Cannabis continues its rise in popularity as more and more states legalize its use either as a medical or recreational drug. Cannabis remains illegal at the federal level, but a number of medical experts and researchers appear to disagree with this decision maintained by the U.S. Drug Enforcement Administration (DEA).
While more peer-reviewed clinical research is needed, myriad studies support cannabis as a legitimate and safe therapeutic substance when used properly under expert supervision. Learn more about the various medical conditions cannabis can help treat, as well as what industry experts have to say about cannabis use.
What Is Cannabis?
Cannabis sativa, or cannabis, is a complex plant that belongs to the Cannabaceae family. It contains about 540 chemical compounds, including more than 100 cannabinoids, the most well known of which are tetrahydrocannabinol (THC) and cannabidiol (CBD).
The term “marijuana” typically refers to components of the cannabis plant that contain significant amounts of THC. Meanwhile, hemp describes components of cannabis plants that contain less than 0.3% THC by dry weight, according to the federal U.S. government.
THC is the compound that gives cannabis its reputation as an intoxicating, psychoactive drug, because of the feelings of euphoria, decreased anxiety, and increased relaxation it elicits. THC and other cannabinoids found in cannabis plants can have psychoactive effects on the human body due to how they interact with the endocannabinoid system, which regulates pain, appetite and the response to stress, says Daniele Piomelli, Ph.D., director of the Center for the Study of Cannabis at the University of California, Irvine.
Potential Health Benefits of Cannabis
New research supports a number of potential health benefits of cannabis containing THC (as opposed to containing CBD exclusively).
Managing Chemotherapy Side Effects
The U.S. Food and Drug Administration (FDA) approved several prescription drugs featuring synthetic substances similar to THC to help people navigate the uncomfortable side effects often experienced with cancer chemotherapy. Marinol and Syndros both contain dronabinol (synthetic THC), which is used to treat nausea and vomiting. Meanwhile, Cesamet contains nabilone, another synthetic substance similar to THC, and is also used to address nausea and vomiting, as well as loss of appetite and weight in patients with HIV/AIDS.
Managing Multiple Sclerosis Spasticity
Sativex, an oral spray medication available by prescription, contains both THC and CBD and is used in 25 countries to help treat muscle stiffness and spasms caused by multiple sclerosis. In Canada specifically, Sativex is used as an adjunctive treatment (alongside a primary treatment) in adult patients who haven’t responded well enough to other therapies and show meaningful improvement during an initial trial with the drug. In the U.S., Sativex is still being tested as a treatment for adults with multiple sclerosis spasticity.
Addressing Chronic Pain
Evidence suggests medications that combine THC and CBD can be effective treatments for chronic pain, particularly neuropathic pain (pain caused by nerve damage), nociceptive pain (pain caused by ongoing inflammation and related damage) and nociplastic pain (pain arising from the altered function of pain-related sensory pathways), according to a 2022 review of clinical research in Inflammopharmacology. The researchers add that this combination of cannabinoids tends to be more easily tolerated, safer and less addictive than opioid-based analgesics[1].
Improving Sleep Quality
A 2018 study in Sleep found participants with obstructive sleep apnea (OSA) who took dronabinol (synthetic THC) before bed experienced a reduction in the number of times their breathing was interrupted during sleep. The 10-milligram dose performed better than the 2.5-milligram dose and placebo. Participants also experienced stronger sensations of sleepiness[2].
Another 2014 study in the Journal of Clinical Sleep Medicine also observed an association between dronabinol use and improved sleep metrics in patients with OSA[3].
More Potential Health Benefits of Cannabis
Krissy Bernazani, registered pharmacist and clinical director at medical cannabis dispensary Zen Leaf Maryland, says the most common health and wellness needs she and her team address with cannabis include:
- Migraine
- Neuropathy
- Nausea and vomiting
- Appetite loss
- Inflammation
- Inflammatory bowel disease
- Rheumatoid arthritis
Bernazani adds that many medical cannabis patients turn to cannabis after failing to find relief with other more traditional pharmaceuticals.
Potential Health Risks of Cannabis
Health care providers and cannabis experts stress that the general safety profile of cannabis is unlike most other drugs, including many legal pharmaceuticals. Still, cannabis use can cause short-term and long-term effects in different populations depending on the type and amount of cannabis used.
Side Effects
Consuming excessive amounts of THC may lead to side effects including:
- Panic
- Anxiety
- Drowsiness
- Dry mouth
- Impaired motor function and coordination
- Elevated heart rate
- Dizziness
Adverse side effects are more common in women, according to Dr. Piomelli. A small number of inexperienced users may experience vomiting, he adds, which can be treated easily with a hot shower or putting hot chili pepper ointment on the skin.
Smoking Risks
Smoking cannabis (or any other substance, for that matter) poses a risk for people with pulmonary disease, adds Bernazani. When mixing cannabis and tobacco together, a person also assumes the risks associated with tobacco use, such as lung, head and neck cancer, warns Brooke Worster, M.D., chief medical consultant at Ethos Cannabis and assistant professor at Thomas Jefferson University.
Vulnerable Populations
For growing adolescents, it’s unclear how regular cannabis use may alter their bodies and brains—perhaps forever, says Dr. Piomelli. Similarly, little clinical data exists to address how general cannabis use could affect a pregnant person and their fetus(es), he adds. Smoking cannabis is linked to smaller fetus size, although it’s unclear whether the act of smoking or cannabis itself is responsible for this observation. Regardless, Dr. Piomelli cautions against regular cannabis use in both of these populations.
THC may also exacerbate symptoms of schizophrenia and other forms of psychosis in people already predisposed to such psychological conditions.
Drug Interactions
Cannabis may produce adverse effects when interacting with other drugs a person may already take, such as warfarin (a commonly prescribed blood thinner), certain chemotherapy agents, anti-seizure medications, anti-rejection medications used after a transplant surgery or other medications with a “narrow therapeutic index,” warns Bernazani. Drugs where small differences in dose or blood concentration can lead to serious therapeutic failures and/or adverse, life-threatening reactions have a narrow therapeutic index, according to the FDA.
How Sourcing Can Affect Cannabis Quality
It’s crucial to pay attention to the source from which you buy your cannabis to ensure that you’re consuming safe, well-tested products.
“Getting cannabis from regulated state dispensaries certainly adds reliability to the composition and quality of the products,” says Dr. Worster. “They must be tested and labeled so you know what’s in them.” Buying products online, from retail food stores or otherwise doesn’t provide that same level of quality control. In doing so, a person risks purchasing a product containing potentially harmful undisclosed ingredients or substances, such as butane, propane and brodifacoum.
National cannabis provider Verano is an example of the level of quality and transparency a person should look for when purchasing any cannabis product. “Our seed-to-sale operations are specifically structured to maintain clarity, consistency and quality across the 13 states we currently operate in,” says George Archos, founder and chief executive officer of Verano.
During a visit to Verano’s New Jersey facility, Forbes Health learned that Verano clones its existing cannabis plants rather than growing them from new seeds each time to maintain consistency across products made from the plants. All products are then chemically tested by a third-party, state-accredited laboratory to confirm levels of THC, CBD and other cannabinoids in the products, as well as disclose the presence of any heavy metals, pesticides and molds. Verano publicly shares full reports of these results on each of its products in documents called certificates of analysis (COAs).
A Word of Caution
Cannabis farming and product manufacturing lack federal guidelines and fixed medical and recreational use regulations from state to state, leading to varying levels of quality and questions of safety.
For the best experience, visit a licensed dispensary and speak directly with a budtender, a cannabis expert who works at the dispensary, recommends Mack Hueber, president of New York-based cannabis beverage company Ayrloom and chief financial officer of its parent company Beak & Skiff. “Everyone has a different reason to consume cannabis,” he says. “[Budtenders] know the brand, and they know all the products they’re carrying. They [can] work with the customer to understand what they’re looking for.” (Full Story)