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The Complete Guide to Medical Marijuana and CBD
Updated on: October 2022
Reviewed by: Nancy Leahy, RN, APNP
Marijuana has had a turbulent history in the United States. Starting in the mid-1990s, however, there was a push to introduce the medical benefits of cannabis to the American people once again—” once again,” because before the 20th century, marijuana was almost entirely legal.
Beginning in the 1910s, states began to ban the sale of marijuana, eventually leading to a bill called the Marijuana Tax Act in 1937, which decreased the amount of hemp (a version of a cannabis plant) allowed to be produced in the U.S. Later on in the century, the stigma around marijuana grew and Richard Nixon signed into law the Controlled Substances Act, which included marijuana on a list of federally banned drugs alongside heroin, cocaine, and other narcotics.
By the time the 1990s came along, though, states began adopting the medical benefits of marijuana, starting with California. About 15 years after that, marijuana itself—not just the medicinal qualities—became legal for recreational use in Washington and Colorado. As of 2019, 33 of 50 states and the District of Columbia have legalized some form of medical marijuana. A 2013 study revealed that four of five doctors approve of medical marijuana and that more than 90 percent of medical marijuana patients (of around 7,500 surveyed) say that medical marijuana has helped treat their conditions. Seniors were the largest age group in the study (more than 2,300 respondents).
As recent as 2018, new studies are helping to further the evidence that medical marijuana provides symptom relief with minimal side effects. One study involved patients with 27 different health conditions consuming cannabis in various forms, and users reported symptom relief of nearly 4 points using a 1-10 scale of intensity.
With medical marijuana gaining prevalence and popularity in the medical world all over the U.S., let’s look at exactly what it is.
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What is Medical Marijuana?
Medical marijuana is not the drug you can buy in the street, which may be improperly grown, infused with another drug, or not even authentic marijuana.
Medical marijuana stems from pure, uncut cannabis indica plant. Certain medically beneficial chemicals—the “mind-altering” ones that make you feel a buzz or high—are then taken from these planets and used to help treat patients for various medical issues. Sometimes the plants as a whole—and not just the certain chemicals inside it—are used to help with certain medical conditions.
While there are more than 100 chemicals (these are called cannabinoids) in marijuana, the two main chemicals in medical marijuana used for medical purposes are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These chemicals can help treat a slew of diseases and medical conditions, which we’ll discuss later.
How Does Marijuana Compare to CBD?
You may have heard the acronym CBD or its longer name cannabidiol all over the internet and the news throughout the past few years. CBD is a molecule derived from the cannabis, or marijuana plant, similar to the THC that gives marijuana its psychoactive properties. However, CBD is non-psychoactive, and has other possible benefits that some users report without experiencing the “high” that THC provides.
CBD was made federally legal under the 2018 Farm Bill, which also raised restrictions on the growth and transport of the hemp plant. The bill made both hemp and CBD legal as long as it contains .3% or less of THC. To access THC, you either need to be in a state that has legalized recreational use or access it via prescription in states that have legalized medical marijuana.
CBD hasn’t been known to cause many serious side effects, though it may lead to drowsiness or sleepiness, gastrointestinal distress, and irritability. In comparison, marijuana may cause anxiety, dry mouth and eyes, an increased heart rate, and limited coordination. Keep in mind that speaking to a doctor about your prior or current health conditions can help you mitigate possible side effects with marijuana. They’ll work with you to identify specific strains and uses that will work well for your needs.
There is still more research that needs to be done to verify CBD’s potential health benefits, but many users have reported its help with temporary symptoms like pain and anxiety. When it comes to CBD vs. THC for pain, some users report similar outcomes
Medical Marijuana FAQ
Does marijuana affect blood pressure?
A 2017 study showed possible evidence that participating marijuana users had higher risks of complications and death from high blood pressure compared to non-users. The study was preliminary and still needs further research.
Does marijuana help with multiple sclerosis?
The American Academy of Neurology has developed guidelines surrounding multiple sclerosis and marijuana that state THC may be effective for reducing pain and urinary frequency symptoms related to MS. Sativex is a cannabis-based drug that has been approved for patients with MS to help relieve pain, spasms, and sleep disturbances.
Is medical marijuana covered by health insurance?
Currently, health insurers do not cover medical marijuana, even in legal state. Because marijuana is still classified as a Schedule I controlled substance, insurance companies haven’t added it to their list of covered drugs.
What’s the difference between medical cannabis and CBD oil?
Medical cannabis includes the cannabinoid THC, which has psychoactive properties as well as some benefits that include symptom relief. CBD is a separate cannabinoid called cannabidiol, which does not have psychoactive properties, yet studies show it may have similar effects as THC in providing symptom relief.
Can marijuana help with chronic pain?
A recent study showed that 62.2% of studied marijuana users were using it for their chronic pain. Research has shown that humans have cannabinoid receptors within our peripheral nerves, and cannabinoids appear to suppress pain.
How Can Medical Marijuana Help?
Medical marijuana has not been nationally approved by the Federal Drug Administration yet, mainly because there have not been enough clinical trials done on a wide enough scale to prove the plant’s medical benefits. Just because a large government agency hasn’t approved medical marijuana as a proper medical treatment does not mean that the plant itself doesn’t have medical benefits, especially for seniors. Cannabis has actually been used as a medical treatment for thousands of years
Now that we know what medical marijuana is, we can look at the symptoms and illnesses the chemicals inside of the marijuana plants can help qualm or make easier to live with.
One of the primary uses of medical marijuana is to help cancer patients, especially when they are going through rounds of chemotherapy. Some studies have shown that smoking marijuana can help with nausea and vomiting in chemotherapy patients. When dealing with palliative care, especially for patients with cancer, a study points out that most patients (more than 60 percent) experience both of these symptoms rather than one or the other, so medical marijuana can help relieve two symptoms (and potentially many more) at once. Studies have also shown smoked or vaporized marijuana can help with the pain suffered through neurological damage and can help patients get their eating habits back on schedule.
In terms of cancer treatment, there have been three THC-infused oral pills that have been approved by the FDA for federal use: Marinol, Cesamet and Syndros. These have been prescribed to help cancer patients with nausea.
Studies are ongoing in both animals and humans to see how medical marijuana can help treat tumors as well as the symptoms and illness that come with cancer.
Alzheimer’s Disease and Dementia
Patients with Alzheimer’s Disease have sometimes turned to medical marijuana to help with their treatment to assist with symptoms of depression and loss of appetite that may come along with the degenerative brain disease, which affects more than four million Americans’ cognition and memory every year. About 10 percent of seniors have the disease.
In 2014, there was a preclinical study published in the Journal of Alzheimer’s Disease that analyzed the “potential therapeutic effects of THC” on the disease.” Researchers introduced THC to beta-amyloids, which are clumps of proteins that build up on the brain and are one of the leading signs of the presence of Alzheimer’s. They found that THC helped slow the advancement of these beta-amyloids, and the results from the study “strongly suggest that THC could be a potential therapeutic treatment option for Alzheimer’s disease through multiple functions and pathways.”
As recent as early 2019, researchers in the U.K. began the first major trial to use medical marijuana for dementia patients. During the trial, researchers used the drug Sativex to monitor the relief of Alzheimer’s and dementia symptoms that include aggression and agitation. Sativex has already been approved for patients with multiple sclerosis.
Almost all seniors have experienced some sort of pain in their later years, and medical marijuana can help with that. What’s interesting is that you often don’t need to ingest the marijuana to reap the medical benefits of the plant. There are rubs, creams, and lotions infused with THC that can seep through your skin and attack a small, singular area of pain.
“There is increasing evidence that cannabis is helpful in the management of certain kinds of pain,” said Dr. Igor Grant, a professor in the Department of Psychiatry at the University of California, San Diego.
Medical marijuana, whether it’s smoked, consumed, or applied through a topical treatment, can help relieve acute and chronic pain by attacking the already-present cannabinoid receptors in our body. It helps relieve pain from:
- Joint pain, like arthritis
- Nerve damage
- Chronic illness, like cancer
Despite taking up less than 15 percent of the population, seniors are prescribed more than one-third of all prescription drugs in America, and the drugs are often used to treat pain. Medical marijuana is a convenient and healthier alternative, and strays away from the addictive tendencies of opioids.
Anxiety/Mental Health Disorders
Studies have shown that cannabinol (CBD), one of the two main chemicals in marijuana used for medical purposes, can help treat anxiety and other mental health issues, including:
- Obsessive compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
- Panic attacks
- Moderate depression
- General anxiety
Essentially, these studies (conducted in animals, to this point) found that CBD helps stimulate serotonin receptors in the brain, which is the main goal of other anti-anxiety medications like Zoloft. Medical marijuana has been proven to be far less addictive and to actually help counteract addictions to other prescription drugs.
While using medical marijuana to treat anxiety may help for some, others have reported anxiety as a side effects of using it. As Harvard’s health department points out, about 20 to 30 percent of recreational users say smoking marijuana causes anxiety or panic attacks after smoking. It’s important to stay in touch with your doctor once trying medical marijuana as a treatment in case it has adverse effects as planned.
Included in mental health is addiction. Analysis on studies by the National Institute for Drug Abuse show that the presence of legal marijuana laws and marijuana dispensaries show a link between:
- Fewer deaths caused by prescription opioids
- Less treatment for opioid addiction
- General prescribing of opioids
- A reduced number of people self-reporting opioid misuse
Many of these links have been chalked up to doctors prescribing far less harmful medical marijuana than addictive painkillers and antidepressants.
Eating disorders are far more common among seniors than you think. Nearly 80 percent of deaths that occur due to anorexia occur among the elderly.
As seniors age, they may lose the desire to eat. This can happen because they’re making a personal decision about their body image or because of other psychological reasons beyond their control. Poor eating, amidst other issues like bone loss and heart problems, can prove chronic. But in any instance, medical marijuana may help seniors eat more and exit dangerous weight zones.
Studies have found that the body’s marijuana-like neurological system called the endocannabinoid system is underutilized or impaired amongst patients with anorexia and bulimia, essentially making the brain look at food as undesirable. Medical marijuana can help stimulate this system and help the brain treat food as a reward again.
Eating disorders are often treated with antidepressants and antipsychotics, but patients often report their symptoms worsening after taking them. Additionally, many national psychotic and eating disorder foundations and associations have yet to list medical marijuana as a treatment for eating disorders. However, many doctors view medical marijuana as a safer alternative view medical marijuana as a safer alternative to prescription drugs with far less risky side effects.
Glaucoma is an issue with your eyes that occurs when a buildup of fluid damages the nerves in your eyeball. It is the leading cause of blindness for people over the age of 60. This disease causes increasing pressure in your eyes because of the amount of fluid, which affects your eyesight. For years, doctors have prescribed glaucoma eye drops that help relieve the pressure in your eyes, but it has also been proven that marijuana can help relieve pressure for hours at a time.
According to a website dedicated to Oregon eye doctors (where medical marijuana is legal), you need to relieve pressure in your eyes throughout the entire day to help combat glaucoma, which is why eye drops can sometimes be more effective. Other factors that play into using medical marijuana instead of glaucoma drops include cost effectiveness and personal preference.
How Can Medical Marijuana Boost the Brain?
We have looked at all the benefits medical marijuana can have when it comes to treating diseases, conditions, and mental illnesses, but it can also positively affect the brain functions in the elderly.
A study done at the University of Bonn in Germany looked at the how small doses of THC affected the brain cognition in mice that were young, mature, and elderly. As it often does in younger humans, THC inhibited the cognition in young mice slightly. But with the introduction of THC, the two older groups of mice performed better on cognitive tests than younger mice who were also introduced to THC. Before the introduction of THC, the older generations of mice performed significantly worse on the tests.
While this study is obviously not generalized for humans just yet, it is an intriguing building block when it comes to looking at medical marijuana helping increase the cognition in the elderly—something that often declines severely as people age. The next step is seeing how our internal cannabinoid system reacts to THC and how that introduction can help re-stimulate cognition, the study’s leading researcher, Andreas Zimmer, said.
Because cannabis is not considered a class A or dangerous drug in Germany, researchers are able to gain funding from the government to test the effect of THC on cognition in humans, which Zimmer plans on starting soon.
How Can CBD Help Seniors?
CBD has shown some similar promising results when it comes to helping seniors cope with common ailments such as anxiety, pain, and depression. However, the FDA has not cleared CBD as a dietary supplement or medical drug, with the exception of one prescription drug currently being used to treat two forms of epilepsy. Keep this in mind as you search for CBD options. While several studies show promise, your experience with CBD may not always be the same as someone else’s experience.
When it comes to anxiety, a 2015 study showed that oral doses of CBD helped lower anxiety in patients with Seasonal Affective Disorder. The same study showed that CBD could also be potentially affective for patients with PTSD or Generalized Anxiety Disorder.
Aside from anxiety, depression among seniors is unfortunately very common. Ailing health, loss of friends and family, and isolation can all cause stress and depression. A 2014 study with CBD and rats showed that the substance demonstrated some anti-depressant like actions, including increased movement and sleep regulation.
So far, there aren’t many studies that show CBD carries properties that can help alleviate cancer symptoms. Instead, cannabinoids overall show promising therapeutic effects to help modulate tumor growth and relieve symptoms such as appetite, weight loss, and pain. It’s unclear if these possible benefits are the cause of a variety of cannabinoids or only certain molecules, such as THC.
Seniors often have to deal with chronic joint pain and pain from arthritis. CBD has shown promise in temporarily alleviating this pain through both user testimony and clinical studies. According to a recent study, 42% of Baby Boomers use CBD to help alleviate their joint pain. Current research with animals shows that CBD has both pain-relieving and anti-inflammatory properties that may help alleviate the symptoms associated with arthritis. The Arthritis Foundation has even made a statement that it supports expedited studies and regulation from the FDA to develop more guidelines for adults who would like to use CBD.
Like medical marijuana, seniors should start slow and possibly even consult with a doctor before developing a dosage that fits their needs and lifestyle. One important thing to keep in mind about CBD is that it has been found to increase the natural blood thinner coumadin. If you’re currently taking blood thinner medication, you should consult a doctor before any CBD use or consider using medical marijuana instead.
Why Seniors are Turning to Medical Marijuana?
The trend among seniors using medical marijuana is on the up-and-up. From 2007 to 2017, adults over the age of 65 experienced a tenfold increase in cannabis use.
We’ve discussed the many reasons why medical marijuana can be beneficial to seniors because of their health. But let’s take a look at a several more reasons why seniors are turning toward medical marijuana:
- It’s safer and more cost efficient: As we’ve discussed in previous sections, medical marijuana is often a safer alternative to many prescription drugs like opioids and antipsychotics, and has with far fewer severe side effects. It can also be more cost efficient, too. A senior spends on average close to $3,000 per year on prescription drugs alone. Contrast that with the national average of how much a person spends on medical marijuana per year—about $650—and you have a more cost-effective option, too.
- Why not try it?: Some seniors have pain so severe that over-the-counter drugs and prescription medications can’t always cure their maladies. So sometimes they turn to medical marijuana out of desperation and find positive results. A woman named Reba Goodman reached this point of pain that was so severe, she stopped resisting marijuana. “It was just heaven,” she said of her pain relief, noting that she stopped using marijuana once the pain went away for good but that she could easily pick it up again if need be.
- Helps with sleep: Some seniors have found medical marijuana to be a viable alternative for sleeping pills, which sometimes don’t work at all. Kerry Stiles, a 78-year-old nursing home resident who wears a pacemaker, says he places droplets of cannabis under tongue before he goes to bed, and he says it helps him sleep. The same goes for 95-year-old Alice, who experienced insomnia before turning to medical marijuana.
How Do You Consume Medical Marijuana?
There is not one specific way to intake the benefits of medical marijuana. Depending on your medical needs, budget, and your physical abilities, you may prefer one method over another. Let’s take a look at some ways you can consume medical marijuana.
- Smoke it: Smoking marijuana provides some of the most instant relief when it comes to extracting the medical benefits from the plant. There are several ways to smoke marijuana, including through a smaller handheld pipe or device, a water bong (a pipe with a long neck), or a joint (where you use rolling papers). Smoking is typically the cheapest option, too, considering you only need to acquire a single smoking device or inexpensive rolling papers.
- Consume it: Medical marijuana can be infused into foods and drinks to help ease the process of consumption. Essentially, the THC just needs to be extracted from the marijuana, then mixed in with whatever food or drink you want (commonly brownies, smoothies, cookies, etc.). Consuming marijuana usually takes longer to take effect, and even a small increase in dosage can have massive effects on how you feel once they kick in, so be careful with self-dosing. The edible and drinks business is becoming an increasingly popular option. Forbes reports that more $180 million worth of marijuana-infused foods and drinks were sold in California alone in 2016.
- Vaporize it: Similar to smoking, vaporizing marijuana into a mist provides more instant results. For this method, you put a small amount of cannabis inside a machine called a “vaporizer,” which turns the heated cannabis into a vapor that isn’t as hot as smoke but still hot enough to extract the medical benefits. The devices used for vaporizing are usually far more expensive than ones for smoking, but the vapor is usually far less harsh on your lungs.
- Rub it on your skin: Topical treatments like lotions and creams can help relieve maladies like muscle soreness and arthritis. Because they’re applied through the skin, topicals don’t give you the “high” often associated with cannabis. They also allow you to target one specific area of pain rather than inducing a full body effect for one localized area of pain.
- Use droplets: Using droplets or sprays can help you control the dosage you’re taking. You place the treatment underneath your tongue, letting the saliva and tissues absorb the THC. While not as immediate as smoking or vaporizing, using sprays is more cost effective, especially if you need smaller doses.
- Taken in pill form: It’s one of the least popular options, but there are suppositories and other cannabinoid medicines that are FDA-approved and help ease symptoms like nausea and vomiting.
Whatever method you choose to intake medical marijuana, it’s important you consult a medical professional about how much, when, and how often to use it.
Where is Medical Marijuana and CBD Legal?
Though marijuana and its medical abilities are still banned and viewed as a Class A drug on a federal level, individual states have been given the right to legalize marijuana, both on a medical and recreational scale. While the Department of Justice announced under President Barack Obama’s administration that they were leaving the crackdown of the growth and sale of marijuana largely up to the states, there have been seizures and arrests made on dispensaries from the federal level.
As of December 2018, CBD is federally legal so long as it is derived from hemp plants that do not contain more than .3% THC.
As of 2019, 33 out of 50 states have approved medical marijuana beyond the two FDA-approved cannabis drugs, Marinol and Cesamet. These states include (ones in bold also allow it recreationally):
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Dakota
- Rhode Island
- West Virginia
Washington, D.C. has also approved medical marijuana.
States have varying laws for how much you are allowed to possess on your person at one time, how much you are allowed to personally grow, and what conditions are recognized as being helped by medical marijuana. To find out more information on your state’s laws on medical marijuana, visit the National Conference of State Legislatures website.
How to Obtain Medical Marijuana Card?
Even in legal states, you can’t just obtain a medical marijuana prescription from a doctor and head to your local pharmacy, like you would with any other prescription drug. To use medical marijuana, you’ll need to first obtain a medical marijuana card, which you need to show at medical marijuana dispensaries that have been established to distribute marijuana. The card is also your protection if you’re even questioned by authorities about your possession of marijuana. The card shows that you have the right to possess a certain amount of marijuana for medical purposes.
In order to obtain a medical marijuana card, the process may vary slightly from state to state. In most cases, you’ll need to consult with a doctor first or check with your state government to determine the diagnoses or conditions that your state has approved as a prerequisite for prescribing medical marijuana. If your condition or illness is on the list, you’re eligible to apply for a card. In some states, you may need to additionally schedule an evaluation by an approved medical marijuana doctor so they can submit written verification that your illness is approved by the state’s medical marijuana guidelines.
Next, you’ll need to submit your application for a medical marijuana card either in-person, online, or via the mail. Where you access this application will vary from state to state, but your state government website should have more information and links pointing you directly to the application. Most states also charge an application fee for a medical marijuana card, which can vary from $20 to $100 or more.
Once your application is approved, you’ll receive your medical marijuana card in the mail along with more information on the amount of marijuana that you’re able to buy as well as the types of marijuana products that are legal in your state. Most legal medical marijuana states started out by only allowing marijuana concentrates, and have since moved to allow for flower, or marijuana bud.
If you travel with your medical marijuana card and would like to access marijuana in another legal state, you may need to research the specific medical marijuana program of the state you’re visiting. Some states do allow out-of-state cards to be used, while others do not.
Choosing Between Medical Marijuana and CBD
Even though medical marijuana and CBD are derived from the same Cannabis plant, they come with some big differences. CBD is available nationwide, while medical Marijuana is only available in states that have legalized it. While those legal states recognize the medicinal properties of marijuana, both CBD and marijuana have not been approved by the FDA for nationwide medicinal use.
CBD is popping up everywhere – from local coffee shops to smoke shops and specific CBD stores across the country. For medical marijuana, you still need to go through the process of obtaining a medical marijuana card and head to a dispensary that’s licensed by its home state to distribute prescription marijuana.
For either CBD or marijuana, you’ll usually be met with similar methods for use. Just like the methods we listed above, CBD also comes in bud form, topicals, pills, vape cartridges, and even food and beverages. Even though it is currently illegal to market CBD by adding it to food or beverages, you’ll likely still see these products everywhere they turn as they operate in a sort of legal grey area.
If you don’t want to choose and you’re in a legal state, you may be able to find CBD oil with THC or even flower that contains both compounds. The benefits of smoking CBD with THC include a greater activation of CBD’s potential benefits without too much of the high that comes from THC. Furthermore, with a blend, the CBD may help mitigate some of the potential symptoms that can come from only smoking THC.
As you think through whether medical marijuana is an appropriate supplement for your health care, consider alternative options like CBD and always consult with your doctor. If you’re using it smartly and cautiously, it could be the answer to problems you’ve been trying to solve for a while.