Hi, Dr. D’Andre, integrative oncologist, here. I often have patients asking about cannabis for different health conditions, so I put together the most common questions I get. If you are considering using medical cannabis, talk to your primary care provider or a cannabis clinician to see if it may be OK to try.
What conditions can cannabis help treat?
Cannabis, also known as marijuana, can help with a variety of symptoms and medical conditions. In states where cannabis is legal only medically, these conditions or symptoms may qualify you to obtain cannabis:
- Chronic pain
- Cancer-related symptoms
- Multiple sclerosis and associated muscle spasms
- HIV/AIDS
- Tourette syndrome
- Amyotrophic lateral sclerosis (ALS)
- Post-traumatic stress disorder (PTSD)
- Inflammatory bowel disease (IBD)
- Seizures/epilepsy
- Autism
- Obstructive sleep apnea
- Alzheimer’s disease
- Glaucoma
- Sickle cell disease
- Terminal illness
There is some evidence that cannabis use can help alleviate these conditions or symptoms. For people with cancer, evidence suggests that cannabis may help pain, nausea and recovery from severe weight loss.
What is the difference between CBD and THC?
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the most common active compounds (cannabinoids) found in the cannabis plant. But there are many other cannabinoids and compounds present as well.
THC is the compound that causes the “high” feeling and many of the side effects. But THC may also be responsible for many of the beneficial effects of cannabis.
CBD does not produce a high but can have other effects on the mind and body. CBD used alone is approved in a prescription form for treating certain children with seizure disorders. CBD derived from hemp is available widely in many products and may be helpful for anxiety, muscle pain and tightness, but more research is needed. The combination of CBD and THC in medical products may be broadly useful for many conditions.
What is the difference between hemp and cannabis?
Cannabis plants can be bred to produce different compounds. Hemp plants are generally taller and produce fewer flowers. Hemp plants have mostly CBD and have no more than 0.3% THC. Though cannabis is illegal at a federal level, because of the low level of THC in these plants, hemp is legal under the 2018 U.S. Farm Bill. Hemp-based products are widely available. However, the quality of many of these products is questionable. Other cannabis plants are bred to have much more THC and other cannabinoids. These plants are used to make the various products found for sale in dispensaries.
What are the different forms of cannabis products?
Dispensaries have many different types of products. The availability of different products varies by state, but products can include:
- Capsules
- Tinctures or oils, which are drops that you place under your tongue or swallow
- Edibles, such as cookies or candies
- Vaped formulas and dried flowers for smoking
- Skin products, including creams and patches
All of these forms work differently. Generally, oral products and tinctures take effect more slowly but can last many hours. Inhaled products act very quickly but don’t last as long. Creams do not produce a high and have not been reported to cause any major side effects, but more data is needed. Patches are designed to get the product into your bloodstream, and may possibly cause a high. It is important to work with a pharmacist or a health care provider to figure out what products to consider.
Does cannabis treat cancer?
Honestly, we don’t know if cannabis can help treat cancer. In cell models and animal experiments, there does seem to be some anti-cancer activity, but it is complicated! It seems that each type of cancer may respond differently to different products. There are no high-quality studies in humans to tell us what products or doses to use in cancer. We need more trials in humans to determine if cannabis is an effective anti-cancer agent.
How would I get cannabis?
To obtain cannabis, you need to check to see what is legal in your state. Some states have legalized recreational and medicinal cannabis, so access is easier. In these states, high-quality products are consistently found at dispensaries. States that have legalized only medical cannabis require you to obtain a medical card or certification through a state-run program, after which you can purchase products at dispensaries. In some states, cannabis is still illegal.
CBD-only products can be obtained online and without a prescription, but the quality of these products is unknown, as they are not regulated. One study showed many products were not as advertised and actually had some THC in them.
What are the downsides to using cannabis?
Cannabis is not for everyone. People who have active heart disease or severe kidney, liver or lung diseases, are pregnant or breastfeeding, have certain psychiatric conditions, or have a history of addiction should not take cannabis. Cannabis can also affect fertility.
THC can cause side effects, most commonly confusion or mental changes, fast heart rate, dry mouth, red eyes, dizziness and nausea. CBD at higher doses can also cause side effects such as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. Cannabis can also interact with certain medications such as blood thinners and some seizure medications, so work with your providers to make sure it is safe.
Some early reports show that cannabis use may be a risk factor for certain HPV-related head and neck cancers and may interfere with cancer immunotherapy. More studies are needed. Long-term cannabis users can have other health issues. These include lung problems in those who smoke cannabis and poor memory. Despite popular views to the contrary, cannabis use does include risk of addiction and withdrawal.
Cannabis also does not work for everyone. It may take time and patience to figure out whether it will work for you.
To sum it up, cannabis may be useful for a variety of health conditions, but more research is needed in many areas, including cancer. Many forms of cannabis are available. Work with a knowledgeable provider to help guide its safe and effective use. There are side effects and risks to be aware of if you choose to use cannabis.
