Some allow medical marijuana dispensaries and home cultivation. Others only allow home cultivation.

And some allow dispensaries but not home cultivation.

There’s a growing body of research supporting marijuana’s use for medical purposes. Some studies and
anecdotal evidence suggest marijuana can be used for various medical problems, including pain, nausea
and loss of appetite, Parkinson’s disease, inflammatory bowel disease, PTSD (post-traumatic stress
disorder), epilepsy, and multiple sclerosis.

But a review of the evidence from the National Academies of Sciences, Engineering, and Medicine found
little evidence for marijuana’s ability to treat health conditions outside chronic pain, chemotherapy-
induced nausea and vomiting, and patient-reported multiple sclerosis spasticity symptoms.

Several studies show legalizing medical marijuana dispensaries can lead to fewer opioid painkiller
deaths, making medical marijuana one potential way to help fight the opioid epidemic. The rationale for
this is simple: Studies show medical marijuana can effectively treat chronic pain, which opioids are
commonly used for. But unlike opioids, medical marijuana cannot cause deadly overdoses. So medical
marijuana could supplant some opioid use and save some lives.

Medical marijuana legalization also has a lot of popular support: A 2010 Pew Research Center survey
found that 73 percent of American voters back medical marijuana, including 80 percent of Democrats, 76
percent of independents, and 61 percent of Republicans.

But the federal government doesn’t recognize marijuana’s medical potential, largely because the studies
have been small so far, and there have been no large-scale clinical trials proving pot’s medicinal value.

Behind that judgment, though, lies a bit of a catch-22: It’s long been difficult to conduct thorough studies
on the medical uses of marijuana because of the drug’s prohibition and the need for approval from a
federal government that hasn’t been very interested in studying marijuana’s potential benefits. So the
federal government is demanding scientific research proving marijuana has medical value, but the
federal government’s restrictions make it difficult to conduct that research.

For legalization advocates, getting the federal government to acknowledge marijuana’s medical value
could be a significant step forward. For one, it would push the Drug Enforcement Administration to
reclassify marijuana from a schedule 1 to a schedule 2 substance, which could relax some of the
restrictions on the drug. That alone would amount to a huge symbolic shift: After decades of scheduling
marijuana in the strictest possible category, a downgrade could be taken as an acknowledgment by the
federal government that its old policies have failed.

There are no documented deaths from a marijuana overdose, but that doesn’t mean pot is harmless.

”The main risk of cannabis is losing control of your cannabis intake,” Mark Kleiman, a drug policy expert
at New York University’s Marron Institute, said. “That’s going to have consequences in terms of the
amount of time you spend not fully functional. When that’s hours per day times years, that’s bad.”

Jon Caulkins, a drug policy expert at Carnegie Mellon University, put it another way: “At some level, we
know that spending more than half of your waking hours intoxicated for years and years on end is not
increasing the likelihood that you’ll win a Pulitzer Prize or discover the cure for cancer.”

The risk of misuse and addiction (known in medical circles as ”cannabis use disorder”) is compounded by
the widespread perception that pot is harmless: Since many marijuana users believe what they’re doing
won’t hurt them, they feel much more comfortable falling into a habit of constantly using the drug.

The most thorough review of the research yet, from the National Academies of Sciences, Engineering,
and Medicine, found that pot poses a variety of possible downsides — including for respiratory problems
if smoked, schizophrenia and psychosis, car crashes, general social achievement in life, and potentially
babies in the womb.

But it doesn’t seem to cause some issues that are typically linked to tobacco, particularly lung cancer and
head and neck cancers. And the studies reviewed also suggest it carries several benefits, particularly for
chronic pain, multiple sclerosis, and chemotherapy-induced nausea and vomiting. (There wasn’t enough
research to gauge if pot is truly good for some of the other ailments people say it’s good for, such as
epilepsy and irritable bowel syndrome.)

Critics of legalization claim that marijuana is a “gateway drug” that can lead people to try more
dangerous drugs like cocaine and heroin, because there’s a correlation between pot use and use of
harder drugs. But researchers argue that this correlation may just indicate that people prone to all sorts
of drug use only start with marijuana because it’s the cheapest and most accessible of the illicit drugs. So
if cocaine or heroin were cheaper and more accessible, there’s a good chance people would start with
those drugs first.

Overall, marijuana is a relatively safe drug — certainly less harmful than some of the drugs that are legal
today, and potentially beneficial to some people’s health through its medical use. But it’s not harmless.

Given that marijuana’s harms appear to be relatively small, though, advocates argue that, even if
legalization leads to more pot use, it’s worth the benefit of reducing incarceration and crippling violent
drug cartels financed in part by revenue from illicit weed sales

A growing number of states, however, have legalized the use and/or cultivation of marijuana for medical
(and even recreational) purposes, thereby removing any criminal penalties from doctors who prescribe
the drug or from patients who use it within the bounds set by state law. California was the first to
legalize medical marijuana in 1996 when it passed Proposition 215, also called the Compassionate Use
Act. The law allows the possession and cultivation of marijuana for medical purposes upon a doctor's
recommendation.

A majority of states have legalized medical marijuana, including the following:

Arizona - The state allows patients with a written certification from their doctor to possess up to 2.5 oz.
of usable cannabis and the cultivation of up to 12 plants (no cultivation within 25 miles of a licensed
dispensary).

Florida - Patients with a doctor's recommendation may possess a 70-day supply (exact amounts not
specified) and aren't allowed to grow their own supply; dispensaries are licensed by the Florida
Department of Health.

Illinois - Eligible patients must register with the state and may possess up to 2.5 oz. of usable cannabis;
cultivation is not allowed under the law and patients must select a designated state-licensed dispensary.

Minnesota - Eligible patients may possess a 30-day supply of non-smokable cannabis (edibles and other
such preparations), as determined by the patient's doctor; only licensed providers may cultivate the
herb.

Oregon - Patients with a signed doctor's recommendation may possess up to 24 oz. of usable marijuana
and may cultivate up to 24 cannabis plants (only six may be mature).

These state medical marijuana laws typically set the boundaries under which the herb may be
recommended, cultivated, possessed and used. For instance, states may require written documentation
from a person's doctor affirming that the person suffers from a debilitating condition and might benefit
from the medical use of marijuana. Also, states may require people to present this documentation, or
"marijuana ID card" prior to an arrest.

There are few subjects that can stir up stronger emotions among doctors, scientists, researchers, policy
makers, and the public than medical marijuana. Is it safe? Should it be legal? Decriminalized? Has its
effectiveness been proven? What conditions is it useful for? Is it addictive? How do we keep it out of the
hands of teenagers? Is it really the “wonder drug” that people claim it is? Is medical marijuana just a
ploy to legalize marijuana in general?

These are just a few of the excellent questions around this subject, questions that I am going to
studiously avoid so we can focus on two specific areas: why do patients find it useful, and how can they
discuss it with their doctor?

Marijuana is currently legal, on the state level, in 29 states, and in Washington, DC. It is still illegal from
the federal government’s perspective. The Obama administration did not make prosecuting medical
marijuana even a minor priority. President Donald Trump promised not to interfere with people who use
medical marijuana, though his administration is currently threatening to reverse this policy. About 85%
of Americans support legalizing medical marijuana, and it is estimated that at least several million
Americans currently use it.

Marijuana without the high

Least controversial is the extract from the hemp plant known as CBD (which stands for cannabidiol)
because this component of marijuana has little, if any, intoxicating properties. Marijuana itself has more
than 100 active components. THC (which stands for tetrahydrocannabinol) is the chemical that causes
the “high” that goes along with marijuana consumption. CBD-dominant strains have little or no THC, so
patients report very little if any alteration in consciousness.

Patients do, however, report many benefits of CBD, from relieving insomnia, anxiety, spasticity, and pain
to treating potentially life-threatening conditions such as epilepsy. One particular form of childhood
epilepsy called Dravet syndrome is almost impossible to control, but responds dramatically to a CBD-
dominant strain of marijuana called Charlotte’s Web. The videos of this are dramatic.

Uses of medical marijuana

The most common use for medical marijuana in the United States is for pain control. While marijuana
isn’t strong enough for severe pain (for example, post-surgical pain or a broken bone), it is quite effective
for the chronic pain that plagues millions of Americans, especially as they age. Part of its allure is that it
is clearly safer than opiates (it is impossible to overdose on and far less addictive) and it can take the
place of NSAIDs such as Advil or Aleve, if people can’t take them due to problems with their kidneys or
ulcers or GERD.

In particular, marijuana appears to ease the pain of multiple sclerosis, and nerve pain in general. This is
an area where few other options exist, and those that do, such as Neurontin, Lyrica, or opiates are highly
sedating. Patients claim that marijuana allows them to resume their previous activities without feeling
completely out of it and disengaged.

Along these lines, marijuana is said to be a fantastic muscle relaxant, and people swear by its ability to
lessen tremors in Parkinson’s disease. I have also heard of its use quite successfully for fibromyalgia,
endometriosis, interstitial cystitis, and most other conditions where the final common pathway is chronic
pain.

Marijuana is also used to manage nausea and weight loss, and can be used to treat glaucoma. A highly
promising area of research is its use for PTSD in veterans who are returning from combat zones. Many
veterans and their therapists report drastic improvement and clamor for more studies, and for a
loosening of governmental restrictions on its study. Medical marijuana is also reported to help patients
suffering from pain and wasting syndrome associated with HIV, as well as irritable bowel syndrome and
Crohn’s disease.

This is not intended to be an inclusive list, but rather to give a brief survey of the types of conditions for
which medical marijuana can provide relief. As with all remedies, claims of effectiveness should be
critically evaluated and treated with caution.

Talking with your doctor

Many patients find themselves in the situation of wanting to learn more about medical marijuana, but
feel embarrassed to bring this up with their doctor. This is in part because the medical community has
been, as a whole, overly dismissive of this issue. Doctors are now playing catch-up, and trying to keep
ahead of their patients’ knowledge on this issue. Other patients are already using medical marijuana, but
don’t know how to tell their doctors about this for fear of being chided or criticized.
My advice for patients is to be entirely open and honest with your physicians and to have high
expectations of them. Tell them that you consider this to be part of your care and that you expect them
to be educated about it, and to be able to at least point you in the direction of the information you need.

My advice for doctors is that whether you are pro, neutral, or against medical marijuana, patients are
embracing it, and although we don’t have rigorous studies and “gold standard” proof of the benefits and
risks of medical marijuana, we need to learn about it, be open-minded, and above all, be non-
judgmental. Otherwise, our patients will seek out other, less reliable sources of information; they will
continue to use it, they just won’t tell us, and there will be that much less trust and strength in our
doctor-patient relationship. I often hear complaints from other doctors that there isn’t adequate
evidence to recommend medical marijuana, but there is even less scientific evidence for sticking our
heads in the sand.

marijuana?

Marijuana is a combination of shredded leaves, stems and flower buds of the Cannabis sativa plant.
Marijuana can be smoked, eaten, vaporized, brewed and even taken topically, but primarily many people
smoke it for recreation. Medical marijuana, on the other hand, is the use of marijuana’s therapeutic
properties to treat known illnesses. The end product is practically the same as its recreational use, but
regulated and limited solely to medical purposes.

Cannabis better known as marijuana contains more than 100 different chemicals called cannabinoids.
Each one has a different effect on the body. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD)
are the main chemicals used in medicine. While these two are the main culprit for that “feeling” that
marijuana users get when smoking this, they can, however, be therapeutic to the body.

How does it affect your body?

The human body already generates chemicals that have marijuana-like effects which play a role in the
inflammatory and pain process, appetite, and movement. When cannabinoids (the active chemical in
marijuana) enters the body, it affects the central nervous system aka the brain function.

The cannabinoid will target the pleasure center of the brain, much like how alcohol and other prohibited
drugs function when they enter our body. Depending on the quantity, quality, and method of
consumption, the chemicals will stimulate the human brain to release dopamine – a chemical substance
from the brain that’s responsible for your mood, memory, appetite, sensation, etc. High levels of
dopamine will basically elevate all these internal activities in our body.

While the total impact of cannabis can vary from person to person, it’s a well-known fact that the
primary effects of cannabis are relaxation and mood elation. These two effects are basically what
medical marijuana is mainly leveraging on in treating certain illnesses that are mostly associated to pain
and a person’s neurological condition.

How does marijuana alleviate an illness?

While there is still much research needed to substantiate the benefits of medical marijuana further and
to regulate its side-effects, the good outweighs the bad (we’ll get to that later).

The consideration being given to medical marijuana can be attributed to these therapeutic effects:

Reduce anxiety

Reduce inflammation and relieve pain

Control nausea and vomiting caused by cancer chemotherapy

Kill cancer cells and slow tumor growth

Relax tight muscles in people with Multiple Sclerosis

Stimulate appetite and improve weight gain in people with cancer and AIDS (Acquired Immune
Deficiency Syndrome)

What are the conditions prescribed under medical marijuana?

Its ability to reduce chronic pain, nausea, and vomiting due to chemotherapy and spasticity (tight or stiff
muscles) make it a good treatment option for the following conditions:

Alzheimer’s disease

Appetite loss

Cancer
Crohn’s disease

Eating disorders such as anorexia

Epilepsy/ Seizure

Glaucoma

Mental health conditions like schizophrenia and posttraumatic stress disorder (PTSD)

Multiple sclerosis

Muscle spasms

Nausea

Pain

Wasting syndrome (cachexia)