When Can Pot Legally Be Used as a Treatment? Is It Safe?

What Conditions Can Medical Marijuana Treat and Is It Safe?

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Throughout the early decades of the 21st century, the use of medical marijuana has been increasingly explored and recognized to treat a range of problems that are ineffectively treated with other drugs and therapies.

The support of physicians and patients who have found medical marijuana to be effective in helping with symptoms of these conditions has led some jurisdictions to allow the use of medical marijuana under the prescription of a physician for a recognized condition.

Derivatives of marijuana, and synthetic marijuana, which aim to give the same medical benefits without the drug high, are also being developed and in some cases, used as forms of medical marijuana. One of these synthetic forms of medical marijuana is Marinol.

What Can Medical Marijuana Treat?

Over 200 separate indications or uses for medical cannabis have been identified. These can be broken down into the following broad categories:

  • Anti-nauseant and appetite stimulant
  • Anti-spasmodic and anti-convulsant
  • Analgesic (pain reliever)
  • Anti-inflammatory and immune system modulator
  • Anxiolytic (anxiety reliever) and anti-depressant for mood disorders
  • Harm reduction substitute for alcohol, opiates and other dangerous drugs
  • Miscellaneous applications like glaucoma and asthma.

Although it is important to note that the FDA has not approved marijuana for any medical indication, specific conditions which medical marijuana can be prescribed for include, but are not limited to:

Harmful Effects of Medical Marijuana

Several potentially harmful effects of medical marijuana have been identified. These include cardiovascular issues associated with marijuana use such as heartbeat and blood pressure implications, issues while breast-feeding during pregnancy, and possible allergic reactions to marijuana.

Although the risks of medical marijuana are not currently considered to be high, people with heart problems may be affected by the increase in heart rate—tachycardia—caused by marijuana intoxication, and should avoid marijuana or only use after discussing the risks and benefits with their prescribing physician.

Marijuana occasionally causes faintness when users stand up abruptly, a condition known as postural hypotension. This poses a risk of passing out, falling, and possibly suffering a potentially fatal injury. The effects of marijuana on blood pressure are unpredictable, so any concerns should be discussed with your prescribing physician.

Medical Marijuana During Pregnancy

The effects of marijuana during pregnancy are mixed, with some advocating for using medical marijuana as a treatment for morning sickness, and other research indicating possible serious neurological effects on the developing child. A review of research on the effects of prenatal exposure to marijuana on children at various stages of development shows a potential increased risk of stillbirth and low birthweight.

However, these studies, as well as those reflecting the consequences of prenatal marijuana exposure at later stages of development, are confounded or confused by the fact that women who use marijuana during pregnancy are more likely to engage in other behaviors which put the baby at risk, such as tobacco smoking.

Overall, doctors have expressed concern about the safety of marijuana during pregnancy. Marijuana is fat soluble, and easily crosses the placenta and the blood-brain barrier. Therefore, if the mother uses marijuana, it can accumulate in the tissues and brain of the baby. It has the potential to disrupt motor control, memory, and other brain functions.

There is a significantly increased risk for anencephaly—a serious birth defect in which a baby is born without parts of the brain and skull—when the fetus is exposed to marijuana during the first month of gestation, 1 to 4 weeks after conception.

There is also some evidence that marijuana use during pregnancy can impair structural brain development, as well as the neurotransmitters which play a role in cognitive and emotional functioning.

This can lead to impaired regulatory control: irritability, tremors, and poor habituation; difficulty with arousal and state regulation; and sleep disturbance.

Developmental Issues

Numerous studies have documented neurodevelopmental deficits in older children, adolescents, and young adults who were prenatally exposed to marijuana. These studies are consistent with the effects of cannabis on the developing fetal central nervous system.

Children who had been prenatally exposed to marijuana and were followed up over time were found to have a consistent pattern of deficits in cognitive functioning. At 6 years of age, prenatal marijuana exposure was linked to lower verbal reasoning scores and deficits in composite, short-term memory, and quantitative intelligence scores. By the time they were 10 years of age, negative effects of prenatal marijuana exposure had a significant impact on design memory and assessments of learning and memory, and the exposed children had lower test scores on school achievement.

They were also more likely to have increased hyperactivity, impulsivity, and inattention problems as well as significantly increased rates of child depressive symptoms. These symptoms significantly predicted delinquency at 14 years and a significantly increased rate of difficulties with executive functioning, which is central to learning and to managing behavior. Young adults who had been prenatally exposed to marijuana have been found to have altered neural functioning that impacted short-term memory.

As stated above, these research findings are complicated by the tendency of children of mothers who use marijuana during pregnancy to have been exposed to other substances, stressors, and other problems. However, until more conclusive research is available, marijuana is best avoided during pregnancy and breastfeeding.

Potential Reactions to Marijuana

Several reactions to marijuana have been reported, including racing heartbeat, faintness, twitches, numbness, and headaches. Adverse reactions are not always evident at first, but may develop over time as the person is exposed to more marijuana. Although rare, true allergies to marijuana can occur, and range from rashes and itchiness to full flown anaphylaxis. If you experience any symptoms that you think may be allergy related, discontinue use and discuss with your prescribing physician.

What Is Marinol?

Marinol is a form of medical marijuana. It is a synthetic version of the delta-9-THC compound, which occurs naturally in the cannabis plant. Marinol is prescribed as an appetite stimulant for people who have severe symptoms of appetite loss, nausea and vomiting, caused by conditions such as AIDS and cancer, as well as by treatment of these conditions.

Medical marijuana is controversial because recreational marijuana has been a controlled drug for many years. For this reason, Marinol is only prescribed to people who have severe conditions, and who have not responded adequately to other treatments for their symptoms.

Marinol Effects and Side Effects

People who take Marinol may experience some of the pleasurable effects of regular recreational marijuana, including elation and euphoria.

Marinol can have some unpleasant side effects, including paranoia and unusual thoughts, upset stomach, and drowsiness.

Is Medical Marijuana Just Another Way to Abuse Drugs?

The terms "drug abuse" and "substance abuse" are judgmental and imply blame of the person using substances. Therefore, use of these terms is falling out of favor with professionals. However, the question of whether the current medical marijuana system is being used as intended does raise some interesting findings.

Research reported in 2017 indicated that marijuana users who are not medical marijuana patients report using marijuana diverted from dispensaries. Such marijuana users are more likely to use prescription drugs not prescribed to them than those who are prescribed marijuana. This indicates that recreational users are turning to illicit, diverted, prescribed sources of substances, rather than traditional street drugs, adding medical marijuana to the list of prescribed drugs being diverted for recreational use.

However, those who are prescribed marijuana may be benefiting greatly from access to medical marijuana. The same research showed that compared to users who are not medical marijuana patients, young adult medical marijuana patients use more marijuana, and vaporize concentrates of marijuana, such as oil, dab,and wax, more commonly.

On the flip side, many marijuana users who do not access the drug through medical sources report self-medicating untreated symptoms with marijuana and other drugs illegally. And another study of healthcare providers in the state of Washington, where marijuana is legal for both medical and recreational use, shows that many of them are uncomfortable recommending medical marijuana.

So while the medical marijuana system does appear to be providing benefit to some, there are problems with not reaching those who would benefit, and potentially increasing access to medical marijuana for non-medical purposes.

Sources:

Carlini, B., Garrett, S., & Carter, G. Medicinal Cannabis: A Survey Among Health Care Providers in Washington State. American Journal of Hospice and Palliative Medicine, 34: 85 - 91. 2015. doi: 10.1177/1049909115604669

Chasnoff, I. Medical marijuana laws and pregnancy: Implications for public health policy. American Journal of Obstetrics and Gynecology, 216, 27–30. 2017.

Gieringer, D., Rosenthal, E., & Carter, G. Marijuana Medical Handbook: Practical Guide to Therapeutic Uses of Marijuana. Quick American Archives. 2008.

Lankenau, S., Fedorova, E., Reed, M., Schrager, S., Iverson, E., Wong, C. Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users, Drug and Alcohol Dependence, 170, 181–188. 2017.

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