Even with more states implementing medical marijuana laws, questions remain about the legitimate use of marijuana for medical conditions. For cancer patients in particular, medical marijuana may offer an interesting symptom management option. But due to the lack of clinical evidence currently available, many health care providers advise patients to proceed with caution and thoroughly discuss available options with their physician prior to beginning treatment.
Below are answers to common questions that may shed some light on where the medical marijuana field currently stands.
The active component of marijuana (cannabis) is tetrahydrocannabinol (THC). In some people, THC has the effect of controlling nausea, increasing appetite and lessening pain. The synthetic derivative of THC (dronabinol) is manufactured and sold as a Schedule III drug, defined as having low to moderate potential for physical or psychological dependence, and may be prescribed by your physician. These medications are strictly regulated by the U.S. Food and Drug Administration (FDA) for purity, effectiveness and safety. The FDA approves the use of dronabinol for anorexia related to AIDS wasting syndrome, as well as for refractory chemotherapy-induced nausea and vomiting. THC may also be obtained by smoking or eating the marijuana (cannabis) plant. However, the dosage of these plant-based forms is variable and not regulated by the FDA. This variability may lead to decreased effectiveness or increased side effects among users of marijuana.
Although THC may help reduce nausea or increase appetite, its side effects may also include the inability to think clearly or concentrate and, over the long-term, may include mental disorders such as schizophrenia, depression and/or bipolar disorder. In addition, respiratory complications such as chronic bronchitis could develop as a side effect of THC.
As with any medicine, marijuana may amplify side effects of other medications. It is important that you discuss the use of medicines and supplements with your physician and ask about potential side effects or interactions.
Although states have passed laws permitting the use of medical marijuana, under federal law, marijuana continues to be an illegal Schedule I drug, meaning that it is considered to have a high potential for abuse and is not recognized for medicinal use. Because of this, marijuana cannot be used in hospital settings or dispensed at licensed pharmacies. Insurance companies do not cover the cost of medical marijuana, but most will cover the use of the pharmaceutical dronabinol, which contains the active component THC.
Aside from anecdotal reports, very little medical evidence is available to support the use of medical marijuana. Only a small number of controlled studies have examined the benefits and risks of marijuana use. At this time, it is difficult to make a medical judgement regarding the use of medical marijuana with so little evidentiary details on which to base it.
Regulation of medical marijuana possession and use varies from state to state. Ultimately, medical decision-making is shared between individual patients and their physicians. If a physician determines that a medical indication exists for its use, the method of obtaining the product varies depending on that state's laws. It is up to you and your physician to determine and comply with all state and federal regulations.