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Marijuana as Medicine

What is medical marijuana?

Photo by ©Shutterstock.com/Atomazul

The term medical marijuana refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions. The U.S. Food and Drug Administration (FDA) has not recognized or approved the marijuana plant as medicine.

However, scientific study of the chemicals in marijuana, called cannabinoids, has led to two FDA-approved medications that contain cannabinoid chemicals in pill form. Continued research may lead to more medications.

Because the marijuana plant contains chemicals that may help treat a range of illnesses and symptoms, many people argue that it should be legal for medical purposes. In fact, a growing number of states have legalized marijuana for medical use.

Why isn’t the marijuana plant an FDA-approved medicine?

The FDA requires carefully conducted studies (clinical trials) in hundreds to thousands of human subjects to determine the benefits and risks of a possible medication. So far, researchers haven't conducted enough large-scale clinical trials that show that the benefits of the marijuana plant (as opposed to its cannabinoid ingredients) outweigh its risks in patients it's meant to treat.

Read more about the various physical, mental, and behavioral effects of marijuana in our Marijuana DrugFacts.

What are cannabinoids?

Cannabinoids are chemicals related to delta-9-tetrahydrocannabinol (THC), marijuana’s main mind-altering ingredient that makes people "high." The marijuana plant contains more than 100 cannabinoids. Scientists as well as illegal manufacturers have produced many cannabinoids in the lab. Some of these cannabinoids are extremely powerful and have led to serious health effects when misused. Read more in our Synthetic Cannabinoids (K2/Spice) DrugFacts.

CBD and Childhood Epilepsy 

There is growing interest in the marijuana chemical cannabidiol (CBD) to treat certain conditions such as childhood epilepsy, a disorder that causes a child to have violent seizures. Therefore, scientists have been specially breeding marijuana plants and making CBD in oil form for treatment purposes. These drugs aren't popular for recreational use because they aren't intoxicating.

The body also produces its own cannabinoid chemicals. They play a role in regulating pleasure, memory, thinking, concentration, body movement, awareness of time, appetite, pain, and the senses (taste, touch, smell, hearing, and sight).

Are People with Health- and Age-Related Problems More Vulnerable to Marijuana’s Risks?

State-approved medicinal use of marijuana is a fairly new practice. For that reason, marijuana’s effects on people who are weakened because of age or illness are still relatively unknown. Older people and those suffering from diseases such as cancer or AIDS could be more vulnerable to the drug’s harmful effects, but more research is needed.

How might cannabinoids be useful as medicine?

Currently, the two main cannabinoids from the marijuana plant that are of medical interest are THC and CBD. 

THC can increase appetite and reduce nausea. THC may also decrease pain, inflammation (swelling and redness), and muscle control problems.

Unlike THC, CBD is a cannabinoid that doesn't make people "high." It may be useful in reducing pain and inflammation, controlling epileptic seizures, and possibly even treating mental illness and addictions.

Many researchers, including those funded by the National Institutes of Health (NIH), are continuing to explore the possible uses of THC, CBD, and other cannabinoids for medical treatment.

Photo by ©iStock.com/AlexRaths

For instance, recent animal studies have shown that marijuana extracts may help kill certain cancer cells and reduce the size of others. Evidence from one cell culture study with rodents suggests that purified extracts from whole-plant marijuana can slow the growth of cancer cells from one of the most serious types of brain tumors. Research in mice showed that treatment with purified extracts of THC and CBD, when used with radiation, increased the cancer-killing effects of the radiation.1

Scientists are also conducting preclinical and clinical trials with marijuana and its extracts to treat symptoms of illness and other conditions, such as:

• diseases that affect the immune system, including:
  • HIV/AIDS
  • multiple sclerosis (MS), which causes gradual loss of muscle control
• inflammation
• pain
• seizures
• substance use disorders
• mental disorders

Read more about the NIH’s marijuana research:

• Marijuana and Cannabinoid Research at NIDA
• NIH Research on Marijuana and Cannabinoids

Using Medical Marijuana During and After Pregnancy

Some women report using marijuana to treat severe nausea they have during pregnancy. But there's no research that shows that this practice is safe, and doctors generally don't recommend it. 

Pregnant women shouldn't use medical marijuana without first checking with their health care provider. Animal studies have shown that moderate amounts of THC given to pregnant or nursing women could have long-lasting effects on the child, including abnormal patterns of social interactions2 and learning issues.3,4 Read more in our Substance Use in Women Research Report.

What medications contain cannabinoids?

Two FDA-approved drugs, dronabinol and nabilone, contain THC. They treat nausea caused by chemotherapy and increase appetite in patients with extreme weight loss caused by AIDS. Continued research might lead to more medications.

The United Kingdom, Canada, and several European countries have approved nabiximols (Sativex®), a mouth spray containing THC and CBD. It treats muscle control problems caused by MS, but it isn't FDA-approved.

Epidiolex, a CBD-based liquid drug to treat certain forms of childhood epilepsy, is being tested in clinical trials but isn't yet FDA-approved.

Points to Remember

• The term medical marijuana refers to treating symptoms of illness and other conditions with the whole, unprocessed marijuana plant or its basic extracts.
• The FDA has not recognized or approved the marijuana plant as medicine.
• However, scientific study of the chemicals in marijuana called cannabinoids has led to two FDA-approved medications in pill form, dronabinol and nabilone, used to treat nausea and boost appetite.
• Cannabinoids are chemicals related to delta-9-tetrahydrocannabinol (THC), marijuana’s main mind-altering ingredient.
• Currently, the two main cannabinoids from the marijuana plant that are of interest for medical treatment are THC and cannabidiol (CBD).
• The body also produces its own cannabinoid chemicals.
• Scientists are conducting preclinical and clinical trials with marijuana and its extracts to treat symptoms of illness and other conditions.

What are synthetic cannabinoids?

Synthetic cannabinoids refer to a growing number of man-made mind-altering chemicals that are either sprayed on dried, shredded plant material so they can be smoked (herbal incense) or sold as liquids to be vaporized and inhaled in e-cigarettes and other devices (liquid incense).

These chemicals are called cannabinoids because they are related to chemicals found in the marijuana plant. Because of this similarity, synthetic cannabinoids are sometimes misleadingly called "synthetic marijuana" (or "fake weed"), and they are often marketed as "safe," legal alternatives to that drug. In fact, they may affect the brain much more powerfully than marijuana; their actual effects can be unpredictable and, in some cases, severe or even life-threatening.

False Advertising

Synthetic cannabinoid products are often labeled "not for human consumption." Labels also often claim that they contain "natural" material taken from a variety of plants. However, the only parts of these products that are natural are the dried plant materials. Chemical tests show that the active, mind-altering ingredients are cannabinoid compounds made in laboratories.

Synthetic cannabinoids are included in a group of drugs called "new psychoactive substances" (NPS). NPS are unregulated psychoactive (mind-altering) substances that have become newly available on the market and are intended to copy the effects of illegal drugs. Some of these substances may have been around for years but have reentered the market in altered chemical forms or due to renewed popularity.

Manufacturers sell these herbal incense products in colorful foil packages and sell similar liquid incense products, like other e-cigarette fluids, in plastic bottles. They market these products under a wide variety of specific brand names; in past years, K2 and Spice were common. Hundreds of other brand names now exist, such as Joker, Black Mamba, Kush, and Kronic.

For several years, synthetic cannabinoid mixtures have been easy to buy in drug paraphernalia shops, novelty stores, gas stations, and through the Internet. Because the chemicals used in them have a high potential for abuse and no medical benefit, authorities have made it illegal to sell, buy, or possess some of these chemicals. However, manufacturers try to sidestep these laws by changing the chemical formulas in their mixtures.

Easy access and the belief that synthetic cannabinoid products are "natural" and therefore harmless have likely contributed to their use among young people. Another reason for their use is that standard drug tests cannot easily detect many of the chemicals used in these products. 

How do people use synthetic cannabinoids?

Users usually smoke the dried plant material sprayed with synthetic cannabinoids. Sometimes they mix the sprayed plant material with marijuana, or they brew it as tea. Other users buy synthetic cannabinoid products as liquids to vaporize them in e-cigarettes.

How do synthetic cannabinoids affect the brain?

Synthetic cannabinoids act on the same brain cell receptors as delta-9-tetrahydrocannabinol (THC), the mind-altering ingredient in marijuana.

So far, there have been few scientific studies of the effects of synthetic cannabinoids on the human brain, but researchers do know that some of them bind more strongly than marijuana to the cell receptors affected by THC, and may produce much stronger effects. The resulting health effects can be unpredictable.

Because the chemical composition of many synthetic cannabinoid products is unknown and may change from batch to batch, these products are likely to contain substances that cause dramatically different effects than the user might expect.

Synthetic cannabinoid users report some effects similar to those produced by marijuana:

• elevated mood
• relaxation
• altered perception—awareness of surrounding objects and conditions
• symptoms of psychosis—delusional or disordered thinking detached from reality

Foto, ©iStock.com/trendobjects

Psychotic effects include:

• extreme anxiety
• confusion
• paranoia—extreme and unreasonable distrust of others
• hallucinations—sensations and images that seem real though they are not

What are some other health effects of synthetic cannabinoids?

People who have used synthetic cannabinoids and have been taken to emergency rooms have shown severe effects including:

• rapid heart rate
• vomiting
• violent behavior
• suicidal thoughts

Synthetic cannabinoids can also raise blood pressure and cause reduced blood supply to the heart, as well as kidney damage and seizures. Use of these drugs is associated with a rising number of deaths. 

Are synthetic cannabinoids addictive?

Foto, Humannet/©Shutterstock

Yes, synthetic cannabinoids can be addictive. Regular users trying to quit may have the following withdrawal symptoms:

• headaches
• anxiety
• depression
• irritability

Behavioral therapies and medications have not specifically been tested for treatment of addiction to these products.

Points to Remember

• Synthetic cannabinoids refer to a growing number of man-made mind-altering chemicals sprayed on dried, shredded plant material or vaporized to get high.
• Synthetic cannabinoids are sometimes misleadingly called "synthetic marijuana" (or "fake weed") because they act on the same brain cell receptors as delta-9-tetrahydrocannabinol, the mind-altering ingredient in marijuana.
• The effects of synthetic cannabinoids can be unpredictable and severe or even life-threatening.
• The only parts of synthetic cannabinoid products that are "natural" are the dried plant materials. Chemical tests show that their active ingredients are man-made cannabinoid compounds.  
• Synthetic cannabinoid users report some effects similar to those produced by marijuana:
  • elevated mood
  • relaxation
  • altered perception
  • symptoms of psychosis
• Synthetic cannabinoids can also cause serious mental and physical health problems including:
  • rapid heart rate
  • vomiting
  • violent behavior
  • suicidal thoughts
• Synthetic cannabinoids can be addictive.
• Behavioral therapies and medications have not specifically been tested for treatment of addiction to these products.

What is methamphetamine?

Photo by DEACrystal methamphetamine

Methamphetamine is a stimulant drug usually used as a white, bitter-tasting powder or a pill. Crystal methamphetamine is a form of the drug that looks like glass fragments or shiny, bluish-white rocks. It is chemically similar to amphetamine [a drug used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy, a sleep disorder]. 

Other common names for methamphetamine include chalk, crank, crystal, ice, meth, and speed.

How do people use methamphetamine?

People can take methamphetamine by:

• inhaling/smoking
• swallowing (pill)
• snorting
• injecting the powder that has been dissolved in water/alcohol

Because the "high" from the drug both starts and fades quickly, people often take repeated doses in a "binge and crash" pattern. In some cases, people take methamphetamine in a form of binging known as a "run," giving up food and sleep while continuing to take the drug every few hours for up to several days. 

How does methamphetamine affect the brain?

Methamphetamine increases the amount of the natural chemical dopamine in the brain. Dopamine is involved in body movement, motivation, pleasure, and reward (pleasure from natural behaviors such as eating). The drug’s ability to release high levels of dopamine rapidly in reward areas of the brain produces the "rush" (euphoria) or "flash" that many people experience.

Short-Term Effects

Taking even small amounts of methamphetamine can result in many of the same health effects as those of other stimulants, such as cocaine or amphetamines. These include:

• increased wakefulness and physical activity
• decreased appetite
• faster breathing
• rapid and/or irregular heartbeat
• increased blood pressure and body temperature 

How Do Manufacturers Make Methamphetamine?

Manufacturers make most of the methamphetamine found in the United States in "superlabs" here or, more often, in Mexico. But some also make the drug in small, secret labs with inexpensive over-the-counter ingredients such as pseudoephedrine, a common ingredient in cold medicines. To curb production, the law requires pharmacies and other retail stores to keep a purchase record of products containing pseudoephedrine. A person may only buy a limited amount of those products on a single day.

What are other health effects of methamphetamine?

Photo by Dozenist/CC BY-SA"Meth mouth"

Long-Term Effects

People who inject methamphetamine are at increased risk of contracting infectious diseases such as HIV and hepatitis B and C. These diseases are transmitted through contact with blood or other bodily fluids. Methamphetamine use can also alter judgment and decision-making leading to risky behaviors, such as unprotected sex, which also increases risk for infection. 

Methamphetamine use may worsen the progression of HIV/AIDS and its consequences. Studies indicate that HIV causes more injury to nerve cells and more cognitive problems in people who have HIV and use methamphetamine than it does in people who have HIV and don't use the drug.1Cognitive problems are those involved with thinking, understanding, learning, and remembering.

Long-term methamphetamine use has many other negative consequences, including:

• extreme weight loss
• severe dental problems ("meth mouth")
• intense itching, leading to skin sores from scratching
• anxiety
• confusion
• sleeping problems
• violent behavior
• paranoia—extreme and unreasonable distrust of others
• hallucinations—sensations and images that seem real though they aren't

In addition, continued methamphetamine use causes changes in the brain's dopamine system that are associated with reduced coordination and impaired verbal learning. In studies of people who used methamphetamine over the long term, severe changes also affected areas of the brain involved with emotion and memory.2 This may explain many of the emotional and cognitive problems observed in those who use methamphetamine.

Although some of these brain changes may reverse after being off the drug for a year or more, other changes may not recover even after a long period of abstinence.3 A recent study even suggests that people who used methamphetamine have an increased the risk of developing Parkinson's disease, a disorder of the nerves that affects movement.4

Are there health effects from exposure to secondhand methamphetamine smoke?

Researchers don't yet know whether people breathing in secondhand methamphetamine smoke can get high or have other health effects. What they do know is that people can test positive for methamphetamine after exposure to secondhand smoke.5,6 More research is needed in this area.

Can a person overdose on methamphetamine?

Yes, a person can overdose on methamphetamine. An overdose occurs when the person uses too much of a drug and has a toxic reaction that results in serious, harmful symptoms or death.

Methamphetamine overdose can lead to stroke, heart attack, or organ problems—such as kidney failure—caused by overheating. These conditions can result in death. 

How can a methamphetamine overdose be treated?

Because methamphetamine overdose often leads to a stroke, heart attack, or organ problems, first responders and emergency room doctors try to treat the overdose by treating these conditions, with the intent of:

• restoring blood flow to the affected part of the brain (stroke)
• restoring blood flow to the heart (heart attack)
• treating the organ problems

Is methamphetamine addictive?

Yes, methamphetamine is highly addictive. When people stop taking it, withdrawal symptoms can include:

• anxiety
• fatigue
• severe depression
• psychosis
• intense drug cravings

How can people get treatment for methamphetamine addiction?

The most effective treatments for methamphetamine addiction so far are behavioral therapies, such as:

• cognitive-behavioral therapy, which helps patients recognize, avoid, and cope with the situations in which they are most likely to use drugs
• motivational incentives, which uses vouchers or small cash rewards to encourage patients to remain drug-free 

While research is under way, there are currently no government-approved medications to treat methamphetamine addiction.

Points to Remember

• Methamphetamine is usually a white, bitter-tasting powder or a pill. Crystal methamphetamine looks like glass fragments or shiny, bluish-white rocks. 
• Methamphetamine is a stimulant drug that is chemically similar to amphetamine (a drug used to treat ADHD and narcolepsy). 
• People can take methamphetamine by inhaling/smoking, swallowing, snorting, or injecting the drug.
• Methamphetamine increases the amount of dopamine in the brain, which is involved in body movement, motivation, pleasure, and reward.
• Short-term health effects include increased wakefulness and physical activity, decreased appetite, and increased blood pressure and body temperature.
• Long-term health effects include risk of contracting HIV and hepatitis; severe dental problems ("meth mouth"); intense itching, leading to skin sores from scratching; violent behavior; and paranoia.
• Researchers don't yet know whether people breathing in secondhand methamphetamine smoke can get high or have other health effects.
• A person can overdose on methamphetamine. Because methamphetamine overdose often leads to a stroke, heart attack, or organ problems, first responders and emergency room doctors try to treat the overdose by treating these conditions.
• Methamphetamine is highly addictive. When people stop taking it, withdrawal symptoms can include anxiety, fatigue, severe depression, psychosis, and intense drug cravings.
• The most effective treatments for methamphetamine addiction so far are behavioral therapies. There are currently no government-approved medications to treat methamphetamine addiction.