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An Introduction to Medical Cannabis

Medical cannabis – a millennia-old medical remedy
Although cannabis use for medical purposes is a relatively new phenomenon in the United States, cannabis has been used to treat medical ailments for millennia. In ancient Chinese and Indian societies, cannabis was used to treat gout, malaria, dysentery, and rheumatism, among other conditions. In the Middle Ages in Europe, it was used to treat cough, tumors, and other conditions. And in China almost 2,000 years ago, medical cannabis was used as an anesthetic.

The United States and cannabis
The history of cannabis use in the United States has been complex. Until recently, the use of cannabis, for both medical and recreational purposes, was restricted. In 1906, the Food and Drug Administration (FDA) was created to prevent a morphine addiction crisis, and it mainly controlled opium and morphine during this time. Under the Harrison Act in 1914, all drug use, including cannabis, was declared a crime and in 1937 the Cannabis Tax Act was passed, making the use of non-medical cannabis illegal. In 1970, cannabis was categorized as a Schedule I drug, along with other significantly more dangerous drugs (ex: heroin, LSD). In addition, the government restricted further research on the impacts of cannabis on the body. The reason for making cannabis a Schedule I drug is likely tied to political reasons. Research moved quite slowly for decades due to government restrictions. Given the pain epidemic and need for improved and safer pain control, as well as the other historical benefits of cannabis, significant research is now being done on the impacts and effects of cannabis on the human body. As a result of the relative safety of cannabis compared to other drugs, both legal (ex: alcohol) and illegal, as well as the demand for further research, cannabis is now legal for recreational use in 10 states and for medical use in 33 states.

Cannabis is still technically classified as a Schedule 1 drug, which makes the legal procurement of cannabis for research a difficult a laborious process. This makes any research on the subject more difficult than it should be. Despite these restrictions, there has still been quite a lot of research performed and to date, the three conditions that have shown the most benefit are chronic pain, muscle spasms (associated with multiple sclerosis), and nausea and vomiting. However, secondary outcomes in numerous studies have found other benefits as well, including improvements in sleeping habits, quality of life, gastrointestinal symptoms, PTSD symptoms, and in seizure disorders, as well as decreased anxiety and stress. As the endocannabinoid system (the chemical system in the body affected by cannabis) is found in almost every organ, it makes sense that influencing its activity could yield benefit (or potential harm) in many ways. In future posts, I will discuss the known impacts of cannabis on the different organ systems and diseases for which there is available research. I will also talk about the exciting preclinical research that will help guide future clinical trials. Overall, the available research shows that there is clinical benefit, we simply need more research to determine where the benefits are greatest.

Take home message
Make no mistake, cannabis is not now, and likely never will be, the cure for everything that ails you. For example, there have been news articles about the potential for cannabis to cure cancer. Although the research being done is quite exciting and preclinical trials have found anti-tumoral effects of cannabis and cannabis-based products, no clinically relevant research has been completed to demonstrate such an effect in a human population. This doesn’t mean that there is no effect, only that more research needs to be completed before it becomes a relevant conversation for patients. Furthermore, some of the conditions for which the prescription of medical cannabis is allowed don’t seem to have any benefit found in a reputable research article, and may in fact have harmful effects (ex: in patients with hepatitis C, cannabis use may increase the fibrotic process that eventually leads to cirrhosis).

This blog is not meant to promote specific products. Rather, it is meant to be an educational tool for patients and providers to understand the potential benefits and harms of cannabis. We will start with the information that we know to date and will keep you posted as more studies and evidence becomes available. If anyone has specific topics they would like covered, please let us know and we will try to address them in future articles.

Comment: the disclaimer at the bottom of this post is meant to apply to all posts and shouldn’t just be on this post (although this is a good place to start). It either needs to be included in all posts or in a readily visible section for readers. It should also be approved by a legal department to make sure that it protects us from getting into any trouble.

By |2019-04-18T19:56:53+00:00March 5th, 2019|Editorials, Marijuana|0 Comments

About the Author:

Dr. Bressman attended Swarthmore College, where he received a bachelors degree with a focus on biology, before attending the NYU School of Medicine, currently ranked as the #3 medical school by the US News Rankings. He is currently a resident in Internal Medicine at Montefiore Medical Center in the Bronx, NY. Dr. Bressman has participated in both basic science research, as well as clinical research, with multiple publications and awards. Most recently he was named the winner of the Trainee Award at the national conference for Society of Hospitalist Medicine for a rare case involving licorice toxicity. When not hard at work, Dr. Bressman can usually be found on the golf course or cooking at home.

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