This is the third article in a 6-part series on medical cannabis. Check out the other posts here.

People use cannabis for a variety of reasons, including for recreation and to treat medical conditions. Cannabis is known to have a number of medical and therapeutic uses, although research is still ongoing. Medical cannabis is legal in many jurisdictions (including Canada!), even in some areas where recreational cannabis is illegal.

Let’s discuss what medical cannabis is, the uses and side-effects of medical cannabis, and the different methods of consuming medical cannabis.

What is Medical Cannabis?

Medical or medicinal cannabis refers to cannabis prescribed by a healthcare practitioner for the purpose of treating a medical condition. It is distinguished from recreational cannabis, which can be purchased from a licensed retailer (where legal).

People report using medical cannabis for a variety of conditions. Healthcare practitioners use their own discretion when prescribing cannabis products. While the research is still fairly scant, good research supports the therapeutic use of medical cannabis for a number of conditions.

Some people may use cannabis to self-treat a medical condition. While this does not technically fall under the category of medical cannabis, it is somewhat of a gray area between recreational and medicinal use. This is more common in areas where it is more difficult to get a prescription for cannabis.

Although recreational cannabis is legal in Canada, many people still use medical cannabis products, as their healthcare practitioner can prescribe the most appropriate dosing and product composition for their particular needs. Purchase, possession, consumption, taxation, and insurance may also be treated differently under the law for medical vs. recreational cannabis. In the U.S., recreational cannabis is still illegal in many states, although medical cannabis is legal in more places.

What are the Medical Uses of Cannabis?

Medical cannabis is prescribed by a healthcare practitioner for the purpose of treating a medical condition. You may be wondering which conditions cannabis can help to treat. While plenty of good quality evidence supports the use of cannabis for specific conditions, other conditions are still being researched. The list of uses of medical cannabis may grow and expand over the coming years.

According to Health Canada, excellent quality evidence supports the use of cannabis in the following situations:

• For chronic pain of various conditions, including “musculoskeletal, post-traumatic, arthritic, peripheral neuropathy, cancer, fibromyalgia, migraine, multiple sclerosis, sickle cell disease, and thoracic outlet syndrome”
• To treat inflammation and pain in Crohn’s disease
• For neuropathic pain resulting from multiple sclerosis, AIDS, surgery, or spinal cord injury
• To treat weight loss in AIDS — cannabis stimulates the appetite

Furthermore, good quality evidence supports the use of cannabis in the following situations:

• Chemotherapy-induced nausea and vomiting
• Multiple sclerosis
• Epilepsy
• Anxiety, in particular CBD may be effective
• Alzheimer’s disease
• Gastrointestinal disorders

Note that healthcare practitioners may decide to prescribe cannabis for any number of conditions, regardless of the quality of the evidence to support the link.

Side-Effects of Medical Cannabis

Although cannabis appears to be effective for a number of uses, it is important to take note of its side-effects, which may reduce its appeal to some patients. Indeed, Health Canada reports that the psychoactive side-effects of cannabis may reduce its therapeutic potential. A 2018 article published in the European Journal of Internal Medicine advises healthcare providers and patients to find the minimum effective dose that produces a therapeutic benefit without side-effects.

The most common side-effects of cannabis include:

• Confusion
• Fatigue
• Impaired ability to:
  • remember
  • concentrate
  • pay attention
  • react quickly
• Anxiety, fear or panic
• Psychotic episodes
• Increased heart rate

THC vs. CBD in Medical Cannabis

THC and CBD are the two major active compounds found in the cannabis plant. These compounds are thought to be responsible for many of the therapeutic benefits of medical cannabis.

According to Health Canada, THC has many different effects on the body. These include psychological, sedative, anti-epileptic, analgesic, anti-nausea, and appetite stimulation effects. THC is known to affect the respiratory, gastrointestinal, cardiovascular, and reproductive systems in the body.

CBD, on the other hand, does not produce any psychoactive “high.” According to the Ontario Cannabis Store website, CBD produces a “body buzz” rather than a “head high.”

CBD’s medical effects include “anti-inflammatory, analgesic, anti-nausea … anti-psychotic, … anxiolytic, and anti-[epilepsy] effects,” according to Health Canada’s cannabis information page for health care practitioners.

Healthcare providers may recommend THC- or CBD-dominant cannabis products depending on the patient’s individual needs and preferences.

The best way to protect from unpleasant effects is to start by consuming small amounts of cannabis.

How To Use Medical Cannabis

Medical cannabis comes in a variety of different forms, including dried flower, tinctures, capsules, and oils. Dried flower is typically inhaled, whereas tinctures, capsules, and oils are ingested. The effects experienced will always depend many factors unique to every individual. The best way to protect from unpleasant effects is to start by consuming small amounts of cannabis.

Dried flower is most often inhaled through smoking or vaporizing. Inhalation comes may come with risks to lung health and should not be done around children. Vaporizers are a popular option as they reduce some of the harmful effects of smoking.

Tinctures, capsules, and oils are created from the cannabis plant. They are ingested orally and take longer to produce effects given the length of time it takes to enter the bloodstream, although effects may be stronger and last longer than through inhalation. New users should sample a small amount and wait at least an hour to gauge the body’s response. Many people like to use CBD in particular in oil form.

Edibles are not currently legal in Canada. Legislation around edibles is expected in October 2019.

How To Access Medical Cannabis

Medical cannabis must be prescribed by a licensed health care practitioner—this can either be a physician or nurse practitioner who is the main health practitioner responsible for treating your condition and symptoms.

Medical cannabis can be legally sourced only through licensed producers, personal production and designated production. A complete list of licensed cultivators, processors and sellers can be found on the Health Canada website.

Summary

Medical cannabis is cannabis used to treat a medical condition. It must be prescribed by a healthcare professional, although some people may choose to self-medicate using recreational cannabis.

Medical cannabis has been shown to have therapeutic effects for a number of conditions, including AIDS-related weight loss, neuropathic pain, chronic pain, and Crohn’s disease.

Patients can benefit from THC and CBD in medical cannabis, alongside a number of other minor compounds. Depending on patients’ individual needs, they may be prescribed a THC-dominant or CBD-dominant strain.

Although current research is promising, it is only the beginning. Continued research will reveal more about the uses and benefits of medical cannabis. 

Please note that the content of this article is provided for general informational purposes only and should not be taken as medical advice. Contact your healthcare provider with any questions about your condition or treatment.