Cannabis

Cannabis is a plant (Cannabis spp.) that contains a complex of psychoactive substances, the most notable of these being tetrahydrocannabinol (usually shortened to THC). The primary species used as drugs are C. indica and C. sativa. C. ruderalis, which has a low THC content, has been used in some cross-breeding.[2]

Our secret stash of
Drugs
Highs and lows
v - t - e
“”It's good for the flu

Good for asthma,
Good for tuberculosis,

Even …[note 1]
—"Bush Doctor" Peter Tosh, "Legalize It" lyrics (1976)[1]

Marijuana woo is an umbrella term for various claims regarding the positive effects of marijuana cultivation and use. These generally fall into three basic areas:

  • Claims concerning psychoactivity (occasionally extending all the way to Terrence McKennaFile:Wikipedia's W.svg-esque soul-babble)
  • Health claims (often promoted as a panacea,[3] sometimes amounting to a quack cancer cure)
  • Ecological claims (positive instead of negative predictions from the same scientific illiterates who detest GMO's)

In the United States, marijuana currently falls into a legal gray-area: illegal at the federal level, legal in some states (e.g., Colorado), quasi-legal in other states ("medical marijuana", e.g., California[note 2]), and still illegal in others (e.g., Texas). So far, the only countries that have legalized recreational use nationwide are Uruguay and Canada. In some other countries, such as the Netherlands, it is not legal but it is tolerated.

Marijuana woo has been associated with other types of woo, such as aromatherapy[4] and chakras.[5]

Marijuana fans claim a startling assortment of things that marijuana is just about the best thing ever for, and none of this is because they want to get high as hell, maaaaan. (Of course, getting high might make you feel like your problems are solved, or alleviated.)

Health claims

Health claims, particularly in the medical marijuana jurisdictions, tend towards the dietary supplement realm even though marijuana is not covered by the Dietary Supplement Health and Education Act of 1994 (DSHEA) because it is illegal at the Federal level. Some health claims even have the Quack Miranda Warning,[6][5] which was a byproduct of DSHEA.

Let's start with some background on marijuana chemistry. Relevant chemicals in marijuana fall into two broad classes: cannabinoids (which in plants are specific to the Cannabis genus) and terpenoids (which are widespread in many plants).[7][8] Humans and other animals, produce endocannabinoids, which are different than but in the same chemical class as those cannabinoids found in marijuana. The main psychoactive chemical in marijuana is tetrahydrocannabinol (THC). Another important cannabinoid is cannabidiol (CBD), which is not psychoactive but has many claimed health benefits. Terpenoids in marijuana include ocimene, myrcene, β-caryophyllene, limonene, pinene, myrcene, linalool.

There are two major problems with evaluating medical claims for marijuana:

  1. There is a large variability of the chemical content of marijuana, particularly since marijuana has been bred for different pharmacological properties. From the medical marijuana supplier perspective, this ranges from plants with high-THC/low-CBD to low-THC/high-CBD, as well as variations in terpenoid content.[6][5] These chemicals may have either synergistic or antagonistic effects with regard to a particular medical treatment, so assessing the effectiveness of medical marijuana as a whole is difficult due to the quantitative chemical variability.
  2. In general, the quality of medical evidence forms a scale, or hierarchy of evidence, ranging from in vitro cell studies (lowest evidence) to animal bioassays (in vivo) to human retrospective studies to human prospective studies to meta-analyses and reviews of all direct evidence. It is difficult and expensive to conduct large-scale, long-term human studies, and the ability of researchers to conduct these has often been hampered by marijuana's illegality. Marijuana advocates may make claims based on in vitro studies of single chemicals, but this is never convincing evidence for human health — it is merely suggestive for further research.
  3. "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."[9]

Another problem with research on the medical effects on marijuana is that for the rare cases of US Federal Government-funded research, the marijuana is required to be sourced from the Federal Government.[10] Such marijuana by today's commercial marijuana standards is considered to be low-grade (ditch weed), and is not comparable in terms of chemical content to what most people actually smoke.[10]

Toxicity

Marijuana and THC are generally considered to have low toxicity, particularly compared to other recreational drugs. One method of assessing toxicity is using the Margin of Exposure (MOE) method, where MOE = Human exposure / Animal median lethal dose. For example, for alcohol and nicotine, the MOE is low (<10), meaning the risk is high with the exposure dose close to the lethal dose. For THC, the MOE is high (>10,000), meaning the risk of death is low.[11]

It has often been claimed (including by former-Presidential candidate Gary Johnson) that no one has ever died from a marijuana overdose.[12][13] The first problem with this claim is that it does not clearly state whether the lack of mortality is from direct causes (toxicity), or from indirect causes (i.e., from judgment or psychomotor impairment).[13]

“”Too often individuals cite that individuals haven’t died from cannabis — I don't think that's true. It certainly can be argued that cannabis use has contributed to the deaths of individuals, such as due to impairment during driving.
—Dr. Ryan Vandrey, researcher at Johns Hopkins University who specializes in the behavioral effects of marijuana[13]

Marijuana has been cited as the sole cause of at least some traffic fatalities.[14][15] After marijuana legalization in Colorado, traffic fatalities in which marijuana was at least partly-responsible increased to 94 in 2014, a not-insignificant number compared to alcohol-related traffic fatalities for that year (170 fatalities).[14] It should be noted that marijuana does impair judgment, motor coordination, and reaction time,[14][16][17] and its effect on impairment is either additive or synergistic with alcohol.[17]

Marijuana has been associated with at least 7 cases of heart attacks in different people (at least 4 of whom had normal coronary vasculature) and possibly some deaths, and marijuana is known to have several vascular effects that may be causative (e.g., tachycardia, hypertension, bradycardia, and hypotension).[18][19][20][21][22]

Pain and spasticity

A 2015 review of human studies in The Journal of the American Medical Association found that there was high-quality evidence for treatment of chronic pain, neuropathic pain, and spasticity from multiple sclerosis (MS).[23] The author also concluded that "Medical marijuana is used to treat a host of indications, a few of which have evidence to support treatment with marijuana and many that do not."[23]

A large, multi-faceted literature review by the National Academies of Sciences, Engineering, and Medicine (NASEM) also concluded:[24]

“”
  • In adults with chronic pain, patients who were treated with cannabis or cannabinoids are more likely to experience a clinically significant reduction in pain symptoms.
  • In adults with multiple sclerosis (MS)-related spasticity, short-term use of oral cannabinoids improves patient-reported spasticity symptoms.

The review also concluded that the effects were modest.[24] However, separate studies have shown that US states with medical marijuana have reduced opioid prescriptions[25][26] and 25% fewer opioid-related deaths.[25][27]

Nausea

A 2015 review of randomized controlled trials in humans found that the majority of the studies were at risk of bias due to not being double blind, or from attrition of test subjects. Nonetheless, the authors concluded that marijuana-based medications may be useful for treating nausea.[28] The NASEM report also concluded, "In adults with chemotherapy induced nausea and vomiting, oral cannabinoids are effective antiemetics," and that the effects were modest.[24]

Glaucoma

Marijuana treatment for intraocular pressure from glaucoma is widely cited as effective, particularly because the first authorized usage of medical marijuana since its criminalization was based on a court case by Robert Randall in 1976.[29] There is some supporting scientific evidence that marijuana is efficacious for at least some types of glaucoma, based on small studies on humans. The effect on intraocular pressure is relatively brief, and there are other pharmaceutical treatments available for glaucoma which have been tested for safety and efficacy.[30][31] The American Glaucoma Society[32] and the Canadian Ophthalmological Society[33] oppose medical marijuana usage due to extensive adverse effects.[30]

Mental health

The 2017 NASEM review concluded:[24]

“”
  • Cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use the greater the risk.
  • In individuals with schizophrenia and other psychoses, a history of cannabis use may be linked to better performance on learning and memory tasks.
  • Cannabis use does not appear to increase the likelihood of developing depression, anxiety, and posttraumatic stress disorder.
  • For individuals diagnosed with bipolar disorders, near daily cannabis use may be linked to greater symptoms of bipolar disorder than non-users.
  • Heavy cannabis users are more likely to report thoughts of suicide than non-users.
  • Regular cannabis use is likely to increase the risk for developing social anxiety disorder.

Psychosis is associated with marijuana users who favor high THC/low CBD varieties.[34] There is also evidence that psychosis is associated with highly-concentrated forms of marijuana (e.g., "dabs", "shatter" and "wax"), as well as with substances with synthetic cannabinoids (a.k.a., "spice").[34] The erroneous idea that dabs are "safe" has been propagated by parts of the marijuana industry without addressing the known risks of consuming high levels of THC.[35][34]

General

Claim: "The combination of THC and terpenes modulates each strain to have its own effect, flavor, energy and medical uses."[6]

Research findings: This is sufficiently vague that it is basically true,[36] but not very informative.

Cannabinoids

Because of the evidence above from studies on whole marijuana, the focus below on specific chemicals will be on claims other than for treatment of pain, nausea, glaucoma, depression and MS. There is reasonable evidence of marijuana efficacy for these claims, though the efficacy regarding a specific chemical may be another matter. Furthermore, the focus below will be on claims regarding specific diseases (e.g. cancer) or implying the treatment of diseases (e.g., anti-proliferative implies cancer treatment), rather than vague disease-related claims (e.g., antimicrobial).

Cannabichromene (CBC)

Claims: treatment of anxiety and stress, anti-viral, cancer, bone growth[37]

Research findings:

  • Anxiety: see above
  • Stress: no studies in PubMed
  • Anti-viral: no studies in PubMed
  • Cancer: CBC had some effect against breast tumors in vitro.[38] The evidence is suggestive for further research.
  • Bone growth: no studies in PubMed

Cannabidiol (CBD)
See the main article on this topic: CBD

Claims: treatment of MS, epilepsy, diabetes (by lowering blood sugar), stress, insomnia[37]

Research findings:

  • Diabetes: CBD was effective in lowering the incidence of diabetes in mice in two studies.[39][40][41] Two studies in humans showed a possible protective effect from marijuana on diabetes onset (association but not necessarily causation).[42][43]
  • Epilepsy: A 2015 review found that purified CBD showed promise in uncontrolled studies, but that controlled studies were lacking. Questions remain about safety and efficacy.[44] A 2017 trial study of 120 patients found that children with a type of childhood epilepsy known as Dravet Syndrome had a greater reduction in convulsions when treated with CBD than placebo.[45] In 2018, an FDA panel recommended CBD as the very narrowly defined treatment, specifically for "seizures caused by Lennox-Gastaut syndrome (LGS) and Dravet syndrome in patients aged 2 and older."[46]

There is a lot of interest in potential medical uses of CBD, but as of 2019, treatment of Dravet Syndrome-type epilepsy is the only FDA-approved treatment.[47]

Cannabidiolic Acid (CBD-A)

Claims: treatment of inflammation and cancer[37]

Research findings:

  • Cancer: There are a few in vitro studies, so the evidence is only suggestive that more research is needed.[48]

Cannabigerol (CBG)

Claims: stimulates the growth of new brain and bone cells, antibacterial, anti-tumor (cancer), treatment of insomnia[37]

Research findings:

  • Brain growth: Ordinarily, one does not want to stimulate cell growth because it could increase the risk of cancer. The idea that this is a good thing seems to imply that the claimants (Steephill Labs)[37] are referring to Huntington's disease, a progressive disease of the brain that causes degeneration of nerve cells.[49] A CBG derivative — not CBG itself — was tested in mice with a Huntington's-like disease — not Huntington's itself, and the results showed promise.[50] A different study of CBG itself in mice that did not have any disease also showed some neuroprotection.[51] No studies have been conducted on humans, the evidence of CBG being effective on Huntington's is weak.
  • Bone growth: no publications on CBG and bone in PubMed between 1966 and 2016
  • Cancer: a study of CBG on a mouse model of colon cancer (in vivo) showed that CBG hampered tumor progression.[52] No studies have been conducted on humans.
  • Insomnia: No studies in PubMed

Cannabinol (CBN)

Claims: treatment of insomnia, nausea and convulsions[37]

Research findings:

  • Insomnia: A 2014 review of cannabinoid administration on sleep found that there were "various effects of cannabinoid administration on several aspects of sleep", and that because of methodological issues, it was not possible to make a conclusion.[53]
  • Convulsions: Only 1 reference was found in the US National Library of Medicine PubMed database (between 1966 and 2016) on CBN and convulsions in humans: a single page in an obscure journal.[54] A study on CBD on induced seizures in rats showed that it was an effective anticonvulsant.[55] One would have to conclude that the evidence is weak.
  • Nausea: see above

Tetrahydrocannabinol (THC)

Claims: "THC has been shown to be effective in the treatment of a variety of ailments and disorders including pain, tumors (cancer), nausea and ADHD."[37] Kelly Hauf claimed to have cured herself of oligodendroglioma brain cancer by treating herself with cannabis oil.[56] She now runs a website that reports testimonials, a single case study, and in vivo studies. The website is also anti-chemotherapy.[57]

Research findings:

  • Cancer: The best evidence of treatment of cancer with marijuana chemicals is suggestive but not convincing, because it relies on in vitro studies.[58] A phase 1 clinical trial on a THC-CBD mixture for treatment of brain (and spinal cord) tumours is currently underway.[59][60]
  • ADHD: In humans, marijuana exposure to the developing embryo and fetus "is associated "with a plethora of neurobehavioural deficiencies…" There is evidence that the deficiencies are due to THC. The deficiencies include anencephaly, ADHD, memory impairment, and learning disability.[61]
  • Pain: see above

α-Bisabolol

Claims: anti-inflammatory, anti-irritant, antioxidant, anti-microbial, analgesic[62]

β-Caryophyllene

Claims: treatment of sepsis and inflammation, infections (bacterial and fungal), alcoholism, and cancer[37][63]

Guaiol

Claims: antimicrobial, anti-inflammatory[64]

Humulene

Claims: treatment of cancer, infections (bacterial), inflammation, and appetite suppression[37][63]

Research findings:

  • Cancer: A small, short study of injected tumor cells in mice found some inhibitory effects of α-humulene.[65] Given the shortcomings of this study (injected tumors, small number of animals), the relevance to humans is minimal. In vitro studies on humulene have also been conducted.

d-Limonene
d-Limonene

Claims: treatment of gastric reflux, antibacterial, antifungal, depression, anxiety, and cancer[37][66][67]

Research findings:

  • Gastric reflux: a single, small unpublished study reported positive results in humans.[68] This is not convincing evidence because the study was not peer-reviewed (e.g., the study methods could have been defective, or there could have been bias in the study).
  • Cancer: d-limonene was tested in a small phase I trial and a limited phase II for treatment of cancer patients; effectiveness of the treatment was not reported as only tolerance of d-limonene was tested.[69] d-limonene inhibited a liver carcinogenesis mechanism in vitro,[70][7][8] but this is only suggestive of further research. Furthermore, d-limonene caused kidney tumors in male rats at high doses.[71][72]
  • Depression and anxiety: see above

Linalool

Claims: treatment of insomnia, psychosis, anxiety, epilepsy, depression, and pain[37][62]

Research findings:

  • Psychosis: A 2015 review found that marijuana containing high levels of THC was associated with psychosis in users.[73] Linalool may or may not counteract the psychotic effects of THC, but it would seem to be wise to avoid marijuana (and THC) as a psychosis treatment.
  • Depression and anxiety: see above
  • Pain: see above

β-Myrcene

Claims: treatment of cancer, inflammation, pain, insomnia, infection and spasms[37][62]

Research findings:

  • Cancer: β-Myrcene inhibited a liver carcinogenesis mechanism in vitro,[70][7][8] but this is only suggestive of further research.
  • Pain: see above

trans-Nerolidol

Claims: inhibits growth of leishmaniasis, antiparasitic, antifungal, antimicrobial[63]

Research findings:

  • Leishmaniasis: A mixture of cis- and trans-nerolidol was effective at inhibiting the growth of Leishmania spp. in vitro.[74] The results would only warrant further research.

Ocimene

Claims: antiviral, antifungal, antiseptic, decongestant, antibacterial[64]

α-Pinene

Claims: treatment of asthma and inflammation[37]

Terpinolene

Claims: anticancer, antioxidant, sedative, antibacterial, antifungal[64]

Psychoactive claims

Claim: God gave us cannabinoid receptors so we could smoke pot all day.[75]

Reality: Cannibinoid receptors are activated by endocannabinoids,File:Wikipedia's W.svg i.e., cannibinoid chemicals that are naturally produced by the human body (e.g. arachidonoylethanolamine). Activation of cannibinoid receptors causes several physiological functions including gastrointestinal activity, cardiovascular activity and bone growth.[76][77]

So, why then are there cannabinoids in marijuana; did God put them there because he liked stoners? No. The most likely answer is that wild Cannabis species with higher levels of THC deter grazing by herbivores. Yes, cannabinoids are one of many[78][79][80] natural pesticides produced by plants,[81] just like others—such as caffeine and capsaicin (the active ingredient in spicy foods)—that we clever apes have found useful and/or enjoyable.

Ecological claims

Marijuana has sometimes been greenwashed as being particularly ecologically sound, either explicitly[82] or implicitly (e.g., just by associating it with the word "green"). While this may be true of ditch weed (e.g. uncultivated marijuana with low THC/CBD content) or commercial hemp, it is not very likely for what you're buying for psychoactive and/or medical purposes. Commercial marijuana is either farmed outdoors (often requiring synthetic pesticides), or indoors (requiring large amounts of electricity for lighting). In California, outdoor marijuana is often grown illegally on public land, which both deprives the public of access (since it's heavily guarded) and degrades ecosystems with clearing and pollution.[83]

Risks

For many people, knowing the actual risks of cannabis is difficult. On the one hand, there are those who say it is extremely addictive and causes cancer and mental illness; on the other hand, there are those who say it is not addictive and can remedy cancer and mental illness. To add to the confusion, both camps can quote a large amount of scientific literature supporting their claims. There are two main reasons the scientific evidence behind the risks of cannabis can seem so contradictory: first, prohibition makes studying cannabis's effects tricky for researchers, and second, media often reports studies that have major implications, but not the many subsequent studies that undermine them. For instance, a recent study that reported cannabis use causes an irreversible and large IQ drop was heavily reported, but the many subsequent studies that failed to replicate its findings were not. This is not just a problem when it comes to cannabis, but all media reporting on science.

It is believed that cannabis is nowhere near as dangerous as heroin or cocaine, and is also much safer than legal drugs alcohol and tobacco. However, there are other illegal drugs, such as psilocybin and LSD, which are considered safer than cannabis.[84]

Adverse effects

As previously mentioned, cannabis impairs awareness and thus it is very dangerous to drive or operate machinery while under its influence. It can also cause adverse effects which, particularly in high doses, can be dangerous. Bad trips can provoke psychotic and suicidal symptoms. Harm reduction advocates recommend "trip sitters" as a way of dealing with the adverse effects of psychedelics.

Dependence

Cannabis dependence occurs in about half of long-term daily users. Cessation by a dependent user causes withdrawal, usually characterized by anxiety, cravings, low mood, and disturbed sleep. These symptoms usually last a couple of days to a week.[85] (While this is clearly not a good thing, anyone tempted to cite it as a reason to ban cannabis should compare it to the effects of quitting smokingFile:Wikipedia's W.svg or alcoholFile:Wikipedia's W.svg.)

Effect on the young

Cannabis use during pregnancy "is associated with decreased attention span and behavioral problems." Additionally, children exposed to cannabis in utero also are reported to have "lower scores on tests of visual problem solving, visual-motor coordination, and visual analysis" than children who were not exposed.[86]

Although a 2012 study purported to find that cannabis use in adolescents leads to a drop in IQ, subsequent studies have found no such effect. But a UK study did find a 3% drop in school exams taken at age 16."[87]

Relationship with mental illness

The link between cannabis use and mental illness is controversial and hotly debated. Cannabis use is associated with anxiety disorders,[88] but not depressive disorders.[89] Correlation does not imply causation, however, especially when cannabis is so heavily associated with relieving stress. Many sufferers of depression and anxiety who self-medicate with cannabis believe it helps them more than many other remedies.

The relationship between cannabis and psychotic illnesses is more controversial and intricate. It is thought that cannabis with a high concentration of THC (i.e. cannabis that is smoked to get high) worsens pre-existing psychotic illnesses,[90] but cannabis with a lower concentration of THC and higher concentration of CBD (i.e. most medicinal cannabis) can help remedy psychosis.[91] It is thought that, for people with a genetic predisposition towards psychotic illness, heavy use of cannabis with a high concentration of THC can "nudge" them into psychosis.[92] However, it should be noted that something as seemingly harmless as living in a city carries the same risk of "nudging" someone into psychosis.

Lung damage

Smoking cannabis can cause bronchitis episodes.[93] Sharing water pipes and smoking with multiple people in a confined area ("hotboxing") can contribute to the spread of respiratory disease.[94]

If medical marijuana is taken by smoking it, this presents the usual problems from a scientific perspective, that is the harm done to the lungs — pot smoke actually contains more "tar" (i.e. aromatic carcinogens like pyrenes) than cigarettes; while usually less smoke is inhaled, whatever smoke is inhaled is inhaled more deeply than cigarette smoke. Marijuana has not been proven to cause lung cancer,[95] but bronchitis among other irritations is quite possible.This particular problem can be reduced or avoided by using a vaporizer or putting the marijuana in food or using consumables such as chocolate containing THC. Also, researchers are working on isolating specific active compounds in order to make them deliverable via pill.[96]

Relationship with cancer

Perhaps the most hotly debated risk of cannabis use is its effect on cancer. Like many plants, cannabis contains chemicals that are tumorigenic[97] and anti-tumorigenic[98] in vitro (in the lab dish): this is not convincing evidence with regard to human health. For example, both aristolochia and coffee contain tumorigenic and anti-tumorigenic chemicals, yet aristolochia is a very potent human carcinogen but coffee improves human health and reduces the risk of some cancers.

Due at least in part to the illegality of cannabis, there has been a dearth of large-scale, high quality epidemiology studies on cannabis and cancer.[99] A 2015 review of 34 epidemiologic studies found no clear evidence for head and neck cancers, an association with testicular cancer in three relatively small case-control, and insufficient evidence for other cancers.[99] It was noted that the majority of the studies were case-control (retrospective) with inherent study weaknesses, and the authors recommended that a large-scale prospective study be conducted.[99] A 2015 large-scale case-control study of cannabis use and bladder cancer that was not reported in the 2015 review found that cannabis was associated with a reduced incidence of bladder cancer, but no cause-and-effect relationship could be established.[100]

Harm reduction experts have recommended eating or vaporizing cannabis as a way to avoid or minimize possible carcinogenic chemicals in the smoke.[101]

Gateway drug hypothesis
Main article: Gateway drug theory

Medical marijuana

Medical marijuana[102] is the use of marijuana for medicinal purposes, largely to relieve conditions such as glaucoma[note 3], nausea associated with chemotherapy, and appetite loss in AIDS patients. It is well established to relieve chronic pain[103] without the intense physical dependency that comes with opiates or other CNS depressants. Marijuana has also been shown to assist in management of many gastrointestinal disorders, including Crohn's disease, irritable bowel disorder, and more.[104][105]

The issue is a hotly contested one (in the United States) because many states have specifically legalized this use of marijuana, while the federal government continues to insist on classifying marijuana as a dangerous "narcotic" with no medical value, and criminally prosecuting those who grow, sell, and use the plant.

Pros
Stoned, but tidy.

The main argument in favor of medical marijuana is a moral one: that the government should not be dictating what an informed person can and cannot put into their own body, and should not be treating those who choose to use one substance or another as criminals. However, see health freedom; depending on who is making the argument, this argument is sometimes the edge of a slippery slope.

While marijuana has any alternative medicine's fair share of anecdotal evidence for symptomatic relief (just ask any pothead about the munchies, regarding use as an appetite stimulant), its effectiveness has also been proven in numerous controlled studies.[104][106][107][108][109] This even includes the aforementioned munchies.[110]

Doctors in US states with medical marijuana write fewer prescriptions for opioid painkillers.[25][111] In a later separate study, it was found that states with medical marijuana had a 25% lower rate of opioid overdose mortality, and that states with recently implemented medical marijuana laws had decreased opioid mortality over time.[25][112]

Cons

Medical marijuana is sometimes also associated with alternative medicine and the use of herbs for medicinal purposes. In this case, there is the lack of a controlled, carefully measured dose of the plant's active compounds,[note 4] which can vary widely from individual herb to herb. However, while it is possible to overdose on marijuana, there are no known cases of overdose by smoking/vaporizing/ingestion leading to permanent health effects or death, and as explained above, the problem of overdosing (as in using more than therapeutically beneficial) could possibly be alleviated by extracting or artificially producing the psychoactive compounds and submitting them for approval by the FDA.

The issue has implications for those of us who believe much (not necessarily all) of alternative medicine is quackery and woo. Believing that, for example, laetrile is ineffective bullshit does not necessarily mean believing that it should be illegal or that people should be prosecuted for using or selling it in the United States as they currently are. The same goes even more so for medical marijuana, which unlike Laetrile does have some scientific studies showing it is effective for treating some specific conditions.[104]

Who should take cannabis?

Cannabis lacks any large-scale studies, thus why it hasn't been legalized federally in the United States.[9] So far, all of cannabis's health benefits are detailed in small studies that suggest that it may be helpful. However, if you're willing to be a guinea pig for a drug with debated long-term side effectsFile:Wikipedia's W.svg and want to get high, go for it.

Safety
Legal notice from the RW Morals Committee

This information is provided for amusement only and under the strict understanding that it not be read, understood, remembered or acted upon. If you have read this page, please go to the discussion page where you need to sign a form stating that you have not understood this page. Thank you.
—The RW morals committee
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gollark: Of course it is.
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gollark: Google basically just unilaterally *writes* half of those and is WebBluetooth really a good idea?

See also

Notes
  1. The last "disease" has been variously reported as "numara thrombosis" or "umara composis", but your guess is as good as anyone's. A live version may have been "glaucomia" [sic].
  2. Californians voted for Proposition 64 in 2016 which legalized marijuana from 2018. The legalization did not eliminate the medical marijuana law, which has a different age minimum (18 for medical, 21 for everyone else).
  3. Damage to the optic nerve, leading to eye damage and ultimately becoming blind being a person with blindness seeing with a dog and white cane.
  4. Not just THC, but CBD, CBN and who knows what else.

References
  1. Legalize It lyrics
  2. Marijuana Horticulture: The Indoor/Outdoor Medical Grower's Bible by Jorge Cervantes (2006). Van Patten Publishing, 5th ed., p. 12. ISBN 9781878823236.
  3. International Classification of Diseases 9 - CM 1996 Chronic Conditions Treated With Cannabis Encountered Between 1990-2004 by Tod H. Mikuriya, 2004 (The American Alliance for Medical Cannabis).
  4. Terpenes: The Flavors of Cannabis Aromatherapy Leafly: The World's Cannabis Resource
  5. Patient's Care Collective. The PCC7
  6. Patient's Care Collective. Introducing: The PCC7 system
  7. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects by Ethan B. Russo. Br. J. Pharmacol. 2011 Aug; 163(7): 1344–1364. doi: 10.1111/j.1476-5381.2011.01238.x.
  8. Cannabis and Cannabis Extracts: Greater Than the Sum of Their Parts? by J.M. McPartland, E.B. Russo. J. Cannabis Ther. 2001(3/4):103-132.
  9. https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine
  10. Government marijuana looks nothing like the real stuff. See for yourself. by Christopher Ingraham & Tauhid Chappell (March 13, 2017) The Washington Post.
  11. Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach by Dirk W. Lachenmeiera & Jürgen Rehm (2015). Scientific Reports 5(8126):1-&. doi:10.1038/srep08126.
  12. Here Are All The People Who Have Died From A Marijuana Overdose by Nick Wing (09/03/2013 03:03 pm ET | Updated Sep 04, 2013) Huffington Post.
  13. Is it true that marijuana hasn't caused any deaths, while prescription drugs have caused 100,000? by Joseph Cariz (August 16th, 2016 at 4:07 p.m.) PolitiFact.
  14. Unpacking Pot’s Impact in Colorado by Vanessa Schipani (August 19, 2016) FactCheck.org
  15. The Legalization of Marijuana in Colorado: The Impact. Vol. 3 by Kevin Wong & Chelsey Clarke (2015) Rocky Mountain High Intensity Drug Trafficking Area.
  16. Does marijuana use affect driving? (April 2017) National Institute on Drug Abuse.
  17. Cannabis Effects on Driving Skills by Rebecca L. Hartman & Marilyn A. Huestis (2014) Clin. Chem. 59(3):1-25.
  18. Cardiac arrest following cannabis use: a case report by Abdo H Sattout & Mark F Nicol (2009). Cases J. 2:208. doi:10.1186/1757-1626-2-208.
  19. Acute cardiovascular fatalities following cannabis use by L. Bachs & H. Mørland (2001) Forensic Sci. Int. 124(2-3):200-3.
  20. Is recent cannabis use associated with acute coronary syndromes? An illustrative case series. by I. Casier et al. (2014) Acta Cardiol. 69(2):131-6.
  21. Sudden unexpected death under acute influence of cannabis by B. Hartung et al. (2014) Forensic Sci. Int. 237:e11-3. doi: 10.1016/j.forsciint.2014.02.001.
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  23. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review by K. P. Hill JAMA. 2015 Jun 23-30;313(24):2474-83. doi: 10.1001/jama.2015.6199.
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