Posted on

medical hemp

It would only be considered when other treatments were not suitable or had not helped.

“Pure” products that only contain CBD, such as Epidyolex, do not carry these unknown risks linked with THC.

Epidyolex for children and adults with epilepsy

Some cannabis-based products are available to buy over the internet without a prescription.

Possessing cannabis is illegal, whatever you’re using it for. That includes medical use unless it has been prescribed for you.

CBD and THC can affect how other medicines work. Always discuss possible interactions with a specialist.

Some CBD manufacturers have come under government scrutiny for wild, indefensible claims, such that CBD is a cure-all for cancer, which it is not. We need more research but CBD may be prove to be an option for managing anxiety, insomnia, and chronic pain. Without sufficient high-quality evidence in human studies we can’t pinpoint effective doses, and because CBD is currently is mostly available as an unregulated supplement, it’s difficult to know exactly what you are getting. If you decide to try CBD, talk with your doctor — if for no other reason than to make sure it won’t affect other medications you are taking.

Side effects of CBD include nausea, fatigue and irritability. CBD can increase the level in your blood of the blood thinner coumadin, and it can raise levels of certain other medications in your blood by the exact same mechanism that grapefruit juice does. A significant safety concern with CBD is that it is primarily marketed and sold as a supplement, not a medication. Currently, the FDA does not regulate the safety and purity of dietary supplements. So, you cannot know for sure that the product you buy has active ingredients at the dose listed on the label. In addition, the product may contain other (unknown) elements. We also don’t know the most effective therapeutic dose of CBD for any particular medical condition.

CBD stands for cannabidiol. It is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is derived directly from the hemp plant, which is a cousin of the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a "high." According to a report from the World Health Organization, "In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD."

Is CBD safe?

CBD is commonly used to address anxiety, and for patients who suffer through the misery of insomnia, studies suggest that CBD may help with both falling asleep and staying asleep.

CBD has been touted for a wide variety of health issues, but the strongest scientific evidence is for its effectiveness in treating some of the cruelest childhood epilepsy syndromes, such as Dravet syndrome and Lennox-Gastaut syndrome (LGS), which typically don’t respond to antiseizure medications. In numerous studies, CBD was able to reduce the number of seizures, and, in some cases, it was able to stop them altogether. Videos of the effects of CBD on these children and their seizures are readily available on the Internet for viewing, and they are quite striking. Recently the FDA approved the first ever cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.

Image: yavdat/Getty Images

CBD may offer an option for treating different types of chronic pain. A study from the European Journal of Pain showed, using an animal model, CBD applied on the skin could help lower pain and inflammation due to arthritis. Another study demonstrated the mechanism by which CBD inhibits inflammatory and neuropathic pain, two of the most difficult types of chronic pain to treat. More study in humans is needed in this area to substantiate the claims of CBD proponents about pain control.

Medical cannabis is most frequently administered either by smoking or vaporization or in the form of edible preparations. None of these approaches has been standardized, however, and the effectiveness of edible cannabis preparations has not been evaluated in clinical trials. Smoked cannabis has been evaluated in a small number of randomized controlled trials involving patients suffering from neuropathic pain conditions. In each of the trials, patients experienced a reduction in pain intensity at THC concentrations of 3.9 percent or higher. A zero percent THC dose was used as the placebo condition; this formulation was created with cannabis from which all cannabinoid substances had been removed by alcohol extraction. Adverse events from these studies were mild to moderate and included drowsiness, dizziness, and dry mouth. No serious or severe adverse events were reported.

A major safety concern associated with medical cannabis is the possibility of medical use encouraging or transitioning into recreational use, which is associated with side effects that range from acute to chronic. Acute effects include intoxication, impaired cognition and motor function, elevated heart rate, anxiety, and psychosis in predisposed individuals. Chronic effects include bronchitis (from smoked cannabis), psychological cannabis dependency, loss of motivation, and cognitive deficits. By and large these effects seem to disappear on abstinence.

Medical cannabis, also called medical marijuana, herbal drug derived from plants of the genus Cannabis that is used as part of the treatment for a specific symptom or disease. Although the term cannabis refers specifically to the plant genus, it is also used interchangeably with marijuana, which describes the crude drug isolated from the plants’ leaves and flowers.

Effectiveness of medical cannabis

Outside of Canada and the Netherlands, there is no inherent difference between herbal cannabis used recreationally and that used medically. For that reason, medical cannabis may be best understood as the use of cannabis under ongoing medical supervision, with an established diagnosis of the target symptom-disease complex. Herbal cannabis is used in conjunction with, or in consideration of, other pharmacological and nonpharmacological approaches and with the goal of reaching prespecified treatment outcomes. Anecdotal reports and the results of randomized clinical trials have suggested that cannabis may be useful in the management of a variety of conditions, including pain, spasticity, nausea, anorexia, and seizures. (In a randomized clinical trial, participants are assigned by chance to different treatment groups.)

Several pharmaceutical drugs based on cannabis, in purified and standardized form, have been made available for medical use. However, the use of herbal cannabis in medicine remains highly controversial, in part because of the lack of standardization among products to ensure safe and consistent dosing and in part because of disagreement over legalization. In the United States, for example, while the cultivation, possession, and consumption of cannabis is illegal, some states have enacted laws that legalize the use of herbal medical cannabis specifically. Examples of products that have been approved by the U.S. Food and Drug Administration include cannabidiol (CBD), an active ingredient in cannabis, and certain synthetic cannabis-like drugs, namely dronabinol and nabilone. While the use of herbal medical cannabis is permitted in some European countries, it is illegal in the United Kingdom. The latter does, however, permit the prescription of a cannabis-based drug known as nabiximols (Sativex).

Medical cannabis may be riskier and perhaps contraindicated if a patient has a personal or family history of psychosis, unstable cardiac disease, and lung disease. Medical cannabis users are advised by physicians not to use tobacco, either alone or mixed with cannabis. They also are advised not to drive or operate machinery while initiating or changing doses and if impaired by the drug. Apart from possible synergistic effects of cannabis with other psychotropic medications, such as sedatives and hypnotics, there are no known major drug-drug interactions.

Despite the legal issues, researchers and drug companies continued to investigate and develop herbal cannabis products. For instance, a standardized cannabis product known as CanniMed was developed for medical use in Canada under Health Canada’s Medical Marihuana Access Regulations (MMAR), which were enacted in 2001. The cannabis plants cultivated for CanniMed are grown under carefully controlled conditions, and the drug is standardized to contain approximately 12.5 percent THC. A similar approach has been taken in the Netherlands, where several herbal cannabis products are available, including Bedrocan (19 percent THC) and Bedrobinol (12 percent THC).