Medical Marijuana

How is medical marijuana obtained? You must obtain a medical prescription from a licensed physician. Medical marijuana is now available in 33 states and DC. “Qualifying conditions” for use of medical marijuana varies from state to state, and some states require an ID card in order to purchase it. Lastly, medical marijuana is only sold at specified dispensaries (https://www.webmd.com/a-to-z-guides/medical-marijuana-faq).

How is medical marijuana different than the marijuana plant? Over 100 chemicals called cannabinoids are found in marijuana. However, two main ingredients are utilized in medical marijuana: Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). The THC causes the “euphoria” that people experience with marijuana. The CBD is helpful with fighting pain and combating nausea, as well as other conditions – see below (https://www.health.harvard.edu/blog/medical-marijuana-2018011513085).

What conditions are being treated with medical marijuana?

• Pain control for various conditions
• Control of nausea and vomiting from chemotherapy and other conditions
• Anxiety
• Post Traumatic Stress Disorder
• Crohn’s Disease and Irritable Bowel Syndrome
• Glaucoma
• Migraines
• Inflammation
• Muscle Spasms
• Eating disorders such as anorexia
• Depression
• Wasting Syndrome
• Insomnia
• Alzheimer’s
• Multiple Sclerosis (MS)
• Epilepsy or Seizure Disorders
• Parkinson’s Disease

How does medical marijuana work? CBD and THC can be prescribed separately or together depending on the medical condition. The chemical in CBD is similar to the body chemicals that are linked to appetite, movement, memory and pain, so for conditions related to these areas, CBD is being utilized for medicinal purposes and can be given in varying doses. When given separately, CBD provides the pain relief, lessens nausea or reduces anxiety without the sedative effect of the THC. THC, on the other hand, helps with symptoms related to insomnia, glaucoma, appetite loss, and muscle spasticity. The two ingredients can also be given together; for example when experiencing pain and insomnia (https://www.healthline.com/health/cbd-vs-thc). The use of medical marijuana is expanding. There is a form of epilepsy called Dravet syndrome, which is extremely challenging to control, if not impossible. Check out the video on the use of CBD for a child’s case of this form of epilepsy; it can be found on Charlotte’s Web (this is not my website). 

Are there specific doses of medical marijuana? The answer is yes and no, the therapeutic range is still unclear. The daily dose for THC is 2.5 mg to 90 mg. The daily range given for CBD is 2.85 to 50 mg/kg/day (https://www.medscape.org/viewarticle/905695). Although we are aware that THC can impair short-term memory and cognitive ability, CBD has minimal side effects (dry mouth, lowering of blood pressure, lightheadedness). Future research will help to spell out the risks and benefits, as well as more specifics about therapeutic doses. Medical marijuana comes in pill or liquid form or it can be taken in by inhalation, edibles, or body oils (topical). CBD is effective for many types of pain; it can take the place of NSAIDs (Advil, Tylenol, etc.) for those people who cannot take them. It is also impossible to overdose on CBD and is far less addictive than opiates. This is good news considering the existing opioid crisis.

What do we know scientifically about the effectiveness of medical marijuana?
Because marijuana has only recently become legal in some states and utilized medicinally, we haven’t had the ability to carry out controlled scientific studies as with other drugs. Now that it is legal, we will be hearing more about the medicinal effects of medical marijuana. One area of study that is very promising with medical marijuana is its apparent ability to treat inflammatory and autoimmune disorders. For years I have written about inflammation being a likely precursor to many diseases (including immune disorders): cancer, heart disease, Alzheimer’s, arthritis, colitis, and MS, to name a few. Cannabinoid is considered a novel anti-inflammatory drug, which includes its ability to suppress cytokine production, along with other bodily inflammatory responses (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/).

What are the drawbacks? Medical marijuana is not legal on a federal level, which results in distribution challenges and limitations with research on a federal level. Further studies are needed to determine more accurate dosing with both CBD and THC separately, as well as their use in conjunction with each other and other drugs. The FDA does not regulate medical marijuana like other drugs. Finally, medical marijuana is not covered by health insurance. The dispensaries must register with their respective state department, but prices are not controlled by the state and there are no discounted prices for patients who cannot afford it
(https://www.health.ny.gov/regulations/medical_marijuana/faq.htm).

Although medical marijuana is gaining ground as a legitimate form of medical treatment, it still remains controversial and many are waiting for a larger body of legitimate scientific research. However, Dr. P. Grinspoon, contributing editor to Harvard Health Publishing, states: “I often hear complaints from other doctors that there isn’t adequate evidence to recommend medical marijuana, but there is even less scientific evidence for sticking our heads in the sand.”

Dispensaries in our area:
Kingston, NY
Etain Health Medical Marijuana Dispensary
 
Great Barrington, MA
Theory Wellness: Recreational and Medical Marijuana Dispensary MA
 
Poughkeepsie, NY
Comprehensive Pain Management, PC
 
Charlotte Michos is a clinical nurse specialist who values personal-centered care and serves as a Healthcare Consultant in helping others make informed decisions.