Marijuana cigarettes containing the cannabinoids (chemical compounds) tetrahydrocannabinol (THC) or cannabidiol (CBD), or both THC and CBDCBD oils, edibles, tinctures, creams, and capsulesCannabis-derived pharmaceutical products approved by the Food and Drug Administration (FDA)
Studies suggest that the medical use of marijuana may help treat the following conditions or help alleviate the following symptoms: (1)
Anxiety, particularly social anxiety disorder Sleep problemsChronic pain Cancer-related pain Cancer-related nausea Loss of appetite due to chemotherapy or HIV/AIDS spasticity related to multiple sclerosis (MS)
Some research has suggested that the cannabinoids in marijuana could also be useful in managing these conditions: (2,3,4,5,6,7)
InflammationArthritisMigrainesHIV/AIDSDigestive disorders like Crohn’s disease and irritable bowel syndrome (IBS)
According to a 2017 report from the National Academies of the Sciences, Medicine, and Engineering (NASME), the strongest scientific evidence so far has been found in support of using marijuana for chronic pain, cancer-related nausea and vomiting, and MS-related spasticity. (1) This NASME report, one of the largest of its kind, looked at more than 10,000 studies published since 1999.
How Does Marijuana Affect the Body?
It depends on whether THC or CBD is the cannabinoid at work. They produce similar effects, but there are differences in intensity because they each affect a different neural pathway. THC is thought to engage with the body’s endocannabinoid system, which helps regulate physiological functioning. THC is similar to a chemical that’s present in this system, and when these two chemicals meet, the similarity allows THC to exert an influence on the body and brain in ways that alter coordination, memory, decision-making, appetite, and mood. The endocannabinoid system also helps regulate gastrointestinal functions, and this may explain why medical marijuana seems to help digestive disorders like IBS. CBD, scientists think, affects the brain because of the way it interacts with the neurological pathways that regulate serotonin, the hormone that regulates anxiety, pain, nausea, and appetite. A study published in May 2018 in JAMA Internal Medicine reported that prescriptions for opioids decreased in states that have medical marijuana laws. Researchers looked at Medicare data from 2010 to 2015 and found that states with active dispensaries saw 3.742 million fewer daily doses of opioids filled by pharmacies. (8) Another study, published in October 2014 in JAMA Internal Medicine, found that states with medical cannabis laws had a 24.8 percent lower annual overdose rate than states without such laws. (9) Some states, like Pennsylvania and New York, now consider opioid use disorder as a qualifying condition for medical marijuana use. New York, for example, allows people who qualify to use medical marijuana instead of opioids to treat pain.
Anxiety disordersNausea and vomitingPsychotic disordersAddictionNon-cancer-related painDepressionAddictionSleep problemsEpilepsy (Dravet syndrome and Lennox-Gastaut syndrome)
Staci Gruber, MD, is an associate professor of psychiatry at Harvard Medical School in Boston and the director of the Marijuana Investigations for Neuroscientific Discovery program at McLean Hospital in Belmont, Massachusetts, which is researching the neurological effects of medical marijuana use. In a large study that she’s conducting on the use of medical marijuana, Dr. Gruber says the second most commonly reported use of medical marijuana among subjects is for anxiety. She’s also about to begin an FDA-approved clinical trial of a CBD sublingual (administered under the tongue) tincture, consisting of CBD in a coconut oil base, for the treatment of anxiety. (Tinctures are medicines — in this case CBD — dissolved in a liquid like alcohol or glycerine.) Indeed, anecdotal evidence points to the effectiveness of CBD as an anxiety and stress reducer, as well as a sleep aid. Eric*, a busy sales executive in San Francisco, has been sleeping more soundly since he started using a high-CBD, low-THC product via a vaporizer three months ago for work-related stress and anxiety. “The quality of my sleep is better, I’m sleeping longer and deeper, and I now have no problem falling and staying asleep,” he says. “It has changed my life.” In addition to being a potentially powerful treatment for anxiety disorders, a growing body of research is suggesting that CBD may help treat symptoms of neurological disorders such as Parkinson’s disease and Alzheimer’s disease. (11,12) Scientists think that CBD acts in yet to be determined ways that protect the brain against inflammation and oxidative stress. (13) Research also points to CBD as a potential treatment for psychosis and schizophrenia. (14,15) Medical marijuana may also be effective in palliative care. In one Canadian case study, published in 2013 in Case Reports in Oncology, physicians reported that CBD oil, administered orally, was a successful treatment for a 14-year-old patient in palliative care with an aggressive form of leukemia. (16) Because CBD isn’t psychoactive like THC, CBD oil won’t give you the high that THC does. There are numerous ways to extract the resin, and some ways are safer than others. Certain preparations rely on chemicals like petroleum and butane for extraction; other methods involve using carbon dioxide. CBD oil is also extracted from hemp plants, but since hemp plants don’t contain as much CBD as marijuana plants, the effects of these oils may not be as potent. CBD extracted from marijuana plants should have little to no THC content.
What Are the Benefits of CBD Oil?
There may not be enough scientific research — yet — to prove without a doubt that CBD oil has medicinal and health benefits. Most of the studies that have been conducted on CBD have been done using CBD in pharmaceutical-grade preparations like oral solutions or pills. But many people report that CBD oils have helped them conquer everything from anxiety to pregnancy-related nausea to chronic pain. Calley Nelson, a writer and artist based in Brooklyn, New York, says she’s been able to transition off of antidepressants since she started taking CBD oil for anxiety in June. People also give it to their pets to help treat arthritis, seizures, anxiety, and illness-related loss of appetite. If you do decide to try CBD oil to treat a condition or alleviate symptoms, make sure you talk to your doctor before you begin taking it.
Where Can I Buy CBD Oil?
If it’s legal in your state of residence, you can buy CBD oil online or through dispensaries. Bottles of CBD oil or oil-based tinctures can cost anywhere from $30 to $70. (17,18)
Is CBD Oil Safe?
Experts say that for the purest, most effective oil, it’s a good idea to buy it from companies that follow these practices:
They use a carbon dioxide extraction method. This method ensures that you’re getting a potent oil that’s free (or nearly free) of harmful chemical by-products.They use third-party lab testing. This means that the company sends its CBD oil to a laboratory that’s going to examine the product and serve as an unbiased judge of its quality and safety.
Scientists say that it may be best to avoid using CBD vape pens. They’re made with a harmful chemical called propylene glycol, which is also used in e-cigarettes. When the temperature’s high enough, propylene glycol can turn into a molecule that can affect your lung tissue. And in a report published in JAMA in November 2017, researchers tested 84 CBD products sold online and found that 26 percent of those products contained less CBD than labeled. They also detected THC in an estimated 21 percent of the products. (19) If you’re concerned about safety and quality, it may be a good idea to talk to your dispensary about the growers they work with, or to the companies that manufacture the CBD products you use. A good vendor of CBD and other marijuana products will be up front about their processes and their safety profile. Read their websites carefully, and ask questions if you need to.
Is CBD Oil Safe for Teenagers?
As with adults, no one knows yet for sure what the long-term effects of regular use of CBD oil would be. Regular recreational use of THC is not beneficial for teenagers (20), but CBD is not psychoactive like THC and does not seem to act on the brain in the same harmful way. CBD-rich pharmaceutical-grade medical marijuana preparations have been shown to help treat seizures in children who suffer from rare forms of epilepsy — so much so that they were recently approved by the FDA. (21) But the research on those drugs was based on pharmaceutical-grade cannabis preparations, not what medical professionals call artisanal preparations: those made by small companies or by individuals who may or may not be capable of or willing to make sure that their product is free of potentially harmful impurities. In addition to the case report of palliative care use with a 14-year-old mentioned earlier, two physicians published a case report in the fall of 2016 in The Permanente Journal that discussed the use of CBD oil to treat the post-traumatic stress disorder–related anxiety and insomnia of a 10-year-old girl. After five months of treatment, the girl reported less anxiety and significantly improved sleep; she did not report any adverse or side effects. (10) In California, emancipated minors may apply for medical marijuana cards. (22) But the American Academy of Pediatrics says that it opposes medical marijuana outside of products that have been or can be approved by the FDA, citing recreational marijuana’s serious effects on adolescent health and development, such as reduced educational attainment. (23) Psychiatric disorders such as psychosis or mania may be worsened by chronic use of marijuana, and it may also worsen the effects of depression, according to the University of Washington’s Alcohol and Drug Abuse Institute. (25) According to the National Alliance on Mental Illness, if you are susceptible to these psychiatric disorders, your risk will increase the longer you use marijuana and the earlier you start regularly using marijuana. (26) A study published in March 2014 in Neuropsychopharmacology also found that regular marijuana use seemed to shrink the regions of the brain associated with emotional and motivational processing. (27) Research has further shown that long-term use can create respiratory problems such as chronic bronchitis. (1) But unlike with cigarettes, there is no evidence showing that smoking marijuana causes lung cancer. (28)
How Will Long-Term Medicinal Use of Marijuana Affect Me?
The research is still new and ongoing, so experts aren’t absolutely sure yet about what the long-term effects of marijuana for medicinal use may be. Since CBD does not produce as many adverse effects as THC, and helps mitigate those of THC, scientists are increasingly conducting more studies on the compound and its medical benefits.
Does Marijuana Come in Pill Form?
The FDA has approved the sale of four cannabis-based prescription drugs in the United States. Most recently, the FDA approved Epidiolex, a drug that is prescribed to treat seizures associated with Dravet syndrome and Lennox-Gastaut syndrome, two rare and severe forms of epilepsy. The others go by these names:
Marinol (dronabinol), prescribed to treat chemotherapy-related nauseaSyndros (dronabinol), prescribed to treat anorexia in those with AIDSCesamet (nabilone), prescribed to treat chemotherapy-related nausea
Each state also has a list of qualifying conditions that they’ve approved for the use of medical marijuana. These lists, while they vary from state to state, often include conditions like cancer, anxiety, and inflammatory bowel disease. Your state’s department of health website should tell you what the qualifying conditions are. No matter what state you’re in, in order to buy medical marijuana, you will have to take these steps:
Find a registered physician who will confirm in writing that you have a qualifying condition that would be improved by the drug.Submit this information to your state’s department of health.Receive an ID card that allows you to purchase medical marijuana at a dispensary.
States, and sometimes counties within states, charge fees for card applications. Some, like California, will waive or reduce the fee for eligible patients. (22) These fees are usually around $100 to $150 for a card that’s valid for one year. Some states, like Vermont, charge $50. (22,29,30) The fees increase if you want a card that’s valid longer. Depending on what state you live in, you can also purchase marijuana for recreational use at dispensaries. *To protect his privacy, Eric requested that his full name not be used.
