
measures". The sample size was small and a high number of individuals
either dropped out of the study or were excluded. The original
Muller-Vahl studies reported individuals who remained in the study;
patients may drop out when adverse effects are too high or efficacy is
not evident. The authors of the original studies acknowledged few
significant results after
Bonferroni correction .
Cannabinoid medication might be useful in the treatment of the
symptoms in patients with TS, but the 2009 review found that the two
relevant studies of cannibinoids in treating tics had attrition bias ,
and that there was "not enough evidence to support the use of
cannabinoids in treating tics and obsessive compulsive behaviour in
people with Tourette's syndrome".
Anecdotal evidence and pre-clinical research has suggested that
cannabis or cannabinoids may be beneficial for treating Huntington\'s
disease or Parkinson\'s disease , but follow-up studies of people with
these conditions have not produced good evidence of therapeutic
potential. A 2001 paper argued that cannabis had properties that made
it potentially applicable to the treatment of amyotrophic lateral
sclerosis , and on that basis research on this topic should be
permitted, despite the legal difficulties of the time.
A 2005 review and meta-analysis said that bipolar disorder was not
well-controlled by existing medications and that there were "good
pharmacological reasons" for thinking cannabis had therapeutic
potential, making it a good candidate for further study.
Cannabinoids have been proposed for the treatment of primary anorexia
nervosa , but have no measurable beneficial effect. The authors of a
2003 paper argued that cannabinoids might have useful future clinical
applications in treating digestive diseases . Laboratory experiments
have shown that cannabinoids found in marijuana may have analgesic and
In 2014, the
American Academy of Neurology reviewed all available
findings levering the use of marijuana to treat brain diseases . The
result was that the scientific evidence is weak that cannabis in any
form serves as medicinal for curing or alleviating neurological
disorders. To ease multiple sclerosis patients' stiffness, which may
be accomplished by their taking cannabis extract by mouth or as a
spray, there is support. The academy has published new guidelines on
the use of marijuana pills and sprays in the treatment of MS.
Cannabis is being investigated for its possible use in inflammatory
bowel disease but as of 2014 there is only weak evidence for its
benefits as a treatment.
A 2007 review said cannabidiol had shown potential to relieve
convulsion , inflammation , cough, congestion and nausea, and to
inhibit cancer cell growth. Preliminary studies have also shown
potential over psychiatric conditions such as anxiety, depression, and
psychosis. Because cannabidiol relieves the aforementioned symptoms,
cannabis strains with a high amount of CBD may benefit people with
multiple sclerosis or frequent anxiety attacks .
* Medicine portal
* Charlotte\'s Web cannabis strain
Medical cannabis in the
* Tilden\'s Extract
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