The Role of Cannabis in Modern Medicine

Cannabis has a long history of use for medicinal purposes, with its applications documented in ancient cultures [1]. In recent decades, the role of cannabis in modern medicine has become increasingly prominent, spurring debates, research, and evolving legal landscapes. This article explores the current state of medical marijuana, its benefits, risks, and future potential.

Historical context

The cannabis plant, specifically cannabis sativa, has been used for centuries in various traditional medicines. Auspiciously, ancient Chinese and Indian texts document its use for treating conditions such as pain and nausea [2] [3]. However, the 20th century saw a decline in its medical use due to legal restrictions, particularly under the Controlled Substances Act in the United States, which classified cannabis as a Schedule I drug, indicating a high potential for abuse with no currently accepted medical use [1].

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Components and medicinal properties

The purported medicinal properties of cannabis are primarily attributed to its cannabinoids, particularly THC (tetrahydrocannabinol) and CBD (cannabidiol). Famously, THC is known for its psychoactive effects, while CBD is non-psychoactive and has been found to offer a variety of potential wellness benefits. Additionally, other cannabinoids and compounds such as terpenes and flavonoids, may contribute to the wellness effects of the cannabis plant [4].

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Physiological mechanisms behind the medical use of cannabis

Cannabinoids, the active compounds in the cannabis plant, interact with the body’s endocannabinoid system (ECS), which promotes wellness by regulating various physiological processes. As such, the ECS, composed of cannabinoid receptors, endocannabinoids, and metabolic enzymes, plays a crucial role in maintaining homeostasis. Medicinal cannabis, through its cannabinoids like THC and CBD, activates the ECS, potentially modulating experiences. For instance, THC binds to CB1 receptors in the brain, which, some believe, makes it a valuable option for patients who do not respond well to traditional pain medicine [5]. However, other patients, including those with cancer, report that THC does not adequately modulate their pain [6]. Research continues to look into theories touting cannabis products as medically valuable.

CBD, on the other hand, interacts with CB2 receptors in the immune system, potentially providing potential wellness benefits without the psychoactive effects associated with smoking cannabis [7].

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Ways to consume cannabis for wellness

The medical use of cannabis extends to various forms of administration, including oral cannabis extracts and other cannabis products. These methods offer alternative ways to address symptoms without the need for smoking cannabis, which can lead to adverse respiratory effects. Unsurprisingly, states with legal medical marijuana have seen increased sales of cannabis extracts and oral formulations prscribed to help address both chronic pain, and to modulate withdrawal symptoms from conventional medications like opioids [8]. However, some researchers and physicians do not recommend cannabis for these purposes, especially for young adults and those with underlying mental health conditions [9].

Despite cannabis’ potential benefits, federal law still classifies it as a Schedule I substance, creating legal barriers to broader medical use [10]. However, as more research supports the efficacy of cannabis in treating various ailments, healthcare providers may increasingly recommend medical marijuana, recognizing its potential to improve patient outcomes and enhance overall wellness.

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Purported wellness benefits of cannabis

Researchers continue studying cannabis for its potential to help with a variety of conditions. Though arguments for and against these applications persist, the following represent some areas of ongoing study regarding cannabis:

Pain management: Researchers study cannabis for its potential efficacy in treating severe pain, including chronic and neuropathic pain. In some studies, smoked cannabis and cannabis extracts have shown promise in modulating symptoms for conditions like multiple sclerosis and rheumatoid arthritis. However, other studies counter these conclusions. Thus, it’s crucial to follow guidance from a physician [11].
Mental health: Healthcare practitioners sometimes recommend medical marijuana to manage symptoms of posttraumatic stress disorder (PTSD), social anxiety disorder, and depression. As a result, some patients report improvements in quality of life with controlled use. However, other findings report increased anxiety. Therefore, it’s important to consult a physician regarding appropriate treatments [12].
Neurological conditions: Recent evidence supports the use of cannabis in treating rare forms of epilepsy, particularly in children. Notably, the American Medical Association and other institutions have highlighted its potential benefits for Dravet syndrome. As a result, the FDA-approved, CBD-based medication Epidiolex can now help people with certain epileptic conditions [13].
Anti-nausea effects: The FDA has recently approved THC-based medications, such as Dronabinol and Marinol, which work by attaching to cannabinoid receptors in nerve cells to help with nausea and vomiting and improve appetite. These are prescribed for treating chemotherapy-induced nausea and vomiting [14]. Researchers continue to study THC’s effects on inflammatory bowel diseases like Crohn’s disease and irritable bowel syndrome.
Cancer treatment and palliative care: Beyond managing nausea and vomiting associated with cancer chemotherapy, cannabis may be recommended by some physicians for palliative care to improve appetite and reduce wasting syndrome [15]. However, cannabis use among this group is controversial. Thus, it’s crucial to consult a physician for appropriate palliative care [16].

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Research and clinical trials

Despite the increasing acceptance of medical cannabis, research remains limited due to regulatory challenges. For example, the National Institute on Drug Abuse and other federal bodies have been slow to approve comprehensive clinical trials [17]. However, systematic reviews and clinical pharmacology studies have provided evidence supporting the efficacy of medical marijuana for various conditions [4]. For example, the National Academies Press published findings highlighting the therapeutic use of cannabis in pain management and neurological disorders [18]. Even so, arguments persists that claim cannabis may not serve to decrease pain sufficiently or relieve neurological conditions.

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Legal and regulatory landscape of cannabis in modern medicine

The legal status of medical marijuana varies globally and within countries. For example, in the United States, federal laws remain stringent, with the federal government maintaining marijuana as a Schedule I drug. However, state medical cannabis laws have evolved, with many states legalizing medical marijuana for specific conditions [19]. As a result, this disparity between federal and state laws poses challenges for patients and healthcare providers.

Risks and side effects

While cannabis carries wellness potential, it also poses risks. For example, short-term side effects may include dizziness, dry mouth, and psychoactive effects. In contrast, researchers continue to study long-term health effects, and concerns include the potential for addiction and increased risk of psychotic disorders. Additionally, smoking marijuana can also have respiratory implications [20].

Notably, the concept of cannabis as a gateway drug remains controversial, with limited evidence supporting this theory [21].

Patient perspectives and experiences

Patient testimonials and case studies provide valuable insights into the benefits and challenges of medical cannabis use. For example, many patients report significant improvements in various symptoms and quality of life, particularly in pain management and mental health conditions [22]. However, it’s unclear as to whether some of these reports stem from the placebo effect. Indeed, some researchers have found inconclusive evidence regarding cannabis and these conditions.

Also, the stigma associated with marijuana use and the legal complexities can hinder access to this treatment, making it challenging for individuals to pursue a potential cannabis solution to their problem [23].

Future of cannabis in modern medicine

The future of cannabis in medicine remains promising, with ongoing research and evolving legal frameworks expanding its applications. For instance, innovations in cannabis-based medicines, such as oral THC in the form of FDA-approved Marinol, Syndros, Cesamet, and Nabilone offer hope for more breakthroughs[14]. As systematic reviews and clinical trials continue to provide evidence, the medical community’s understanding and acceptance of cannabis will grow.

Encouragingly, the potential for new medical applications is vast, from the possibility of treating severe pain and neuropathic pain to managing symptoms of inflammatory bowel disease. Indeed, the integration of cannabis into Western medicine represents a shift towards more holistic and patient-centered approaches. With more rigorous studies, the public will hopefully have more answers about the actual wellness potential of cannabis in the near future.

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Key takeaway: a closer look at cannabis in modern medicine

Cannabis in modern medicine represents a complex and evolving field. Its debated medicinal properties, supported by a growing body of research, may offer significant wellness benefits to many people in need. However, the legal and regulatory landscape, alongside the potential risks and side effects, necessitates careful consideration and medical supervision. Continued research and education are essential to fully understand and harness the powers of the cannabis plant. The future of medical cannabis looks promising, with the potential to revolutionize healthcare.

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Medical Disclaimer / Legal Disclaimer – Information is provided for educational purposes. It does not and is not intended to constitute legal advice or medical advice. We attempt to be accurate and up-to-date, but the legality of cannabinoids and the science of cannabis are evolving. The author is neither a legal professional nor a medical expert. Before buying or using any products, you should check with your local authorities and medical providers.

References

Frequently Asked Questions

How can I obtain medical cannabis if it’s legal in my state?

To obtain medical cannabis in states that have legalized it, you typically need a recommendation from a licensed healthcare provider. After this, you can register with your state’s medical marijuana program and receive a medical cannabis card, which allows you to purchase cannabis from licensed dispensaries [24].

What are the potential risks and side effects of using medical cannabis?

Potential side effects of medical cannabis include dizziness, dry mouth, and psychoactive effects. Also, long-term use may carry risks such as dependency, increased risk of psychotic disorders, and respiratory issues from smoking cannabis [20]. Thus, it’s crucial to use medical cannabis under medical supervision.

Is medical cannabis legal in the United States?

The legality of medical cannabis varies by state. While many states have legalized marijuana use for medical purposes, it remains illegal under federal law. Hence, patients should check their state’s specific regulations regarding medical marijuana use [19].