Any clinical discussion on medical cannabis is limited by the relative paucity of randomized controlled trials. Only a small number of clinical studies involving the therapeutic use of cannabis have been carried out to date. And, of those studies, only short term adverse effects associated with cannabis use have been evaluated.
In general, the medical literature on physiological effects and adverse effects of cannabis use pertains to recreational cannabis use much more so than medicinal cannabis use. As such, most of the information we know comes from studies involving recreational cannabis users who often use tobacco and alcohol, as well as other drugs (prescription and illicit drugs).
When comparing recreational cannabis use to medicinal cannabis use, MANY important factors must be noted which our public media discussions often fail to distinguish:
1. Cannabis used for recreational purposes is most often smoked, while smoking cannabis for medicinal purposes is strictly prohibited in Minnesota.
2. Marijuana often contains significantly higher concentrations of THC and lower concentrations of CBD compared to medicinal cannabis products in which the THC level (e.g. psychoactivity) is controlled exclusively.
3. Contaminants are always present in recreational cannabis that are not present in medical grade cannabis products subjected to rigorous testing and clean standards. (Testing Delays Treament)
4. Unlike many new medical cannabis patients, recreational cannabis users who represent most of the studies are not cannabis naïve, and in fact, may have a multi-year history of using high THC cannabis.
5. Recreational cannabis users represent a different patient population as compared to medical cannabis patients. Nuff said.
Therefore, when speaking, writing, texting, tweeting, etc about medical cannabis, it is essential to realize that the effects may not mirror the published studies, and, analogous to any prescription medication recommendation, decisions must be made on an individualized basis with appropriate follow-up.