Medical and/or recreational cannabis is now legal in 29 states and Washington, DC. With a reported 85 percent voting positively, Americans are in favor of legal access to medical marijuana. What conditions can medical marijuana be used for? Although research is still relatively limited, here is what we do know about the health conditions alleviated by marijuana use.
Research on Medical Marijuana
Most recently, an August 2018 study conducted at the University of New Mexico found that cannabis provided relief for various chronic health conditions, including insomnia, anxiety, depression, and pain, with few unpleasant side effects. Researchers created an app called Releaf through which more than 100,000 registered users could chart and track how cannabis consumption affected their medical conditions.
The research, which was published in Frontiers in Pharmacology, found that for the 27 conditions studied, users reported average symptom reduction of 2.8 to 4.6 points on a 10-point scale. For example, a person with chronic pain at a nine might report pain reduced to a five after consuming medical cannabis. What’s more, 94 percent of users reported that marijuana had a positive effect on their symptoms.
Although the studies below are promising, many are also quite small. These positive results will be corroborated with additional research and large-scale clinical trials, particularly as ever more states legalize medical cannabis.
AIDS and HIV
A 2007 study published in Neurology found that smoking marijuana daily reduced the chronic neuropathic pain associated with HIV and AIDS. More than half the patients studied (52 percent) reported pain reduction of more than 30 percent after using cannabis compared to just 24 percent of patients in the placebo group. These results are comparable to those achieved with oral medications for neuropathy prescribed to this population.
Another study, this one published the same year in the Journal of Acquired Immune Deficiency Syndrome, found that smoking marijuana improved sleep, appetite and mood for HIV-positive study participants. What’s more, the researchers found no evidence of cognitive impairment among the study group prescribed cannabis.
Weight loss can be an issue for individuals who have Alzheimer’s disease. Cannabis has been found to improve appetite and reduce agitation, another common symptom of dementia, among these individuals. Research to this effect was published in a 2016 study in the Journal of Alzheimer’s Disease. What’s more, research published in Molecular Pharmaceutics in 2006 found that the chemical compounds in cannabis may slow the development of protein deposits in the brain that contributes to Alzheimer’s disease. This was corroborated by a 2014 study published in the Journal of Alzheimer’s Disease, which specifically looked at the effects of THC on these proteins.
The chronic pain and inflammation associated with arthritis can be physically debilitating. Several studies have indicated a link between medical cannabis and pain reduction for those who have arthritis and other chronic pain syndromes. Research published in the journal Rheumatology found that cannabis had a significant positive impact on sleep quality as well as pain at movement and at rest for the study group of patients with rheumatoid arthritis. The Journal of Neuroimmunology also found that cannabinoids interact with the body’s immune system, which may indicate the potential for the treatment of inflammatory diseases such as autoimmune syndromes.
Several animal studies have examined the impact of cannabinoids on cancer cells and found that marijuana consumption may kill these cells and/or slow their growth. As reported in the journal Molecular Cancer Therapeutics, rodent studies show that CBD inhibits the growth of certain types of brain tumors. It may also increase the impact of radiation on the destruction of cancer cells.
Medical cannabis also has a documented ability to ease unpleasant chemotherapy side effects such as nausea and loss of appetite. The National Cancer Institute reports that CBD can lower anxiety and reduce pain and inflammations experienced by cancer patients, without the intoxicating effects associated with THC. In fact, two CBD varieties (nabilone and dronabinol) are FDA-approved to treat nausea caused by cancer treatment.
Chronic Pain Relief
Cannabis has been used as a pain relief mechanism for centuries, and both animal and human research backs its effectiveness for treating chronic pain. A 1999 publication from the National Academy of Science, Marijuana and Medicine: Accessing the Science Base, reported that cannabis produces a “substantial analgesic effect.”
In a 2018 post on the Harvard Medical School blog, Dr. Peter Grinspoon noted that chronic pain relief is the most common reason for patients to use medical cannabis. He indicated that it is especially effective for nerve pain that is challenging to treat through other means, and touts its muscle relaxant properties and potential uses to treat endometriosis, cystitis and fibromyalgia.
Medical marijuana can make life more bearable for those who suffer from extreme stomach pain associated with Crohn’s disease. A pilot study published by the journal Digestion in 2012 also demonstrated that individuals with Crohn’s and ulcerative colitis who used cannabis for three months gained more weight and had fewer episodes of diarrhea than their counterparts.
Cannabis has the potential to control certain types of treatment-resistant seizures for those with epilepsy. Early clinical trials at NYU Langone Medical Center looked at 213 pediatric and adult patients and found that the frequency of these seizures decreased by 50 percent with CBD oil treatment. Based on this research and related studies, the FDA approved Epidiolex, a CBD-derived oral prescription medication to treat two specific types of epilepsy (Dravet syndrome and Lennox-Gastaut syndrome), in June 2018. The drug is not yet available to patients, however.
A second study by the team at the University of New Mexico that pioneered the Releaf app described above specifically examined the effects of medical cannabis on insomnia. The results mirrored those of the first study, with those who used marijuana for sleeplessness during the study reporting symptom reduction of up to five points. These results varied depending on the strain and method of ingestion, however.
Multiple Sclerosis and Other Neurological Conditions
Individuals with muscle stiffness as a side effect of multiple sclerosis (MS) may experience relief with medical marijuana. As reported by the National MS Society, a 2012 clinical trial showed marked improvement in this symptom as well as in quality of sleep and presence of spasms and muscle pain among those who were prescribed oral cannabis extract compared to the placebo group. An oral cannabis spray called nabixomols is available in 15 nations (not including the U.S.) to treat muscle spasticity in those with MS.
According to the American Academy of Neurology, research is ongoing about how CBD can alleviate the symptoms of other neurological conditions, such as Tourette’s disease, Huntington disease, and Parkinson’s disease. Israeli research published in the clinical journal Neuropharmacology in 2017 found that Parkinson’s patients saw symptom improvement with medical cannabis, including decreased pain, tremors and muscle stiffness, improved mood, and better quality of sleep.
The National Institute of Drug Abuse (NIDA) is currently funding studies on the potential role of medical marijuana in treating opioid dependency. Early research indicates cannabis use may be able to reduce the prescribed opioid dose for patients with chronic pain. Population-based analyses by NIDA show a link between access to medical marijuana and fewer opioid overdose deaths, prescriptions, self-reports of misuse and admission to addiction treatment for opioids.
Canadian research published in The International Journal of International Drug Policy in 2017 found that 63 percent of the nation’s medical marijuana patients use cannabis to replace other prescription medications, including opioids (30 percent of survey respondents), benzodiazepines (16 percent) and antidepressants (12 percent). The reason? Most reported that marijuana offers comparable relief for their chronic conditions with fewer unwanted side effects than other prescription medications.
Post-Traumatic Stress Disorder (PTSD)
According to the Grinspoon article, veterans and their therapists have reported substantial progress in treating combat-related PTSD with medical marijuana. Anecdotally, cannabis has shown promise in treating other chronic mental health conditions, including anxiety and depression. Phase 2 of the first FDA-approved study researching the effects of medical cannabis on PTSD in the veteran population began in May 2018. This University of Colorado-funded research is the first study of its kind anywhere in the world, heralding a new era of federally approved cannabis studies.
Taking Medical Cannabis
Medical marijuana contains active ingredients called cannabinoids (CBD), which are similar to chemicals in the body that impact appetite, pain, memory, and movement. The human brain has an endocannabinoid system that reacts to these chemicals, which may account for the reported therapeutic effects of cannabis.
Cannabis can be smoked and vaporized to obtain an immediate effect or it can be taken in edible form, which provides relief within about two hours. Sublingual drops can be placed under the tongue. Topical creams and lotions are available for chronic pain and inflammation associated with injury or overuse. The types of ingestion methods available to medical cannabis patients and the conditions that can be treated with marijuana vary dramatically by state law.
One type of cannabinoid, THC, is responsible for the high associated with marijuana. Cannabis strains with THC content will produce effects that may include euphoria, relaxation, increased appetite, reddened eyes, delayed motor reactions, and anxiety. These vary by individual and by the method of ingestion. CBD-only strains, which have limited THC content, do not create psychoactive effects and are thus preferred by many medical users.
Serious negative side effects associated with medical cannabis are rare. According to the Journal of the American Medical Association as reported by Americans for Safe Access, marijuana has no recorded lethal dose. It is less addictive and better tolerated than many existing prescription medications to treat some of the same conditions for which cannabis is effective. Although concerns exist about the effects of marijuana smoke on the lungs, many medical cannabis users avoid this issue by relying on vaporizers. Some users do experience a rapid heart rate and dilated blood vessels, so it’s important to consult your doctor before using cannabis if you have a pre-existing cardiac condition.
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