What Are Medical Marijuana and Cannabidiol (CBD)? Everything You Need to Know
The cannabis plant, from which marijuana is derived, is often smoked for recreational purposes. But people are increasingly using marijuana to treat medical conditions — and this medical marijuana is not always smoked. It comes in many forms:
- Marijuana cigarettes containing the cannabinoids (chemical compounds) tetrahydrocannabinol (THC) or cannabidiol (CBD), or both THC and CBD
- CBD oils, edibles, tinctures, creams, and capsules
- Cannabis-derived pharmaceutical products approved by the Food and Drug Administration (FDA)
Studies suggest that the medical use of marijuana may help treat the following conditions or help alleviate the following symptoms: (1)
Some research has suggested that the cannabinoids in marijuana could also be useful in managing these conditions: (2,3,4,5,6,7)
According to a 2017 report from the National Academies of the Sciences, Medicine, and Engineering (NASME), the strongest scientific evidence so far has been found in support of using marijuana for chronic pain, cancer-related nausea and vomiting, and MS-related spasticity. (1)
This NASME report, one of the largest of its kind, looked at more than 10,000 studies published since 1999.
How Does Marijuana Affect the Body?
It depends on whether THC or CBD is the cannabinoid at work. They produce similar effects, but there are differences in intensity because they each affect a different neural pathway.
THC is thought to engage with the body’s endocannabinoid system, which helps regulate physiological functioning. THC is similar to a chemical that’s present in this system, and when these two chemicals meet, the similarity allows THC to exert an influence on the body and brain in ways that alter coordination, memory, decision-making, appetite, and mood.
The endocannabinoid system also helps regulate gastrointestinal functions, and this may explain why medical marijuana seems to help digestive disorders like IBS.
CBD, scientists think, affects the brain because of the way it interacts with the neurological pathways that regulate serotonin, the hormone that regulates anxiety, pain, nausea, and appetite.
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How Can Marijuana Help Opioid Use Disorder?
Some individuals use marijuana instead of addictive opioids to treat pain. In these cases, marijuana may actually be responsible for a decrease in the use of — and deaths from — these prescription drugs.
A study published in May 2018 in JAMA Internal Medicine reported that prescriptions for opioids decreased in states that have medical marijuana laws. Researchers looked at Medicare data from 2010 to 2015 and found that states with active dispensaries saw 3.742 million fewer daily doses of opioids filled by pharmacies. (8)
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Another study, published in October 2014 in JAMA Internal Medicine, found that states with medical cannabis laws had a 24.8 percent lower annual overdose rate than states without such laws. (9)
Some states, like Pennsylvania and New York, now consider opioid use disorder as a qualifying condition for medical marijuana use. New York, for example, allows people who qualify to use medical marijuana instead of opioids to treat pain.
What Is Cannabidiol and How Will It Affect Me?
Cannabidiol is the cannabinoid in marijuana that, along with interacting with the brain’s serotonin system, may also help relax and calm you, but it doesn’t alter your perception or affect physical reactions too much. CBD may be particularly effective for: (10)
- Anxiety disorders
- Nausea and vomiting
- Psychotic disorders
- Non-cancer-related pain
- Sleep problems
- Epilepsy (Dravet syndrome and Lennox-Gastaut syndrome)
Staci Gruber, MD, is an associate professor of psychiatry at Harvard Medical School in Boston and the director of the Marijuana Investigations for Neuroscientific Discovery program at McLean Hospital in Belmont, Massachusetts, which is researching the neurological effects of medical marijuana use.
In a large study that she’s conducting on the use of medical marijuana, Dr. Gruber says the second most commonly reported use of medical marijuana among subjects is for anxiety. She’s also about to begin an FDA-approved clinical trial of a CBD sublingual (administered under the tongue) tincture, consisting of CBD in a coconut oil base, for the treatment of anxiety. (Tinctures are medicines — in this case CBD — dissolved in a liquid like alcohol or glycerine.)
Indeed, anecdotal evidence points to the effectiveness of CBD as an anxiety and stress reducer, as well as a sleep aid. Eric*, a busy sales executive in San Francisco, has been sleeping more soundly since he started using a high-CBD, low-THC product via a vaporizer three months ago for work-related stress and anxiety.
“The quality of my sleep is better, I’m sleeping longer and deeper, and I now have no problem falling and staying asleep,” he says. “It has changed my life.”
In addition to being a potentially powerful treatment for anxiety disorders, a growing body of research is suggesting that CBD may help treat symptoms of neurological disorders such as Parkinson’s disease and Alzheimer’s disease . (11,12)
Scientists think that CBD acts in yet to be determined ways that protect the brain against inflammation and oxidative stress. (13)
Research also points to CBD as a potential treatment for psychosis and schizophrenia . (14,15)
Medical marijuana may also be effective in palliative care. In one Canadian case study, published in 2013 in Case Reports in Oncology, physicians reported that CBD oil, administered orally, was a successful treatment for a 14-year-old patient in palliative care with an aggressive form of leukemia. (16)