The role of marijuana for medicinal purposes is controversial. Medical marijuana has been used in many diseases states.
In October 2014, the AAFP (American Academy of Family Physicians) updated their policy of medical marijuana saying “The AAFP recognizes that there is support for the medical use of marijuana, but advocates that usage be based on high-quality, patient-centered, evidence based research and advocates for further studies into the use of medical marijuana.”
The AAFP advocated for further research on the benefits and risks of medical marijuana. The AAFP opposes the recreational use of marijuana.
So far there are 23 states that have approved the use of medical marijuana.
There are different formulations of marijuana that may be effective in certain conditions. Herbal marijuana can be smoked, ingested, distilled into oils, and vaporized.
Cannabinoids are the key active ingredients in marijuana. Extracts of two cannabinoids, tetrahydrocannabinol (THC) and cannabidiol, are available in pure forms and in combinations. Cannabinoids have been used in pharmaceutical preparations, but only THC or THC analogues are available in the United States.
There are many medical conditions that patients have inquired about for the use of medical marijuana:
Low back pain
– There is no evidence for medical marijuana in chronic low back pain.
– Medical marijuana improved patients perception of pain and spasm. There is some evidence of decreased episodes of urinary incontinence. Muscle stiffness can improve as well with oral cannabis. Medical marijuana MUST be used is an adjunct to disease modifiying therapy.
– There is some evidence marijuana helps Crohn’s patients intractable to other therapies.
– There is data showing medical marijuana can accelerate liver fibrosis. There is conflicting data also saying that patients who use marijuana were able to stay on interferon therapy longer.
– Some studies show marijuana may decrease intraocular pressure. However, the American Glaucoma Society does not support the use of marijuana
– Marijuana may benefit patients who have HIV neuropathy. It is a reasonable choice for painful neuropathy that is resistant to other treatments. Moreover, marijuana can stimulate appetite and help regain muscle mass caused by AIDS wasting syndrome.
– Marijuana is most often used to treat nausea and vomiting associated with chemotherapy. It is a reasonable option for patients whose nausea has not improved with standard antiemetics or who have a contraindication.
– Patients who use marijuana for fibromyalgia consistently report improvements in pain, sense of well-being, and sleep quality
Chronic neuropathic pain
– Individuals with chronic neuropathic pain may benefit from marijuana, but minimal data exists to support this claim.
In summary, marijuana is NOT the first line treatment for any condition; the patient must receive standard therapy. There is evidence for the use of marijuana for multiple sclerosis, Crohn disease, HIV, and neuropathic pain. Marijuana use may benefit patients with fibromyalgia, chemotherapy-induced nausea, and certain seizure disorders. For most other conditions, the benefits of marijuana use are uncertain.