It is important to examine both the potential benefits and adverse effects when considering the use of cannabis medicinally. Although the FDA has approved only two cannabinoids, several states have approved the legal use of cannabis for medical and/or recreational use. The FDA-approved cannabinoids, dronabinol and nabilone, are indicated for use in chemotherapy-induced nausea. Dronabinol is also used to treat anorexia (wasting syndrome) in AIDS patients. The use of these drugs in treating nausea is somewhat limited because they are only available in oral capsules, but there is an ongoing clinical trial for an oral mucosal spray that might improve absorption.
Marijuana and other cannabinoids can be used to treat symptoms associated with conditions like glaucoma, epilepsy, and chronic pain—but controlled research on their effectiveness has been limited. The initial trials of smoking cannabis for pain relief have been small (50 or fewer patients), although the results are promising. In some studies, smoking cannabis improved caloric intake leading to weight gain in both healthy and HIV-infected patients. For glaucoma, cannabinoids generally do not have as good of treatment outcomes as other medications. In refractory epilepsy, there have been small-scale observational studies, but the mechanism of cannabinoid effects on seizures needs to be further researched.
One potential long-term consequence of heavy marijuana use is its effect on brain development, namely impaired memory and cognition problems; this is mainly a concern in adolescents. Additionally, as with any substance, there is potential for developing dependency or addiction. The dependency is mostly a psychological one, but physical withdrawal symptoms such as irritability, sleeping difficulties, and anxiety can certainly occur. There have also been links between marijuana use and certain psychological illnesses, namely anxiety and depression, but again, more research needs to be done before this can be confirmed. Smoking marijuana can cause inflammation of the lungs and does contain carcinogens. One solution to this issue is to consider other possible routes of administration, such as edible marijuana.
While these risks remain, marijuana may prove helpful in a host of conditions in the future. In any case, it is important to evaluate patients individually to decide whether or not a certain cannabinoid may be a good treatment option for them. For many, the benefits may certainly outweigh the risks.
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