Marijuana Use

I was reading this article in Slate magazine a few weeks ago which commented on the increased potency of cultivated marijuana over the past couple of decades.  The article is serious, though the author takes a slightly tongue in cheek tone in suggesting that growers should be interested in the rich target market of well-to-do boomers who want to get a mild buzz, but not get completely stoned.  This blogger and comedy writer seems to have read the same article, initially scoffed at it, but found it to be a convincing argument after all!

From my professional point of view, I have wondered about what the options are for patients with nausea or glaucoma who are not regular recreational users.  How, after all, do you treat the nausea or elevated eye pressure if you don't actually also want to get high?

It turns out that this is an already well established ongoing concern and area of research (h/t one of my patients). There is a specific class of chemicals called cannabidiols (CBD) have most of the medicinal properties in marijuana. The tetra-hydrocannabilnols (THC) have most of the euphoriant properties (the high).  So, plant breeders are quite interested and active in trying to breed plants with higher CBD content and lower THC content to optimize medicinal value and moderate the buzz in available products.

Of course, specific evidence around the medicinal value of marijuana is somewhat limited at present.  Normally, the most statistically powerful kind of medical studies are so-called randomized double-blind placebo-control studies.  This means you gather a large number of people who are medically similar, sort them into two groups, then test a medication or procedure versus a placebo on the two groups in such a way that the patients in the study do not know which they are receiving, and neither do the doctors in the study.  This is difficult to do in testing marijuana since the federal government and many state governments regard marijuana use as a crime.  It is considered unethical to perform medical studies in which the participants are required to commit crimes.

Nonetheless, certain inferences can be gained.  For example, existing evidence does suggest that marijuana smoking does not cause lung damage or lung cancer, and may have a protective effect on lung health.  This is based on lung function and cancer statistics in surfers (who tend to smoke marijuana but not tobacco) and in Rastafarians (who tend to smoke both).

Public opinion polls reflect a majority of Americans support legalization of marijuana for recreational, let alone medicinal, use.  I think we will eventually see this happen, and am interested to be able to know more about marijuana's medicinal value.