Marijuana is the popular name for cannabis, a plant genus that contains three species. Although often highlighted for its controversial use as a recreational drug, cannabis has drawn increasing attention in recent years for its use in a variety of medical conditions.
Cannabis is chemically complex, containing more than 85 substances (cannabinols) that have biological effects. One cannabinol, tetrahydrocannabinol (THC), stimulates specific receptors in the brain to cause a range of effects, including euphoria. THC is the major factor in the recreational use of cannabis; the other cannabinoids have no known psychoactive effects but have been increasingly used in the treatment of disease.
Clif CleavelandThe U.S. Food and Drug Administration classifies cannabis as a Schedule I drug with a risk of addiction and no accepted medical benefits. Yet two synthetic cannabinoids have FDA approval for medical use. Dronabinol may be used to stimulate poor appetite in HIV patients, while nabilone may be employed in the treatment of severe nausea and vomiting associated with cancer chemotherapy. Epidolex, which contains a plant-derived cannabinol, has been approved recently to treat a rare seizure disorder in infants and young children.
Twenty-three states and the District of Columbia have approved cannabis for widely varying medical uses that include treating glaucoma, post-traumatic stress disorder, Crohn’s disease, complications of multiple sclerosis, rheumatoid arthritis and chronic pain. There is no uniformity among these state-based regulations; each state requires certification to obtain cannabis for medical purposes.
Two articles and an editorial in the June 23 issue of The Journal of the American Medical Association provide a valuable overview of medical cannabis. One of the reports provides a “meta-analysis” of published studies of therapeutic cannabis.