Q: I have several friends who have been advised to use marijuana products for medical problems that I also have been developing. What are the latest recommendations for medical marijuana use?
A: The marijuana plant contains over 100 different chemicals, referred to as cannabinoids; the ones that have shown some promise and by far the most studied regarding medical uses are tetrahydrocannabinol (THC) and cannabidiol (CBD).
THC has been shown to be at least as addictive as nicotine, though pure CBD has not been found to be addictive and has an added advantage, unlike THC, of having no effect on blood pressure.
Most states currently allow some form of THC/CBD use, many for not only medicinal use, but also for recreational use, including Michigan. Most of the relevant laws have not been written in very clear fashion and seemingly without a basis of sound medical research.
FDA-approved formulations of THC/CBD include: 1. Epidiolex was approved in 2018 (for use in adults and children over 1 year of age) for Dravet Syndrome and Lennox-Gastaut Syndrome, uncommon pediatric seizure disorders that respond only poorly to usual anti-epileptic regimens, but have been noted to improve dramatically with use of CBD; and 2. Dronabinol and nabilone (generic names for man-made drugs (known by their brand names [respectively] Marinol and Cesamet) for the nausea & vomiting often resulting from chemotherapy.
Other non-FDA-approved uses include: 1. Pain control, particularly chronic nerve pain, fibromyalgia, endometriosis (uterine), and interstitial cystitis (chronic bladder inflammation). One distinct advantage of THC is that it is far less addictive than opiates.
2. For mild to moderate pain, THC and CBD can take the place of NSAIDs (nonsteroidal anti-inflammatory drugs) for those who cannot tolerate NSAIDs, such as in cases of kidney failure, stomach ulcers, and GERD (gastroesophageal reflux disease).
3. Glaucoma. 4.Weight loss (especially with cancer and AIDS).
5. Post-traumatic stress disorder (PTSD) – currently under study and showing some promise for veterans with this disorder.
6. Wasting syndrome associated with HIV/AIDS.
7. In severe cases of inflammatory bowel disease (ulcerative colitis and Crohn’s Disease).
CBD has also shown promise in treating the tremors associated with Parkinson’s Disease, though definitive results have yet to be published.
As with any other drug, THC has fairly well-defined side effects that include fatigue, diarrhea, bloodshot eyes, depression, dizziness, rapid pulse, appetite changes (usually increased), hallucinations, low blood pressure, and impaired judgment and coordination.
Another concern is that storebought marijuana varies widely in potency and purity, because there are no regulations regarding dosage standardization or limitations on what other chemicals can be added to the product. Other chemicals— such as fentanyl—added to such products are regularly associated with increased toxicity and even death, usually due to respiratory failure from suppression of the automatic breathing mechanisms in the brain.
Another major concern is that when used in teenage years, when the brain has not yet fully developed, and particularly in males, regular marijuana use is associated with lowered IQ, slow mental functioning, and significantly increased risk of various psychiatric disorders, often serious enough to warrant long-term hospitalization.
Thanks to John R. for this question. To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website familydoctor. org, where you can search for your topic of interest.
If you have a particular topic you would like to hear about, please message me at paulmdake@gmail. com.
Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.
