Is Medical Marijuana Right for Me?

As marijiuana for medical use gains acceptance in more states, doctors and other patient-facing allied health professionals, such as medical assistants need to know how best to respond to questions from their patients in an informed and honest manner.

Those who are considering medical marijuana (sometimes abbreviated to MMJ) to help with what’s ailing them, naturally have concerns about its safety and efficacy. Misinformation and misconceptions abound about this so-called wonder drug. Before starting on any new therapy, it’s important they get all the facts and of course to talk with their primary care physician.

Probably the biggest confusion people have about MMJ is understanding the difference between it and pot, also referred to as cannabis and weed. They’re the same, with one major difference—strains that have been developed to treat specific illnesses. It’s estimated there are approximately 800 strains of marijuana in the world¹. Most of them are hybrids of one, two and sometimes three strains. And there are new strains being developed all the time. Additionally, all of them can be used for medical marijuana.

In the same way dog and cat breeders use a process called selective breeding to weed out (no pun intended) unwanted traits and promote traits that are more desired, the same thing is done with cannabis—only in dogs and cats it’s highly questionable whether this process is healthy for the animal.

By understanding that strain x helps a patient with chronic pain and strain b helps with depression (as an example), combined they can produce a new strain with both characteristics.

As you’ll discover, medical marijuana isn’t the same pot you may or may not have smoked (or won’t admit to smoking) when you were younger.

Medical Marijuana: Such Conflicting Information, Who’s Telling the Truth?

Medical Marijuana is legal in 30 states², including the territories of Puerto Rico and very recently Guam. It’s legal for recreational use (meaning, no doctor’s prescription is required to obtain marijuana) in nine states plus Washington, D.C. Laws vary in each state and territory regarding maximum consumption, and whether patients may obtain the flower or the extract (oil, wax, capsules, topical cream or edible) alone or both.

Marijuana is not legal on a federal level, which might seem confusing. If it’s legal for medicinal use in many states and territories but not legal nationwide, you may be concerned about whether medical marijuana is safe, effective and/or addictive. According to an article in the New York Times from 2014³, nine percent of users of marijuana (whether for medicinal or recreational purposes) will develop a substance use disorder.

As to its effectiveness vs. any risk of addiction and possible dangers, the United States government is split on this, which adds to the confusion and misconceptions about MMJ.

A letter from Director Nora D. Volkow, M.D. at the National Institute on Drug Abuse⁴ suggests that consuming marijuana for any reason can affect cognitive ability and impair judgment, and despite the mounting anecdotal evidence about medical marijuana’s efficacy the Food & Drug Administration (FDA) has not approved its use.

However, over the last several years, The National Center for Biotechnology Information⁵, a division of the National Institute of Health, has studied the benefits of marijuana therapy on cancerous tumors, including glioblastoma⁶, described as the most malignant brain cancer. What they’ve discovered is that cannabinoids (frequently dubbed CBD) in combination with tetrahydrocannabinol (usually shortened to THC) and phytocannabinoids found in the marijuana plant are highly successful at shrinking, even eliminating, cancerous tumors.

Speaking of the FDA, although they haven’t approved recreational or medical marijuana on a national level, they have, however, given their approval on a drug that is derived from CBD oil for treating seizures in patients aged two years old and up who have Lennox-Gastaut syndrome or Dravet syndrome.

The FDA’s position on approving medical marijuana in treating other conditions is this: “The FDA is aware that there is considerable interest in the use of marijuana to attempt to treat a number of medical conditions, including, for example, glaucoma, AIDS wasting syndrome, neuropathic pain, cancer, multiple sclerosis, chemotherapy-induced nausea and certain seizure disorders. The FDA also has an important role to play in supporting scientific research into the medical uses of marijuana and its constituents in scientifically valid investigations as part of the agency’s drug review and approval process. As a part of this role, the FDA supports those in the medical research community who intend to study marijuana.”

Will I Get High Using Medical Marijuana?

According to a survey conducted by the Pew Research Center⁷, 61 percent of Americans believe in marijuana legalization. However, because of words like “gateway,” “addictive,” “stoned” and “slacker,” and the inability of many to shake the image of the “stoner” on the couch, unable to form two words without bursting into uncontrollable laughter or talking some kind of gobbledygook, advocates of medical marijuana have a hard time explaining the many benefits of using it.

Given the wide variety of strains available, it’s possible to use one of them or a combination to treat whatever condition you have and never experience the high often associated with pot.

(It’s important to note there are no contraindications associated with MMJ. Treating any and all of your medical issues, even at once, isn’t harmful. The “worst” that will happen with using a lot of weed is that you may fall asleep.)

Although there are exceptions to every rule, sativas offer relief for myriad issues and won’t produce a psychotropic effect (a high), while indicas are more likely to make users high, even stoned. Hybrids of each are available, and it’s important to know whether the strain is sativa- or indica-dominant before buying it and being surprised—either way.

It is not safe to assume that because indicas are more commonly associated with being stoned, they will be ineffective in treating what ails you. Using sites like Leafly⁸ and Big Buds Magazine⁹, along with talking with your dispensary, will help you choose the right strain(s) for your condition(s).

What is Medical Marijuana Approved to Treat Where You Live?

Each state and territory where marijuana is legal for medicinal use has its own list of indications on their approved list. Below is a list of many of the approved indications. To check what your state approves, Leafly has broken it down, state by state¹⁰. No such site exists if you live on Guam or Puerto Rico, which just means, if you live in either territory, check with your Department of Health’s Medical Marijuana division.

Some states have restrictions on how young a patient can be to use MMJ, while others have none. Some states even offer treatments for extreme nausea, known as hyperemesis, associated with pregnancy.

In general, medical marijuana is approved in most states and territories to treat the following indications:

• Chronic pain
• Migraines
• Seizures associated with epilepsy, Lennox-Gastaut and Dravet syndromes
• Pain from glaucoma
• Appetite lost by cancer medications and chronic conditions
• Cancer
• Multiple sclerosis
• Fibromyalgia
• Cystic fibrosis
• Anxiety
• Rheumatoid arthritis
• Muscular dystrophy
• Amyotrophic lateral sclerosis
• Ulcerative colitis
• Spinal cord injuries
• Crohn’s disease
• HIV and AIDS
• Post-traumatic stress disorder (PTSD)
• Depression (some states are starting to approve MMJ for bipolar disorder)
• Cognition in patients with Alzheimer’s
• Tremors associated with Parkinson’s disease
• Terminal illness
• Lupus

Making the decision to use medical marijuana to treat whatever condition(s) you have is a big decision. If you have been using a large biologic (injectable) or small biologic (pill) made by a pharmaceutical company, and you have concerns about the effects on your organs with prolonged use, their likelihood of causing a substance use disorder, and/or you just prefer to take something natural, talk with your doctor and do research into your specific indication.

Medical marijuana isn’t right for every person—for a variety of reasons. However, in states and territories that have approved MMJ, it gives patients the freedom to choose what’s best for them.

¹ What are Strains and How Many are There? https://ganjaroad.com/blogitem/what-are-strains-and-how-many-are-there

² This Map Shows Every State Where Marijuana is Legalized Business Insider, 2018 https://www.businessinsider.com/legal-marijuana-states-2018-1

³ What Science Says About Marijuana, 2014, https://www.nytimes.com/2014/07/31/opinion/what-science-says-about-marijuana.html

⁴ Letter From the Director of the National Institute on Drug Abuse, updated 2018, https://www.drugabuse.gov/publications/research-reports/marijuana/letter-director

⁵ Cannabinoids as therapeutic agents in cancer: current status and future implications, 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171598/

⁶ Cannabinoids in Glioblastoma Therapy: New Applications for Old Drugs, 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964193/

⁷ About six-in-ten Americans support marijuana legalization, 2018, http://www.pewresearch.org/fact-tank/2018/01/05/americans-support-marijuana-legalization/

⁸ Leafly: The World’s Resource for Cannabis Information, https://www.leafly.com

⁹ Big Buds Magazine: Find out about Cannabis legislation, strains, etc. http://bigbudsmag.com

¹⁰ What Medical Marijuana treats by state, https://www.leafly.com/news/health/qualifying-conditions-for-medical-marijuana-by-state