Medical cannabis, or medical marijuana (MMJ), is cannabis and cannabinoids that are prescribed by physicians for their patients. The use of cannabis as medicine has not been rigorously tested due to production and governmental restrictions, resulting in limited clinical research to define the safety and efficacy of using cannabis to treat diseases. Preliminary evidence suggests that cannabis can reduce nausea and vomiting during chemotherapy, improve appetite in people with HIV/AIDS, and reduce chronic pain and muscle spasms. Short-term use increases the risk of minor and major adverse effects. Common side effects include dizziness, feeling tired, vomiting, and hallucinations. Long-term effects of cannabis are not clear. Concerns include memory and cognition problems, risk of addiction, schizophrenia in young people, and the risk of children taking it by accident. The Cannabis plant has a history of medicinal use dating back thousands of years in many cultures. Some American medical organizations have requested removal of cannabis from the list of Schedule I controlled substances maintained by the United States federal government, followed by regulatory and scientific review. Others oppose its legalization, such as the American Academy of Pediatrics. Medical cannabis can be administered through various methods, including capsules, lozenges, tinctures, dermal patches, oral or dermal sprays, cannabis edibles, and vaporizing or smoking dried buds. Synthetic cannabinoids are available for prescription use in some countries, such as dronabinol and nabilone. Countries that allow the medical use of whole-plant cannabis include Australia, Canada, Chile, Colombia, Germany, Greece, Israel, Italy, the Netherlands, Peru, Poland, Portugal, and Uruguay. In the United States, 33 states and the District of Columbia have legalized cannabis for medical purposes, beginning with the passage of California’s Proposition 215 in 1996. Although cannabis remains prohibited for any use at the federal level, the Rohrabacher–Farr amendment was enacted in December 2014, limiting the ability of federal law to be enforced in states where medical cannabis has been legalized.
THC or tetrahydrocannabinolis the psychoactive compound in marijuana. It is responsible for the “high” people feel. There are two man-made drugs called dronabinol (Marinol) and nabilone (Cesamet) that are synthetic forms of THC. They are FDA-approved to prevent nausea and vomiting in people receiving chemotherapy. CBD or cannabidiol is another compound in marijuana that is not psychoactive. CBD is thought to be responsible for the majority of the medical benefits. Epidiolex is a CBD oil extract that is undergoing clinical trials for epilepsy. THC:CBD: Nabiximols (Sativex) is a specific plant extract with an equal ratio of THC:CBD. It is approved as a drug in the UK and elsewhere in Europe for the treatment of multiple sclerosis, spasticity, neuropathic pain, overactive bladder and other indications. Medical marijuana products are available with a huge range of THC and CBD concentrations. Expert opinion states that 10mg of THC should be considered “one serving” and a person new to medical marijuana should inhale or consume no more until they know their individual response.