Cannabis: Uses, Effects and Safety

Common or street names: Bud, ganja, grass, hashish, hemp, Indian hemp, marijuana, pot, reefer, weed.

What is cannabis?

Cannabis sativa, also known as hemp, is a species of the Cannabinaceae family of plants. Cannabis contains the chemical compound THC (delta-9 tetrahydrocannabinol), which is believed to be responsible for most of the characteristic psychoactive effects of cannabis that leads to the “high” that is experienced when cannabis is consumed. However, not all components of cannabis are psychoactive.

The dried leaves and flowers (buds) of the cannabis plant are known as marijuana, which can be smoked (through a pipe or bong, hand-rolled into a joint, or consumed in an edible (for example, cookies, brownies, gummies).
The resinous secretions of the plant are known as hashish, which can be smoked or eaten.
The fiber of the cannabis plant is cultivated as industrial hemp with uses in textile manufacturing.

Compounds which have a structure similar to THC are known as cannabinoids.

What are the effects of cannabis?

The effects experienced by the cannabis (marijuana) user are variable and will depend upon the dose, method of administration, prior experience, any concurrent drug use, personal expectations, mood state and the social environment in which the drug is used.

Effects of cannabis (marijuana) include:

an altered state of consciousness. The user may feel “high”, very happy, euphoric, relaxed, sociable and uninhibited.
distorted perceptions of time and space. The user may feel more sensitive to things around them, and may also experience a more vivid sense of taste, sight, smell and hearing.
increased pulse and heart rate, bloodshot eyes, dilated pupils, and often increased appetite (“the munchies”).
impaired coordination and concentration, making activities such as driving a car or operating machinery difficult and dangerous.
negative experiences, such as anxiousness, panic, self-consciousness and paranoid thoughts.

People who use large quantities of cannabis may become sedated or disoriented and may experience toxic psychosis — not knowing who they are, where they are, or what time it is. High doses may also cause fluctuating emotions, fragmentary thoughts, paranoia, panic attacks, hallucinations and feelings of unreality.

Various concentrations of THC, cannabidiol (CBD), or hybrid products exist in products found cannabis dispensaries in states that have legalized recreational marijuana use.

How long does it take cannabis to work?

The effects of inhaled cannabis are felt within minutes, reach their peak in 10 to 30 minutes, and may linger for two or three hours. However, edible cannabis, which may contain higher amount of THC, can take a longer period of time to reach full effect as it must be absorbed from the gastrointestinal tract. The effect of edible cannabis can last up to 12 hours.

THC is highly lipid soluble and can be stored in fat cells possibly for several months. Stored THC is released very slowly, and unevenly, back into the bloodstream.

Medical uses

While cannabis (marijuana) remains a federal DEA Schedule 1 controlled substance, research has resulted in development and marketing of medications which are synthetic prescription cannabinoid products.

Marinol (dronabinol) is used for the control of nausea and vomiting caused by chemotherapeutic agents used in the treatment of cancer and to stimulate appetite in AIDS patients.
Cesamet (nabilone) is used for the control of nausea and vomiting caused by chemotherapeutic agents used in the treatment of cancer.

Safety of cannabis

Consumption of marijuana leads to a psychoactive drug effect. Do not drive, operate machinery, or perform other hazardous activities while using cannabis (marijuana). It may cause dizziness, drowsiness, and impaired judgment. States that have legalized marijuana for recreational or medical consumption have laws in place that make it illegal to drive under the influence of marijuana; review each states law carefully.

Do not drink alcohol while using cannabis. Alcohol will increase dizziness, drowsiness, and impaired judgment.
Cannabis may increase the effects of other drugs that cause drowsiness, including antidepressants, alcohol, antihistamines, sedatives (used to treat insomnia), pain relievers, anxiety medicines, seizure medicines, and muscle relaxants, among others.
Cannabis is still considered a federal Schedule 1 drug under the U.S. Controlled Substances Act.

Medical Cannabis (Medical Marijuana)

The most common uses for medical cannabis include for severe or long-term pain, nausea and vomiting due to chemotherapy (cancer treatments), and painful muscle spasms. However, there are several medical conditions for which patients can use medical marijuana, which can vary by state law:

Amyotrophic lateral sclerosis
Cancer
Glaucoma
HIV/AIDS
Huntington’s disease
Inflammatory bowel disease
Multiple sclerosis
Muscle spasms
Neuropathy
Parkinson’s disease
Post Traumatic Stress Disorder (PSTD)
Seizures (epilepsy)
Severe pain (and if an alternative to opioid use)
Severe nausea
Spinal cord injury with spasticity
Cachexia or dramatic weight loss and muscle atrophy (wasting syndrome)

Medical marijuana comes in various forms for use, including oil, tablet or capsule, liquid that can be vaporized, nasal spray, and the traditional dried leaves and buds thay can be smoked or taken as edibles.

Talking with your doctor

Many patients find themselves in the situation of wanting to learn more about medical marijuana, but feel embarrassed to bring this up with their doctor. This is in part because the medical community has been, as a whole, overly dismissive of this issue. Doctors are now playing catch-up and trying to keep ahead of their patients’ knowledge on this issue. Other patients are already using medical marijuana, but don’t know how to tell their doctors about this for fear of being chided or criticized.

My advice for patients is to be entirely open and honest with your physicians and to have high expectations of them. Tell them that you consider this to be part of your care and that you expect them to be educated about it, and to be able to at least point you in the direction of the information you need.

My advice for doctors is that whether you are pro, neutral, or against medical marijuana, patients are embracing it, and although we don’t have rigorous studies and “gold standard” proof of the benefits and risks of medical marijuana, we need to learn about it, be open-minded, and above all, be non-judgmental. Otherwise, our patients will seek out other, less reliable sources of information; they will continue to use it, they just won’t tell us, and there will be that much less trust and strength in our doctor-patient relationship. I often hear complaints from other doctors that there isn’t adequate evidence to recommend medical marijuana, but there is even less scientific evidence for sticking our heads in the sand.

Cannabis: Uses, Effects and Safety