What Should I Know About Medical Cannabis?

JAMA INTERNAL MEDICINE PATIENT PAGE What Should I Know About Medical Cannabis?

What Is Cannabis and How Is It Used? • Cannabis (ie, marijuana) is a plant that contains a complex mix- Medical Cannabis Cannabinoids are the active chemicals in cannabis, also known as marijuana. ture of chemicals called cannabinoids. Examples of cannabinoids Cannabis contains hundreds of cannabinoids, including tetrahydrocannabinol (THC) include tetrahydrocannabinol (THC) and cannabidiol (CBD). and cannabidiol. Cannabidiol causes far fewer psychoactive effects than THC. • Whereas THC is primarily responsible for the psychoactive ef- MEDICAL CANNABIS fects (euphoria) of cannabis, CBD may decrease pain but causes Talk to your physician about Patient I dentification Card • Why you think cannabis might far fewer psychoactive effects than THC. N help you ame: • Cannabis is used medically as purified cannabinoids (eg, CBD), syn- DOB: • The safest way to use cannabis Patient ID: thetic cannabinoids (eg, dronabinol), or parts of the whole plant. • How you can legally obtain cannabis Issued on: Expi • Cannabinoids are typically smoked or vaporized; ingested as pills, in your state res on: tinctures,oils,oredibles;orappliedtotheskinascreamsorpatches. • Whether you are at risk for adverse effects

Most states have legalized cannabis use for medical conditions, How Is Cannabis Regulated in the United States? and some states have legalized cannabis use for adult recreation. Most states have legalized cannabis use for medical conditions. Some The potency and content of cannabis products are not typically states have legalized cannabis for recreational adult use. The fed- regulated by the government, even in states where cannabis is legal. eral government considers cannabis use to be illegal. However, cli- nicians and patients who act in accord with state laws on medical use of cannabis are not likely to be federally prosecuted. Typically, FOR MORE INFORMATION cannabis contents, potency,and safety are not regulated by the gov- National Institutes of Health ernment even in states where it is legal. https://www.drugabuse.gov/publications/drugfacts/marijuana National Cancer Institute Page on Medical Cannabis Are There Proven Benefits to Using Medical Cannabis? https://www.cancer.gov/about-cancer/treatment/cam/patient/ Patients with spasticity related to multiple sclerosis, rare forms of cannabis-pdq childhood epilepsy, or nausea associated with chemotherapy have been shown to benefit from medical use of specific cannabinoids. sequences. Smoking cannabis over time is associated with chronic Substantial evidence demonstrates that cannabis helps to mod- breathing problems. These often improve after stopping. Frequent estly reduce pain. The most consistent benefit is seen in nerve pain. cannabis use during adolescence is associated with increased risk Cannabis is often portrayed as a treatment for conditions like anxi- of developing long-term psychiatric conditions. Cannabis use ety, opioid addiction, and insomnia. There is not conclusive evi- during pregnancy is associated with low birth weight and other dence to know if it helps with these conditions. complications. More study must be done to fully understand if there is an association of lung cancer or heart disease with smoking Is Using Cannabis Dangerous? cannabis. No deaths have been conclusively linked to cannabis or cannabi- noid overdose. However, there are some risks associated with can- How Can My Doctor Help Me? nabis use even for medical purposes. Cannabis acutely impairs memory,judgment, and motor skills. Driving under the influence of • Open communication with your clinician will help you have a bet- cannabis affects driving ability. It may be associated with an in- ter understanding of the potential benefits and risks of cannabis creased risk of automobile accidents. Deaths from vaping- use based on your medical history and current medications. associated lung illness have been reported in some individuals using • Talk to your clinician about why you think you would benefit from vaped cannabis product. It is not clear what role cannabis plays in cannabis. There may be other effective ways to address your this illness. Cannabis can be habit forming over time and lead to un- health concerns. healthy use. Long-term daily use, starting at a young age, and using • Your clinician can inform you how to legally obtain cannabis in largeamountsmaybeassociatedwithnegativesocialandhealthcon- your state.

Authors: Michael A. Incze, MD, MSEd; Deepika Slawek, MD, MS, MPH; The JAMA Internal Medicine Patient Page is a public service of JAMA Internal Medicine. Chinazo O. Cunningham, MD, MS The information and recommendations appearing on this page are appropriate in Published Online: February 11, 2020. doi:10.1001/jamainternmed.2020.0018 most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA Internal Medicine Conflict of Interest Disclosures: Dr Slawek reported grants from the National suggests that you consult your physician. This page may be photocopied Institutes of Health during the conduct of the study. No other disclosures were noncommercially by physicians and other health care professionals to share with reported. patients. To purchase bulk reprints, email [email protected]. Section Editor: Michael Incze, MD, MSEd.

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