By Roy Benaroch, MD, Emory University
Marijuana has historically been maligned as a dangerous, illegal substance. But the tide has turned. Should we embrace medical marijuana as the miracle drug that the headlines make it out to be?
The Changing Face of Cannabis
In 1996, California voters approved Proposition 215, the first state legislation legalizing the use of marijuana for medical purposes.
The trend spread rapidly. Most US states now allow either marijuana or its derivatives to be prescribed and used for a variety of ailments, including cancer, anxiety disorders, chronic pain, multiple sclerosis, and epilepsy.
One might think that the rapid expansion of the availability of medical marijuana means there’s a good consensus about how well it works and how to use it, but that is not the case.
The story of marijuana and our changing perceptions of its safety and usefulness is a great example of how different stakeholders—including many people outside of the medical profession—can affect media coverage, drive social changes, and influence legislation.
But is medical marijuana making us healthier?
Learn more about the science of marijuana
The History of Marijuana Legalization
Though several states individually had made marijuana possession or cultivation illegal as far back as the 1910s, the US Federal Government got involved in 1937, when the Marijuana Tax Act effectively outlawed its possession or sale.
President Richard Nixon’s administration labeled marijuana a so-called Schedule 1 controlled substance, lumping it in with heroin and LSD. That meant that for legal purposes, it had no valid medical uses and a high potential for abuse. The Schedule 1 designation stands today, making it difficult for researchers to obtain the plant for medical studies.
This is a transcript from the video series The Skeptic’s Guide to Health, Medicine, and the Media. Watch it now, Wondrium.
As of late 2018, American researchers had to get their marijuana from a single federally mandated source, which provided limited amounts of a poor-quality product that had very different properties and potency from what’s available in state dispensaries. And, also as of late 2018, it remained illegal, under federal law, to prescribe or possess marijuana for any use.
The perspective is a little different in other parts of the world. Israel permitted the use of medical marijuana in 1992, and sponsors a large number of medical cannabis studies. It’s simpler, easier, and cheaper to study marijuana use there than in the United States, with its more restrictive legal climate.
Canada, the Netherlands, and several other countries have relatively liberal laws permitting, and in some cases paying, for medical marijuana.
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How the Press Skews Perceptions of Marijuana’s Benefits
As we’ve seen before, headlines can drive perceptions, and sometimes neither the headlines nor the news stories paint an accurate or complete picture.
A 2017 Huffington Post article declared, “This Scientist Thinks Cannabis Could Be a Wonder Drug for Treating MS.” This is an interview piece that does point out, eventually, that the quoted scientist is relying on anecdotes, but research is underway.
A USA Today headline reads, “Marijauna May Be a Miracle Treatment for Children with Autism.” Look at how these headlines frame the stories: “Wonder drug” or “miracle treatment”.
The USA Today story is about an Israeli study that’s still underway—it hasn’t been completed yet and the results aren’t available. In the text of the article, the lead researcher cautions against premature conclusions, but that’s not the impression given by the headline.
Is now the time to proclaim marijuana a miracle treatment, before the studies are done?
Here’s one more example that combines almost breathless excitement with a little titillation, just to get you to click the headline. The Business Insider website proclaims, “A New Study Suggests Marijuana Could Be a Miracle Drug in the Bedroom.”
What they’re writing about in the article isn’t a clinical study at all, but rather a review of preclinical, mostly bench and animal-based studies of some marijuana-based compounds. Yes, the headline does use the word “could,” but it’s a stretch to go from rat studies to a “miracle drug in the bedroom.”
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Critically Evaluating Pro-Cannabis Articles
It’s important to pay attention to the source of media studies as well—where is the article published and where did they get the information? Several pro-marijuana blogs published reports in June 2016 with headlines like this one, from TheJointBlog: “Over 90% of Medical Cannabis Patients Find Relief in the Medicine.”
Nearly identical headlines can be found at theweedblog, The Extract, and another site selling marijuana seeds. These reports all cite each other, or a single article in the Jerusalem Post titled, “Most Medical Marijuana Users Benefit from Treatment.”
The Jerusalem Post is a legitimate, professional news organization, and the article never mentions the 90-percent figure quoted in those blog headlines. The article only says that “most users benefit”—not over 90%.
Plus, even the Jerusalem Post article is sourced from a presentation at a meeting that hasn’t been published in the peer-reviewed literature. It was then misinterpreted or misquoted for the blogs, which then repeated each other’s misinformation.
Blogs can be useful, but keep in mind that blogs may represent only one viewpoint, and they may not be professionally vetted. Even professional news sites sometimes use sources that cannot be verified.
Understanding Marijuana/Cannabis
Let’s clarify some terms. “Cannabis” is the most appropriate word to use for the plant, any variety of a plant more formally called Cannabis sativa.
The word cannabis also sometimes refers to different preparations of the plant, either dried flowers or other parts, or to other plant products.
The cannabis plant became known as marijuana in the 1900s, using the Spanish word to make a distinction from the hemp plant used to make rope. These terms are sometimes used interchangeably, though the medical literature favors the use of the word cannabis over marijuana.
Cannabinoids are a large group of chemicals that are found in the cannabis plant. There are dozens, probably hundreds, of cannabinoids, each with varying properties, and each with potentially different medical uses and potential side effects.
Different strains of cannabis have different amounts of these chemicals, which are also affected by cultivation and processing techniques. That’s an important factor in medical marijuana research and reports—the products, themselves, may be vastly different and may be labeled inconsistently.
Learn more about medical marijuana
What’s in Cannabis?
Although there are dozens of biologically active cannabinoids, the two found in the highest concentration are THC—tetrahydrocannabinol—and cannabidiol, often abbreviated CBD.
THC is the major psychoactive compound. Whether smoked or eaten, THC gets users high.
Though it’s quite variable, the concentration of THC in marijuana has increased tenfold since the 1960s. What’s being purchased now is generally far more potent than what was smoked during the “Summer of Love” in 1967.
CBD is the other major cannabinoid, and it’s purported to have medicinal properties, especially to combat seizures, cancer, anxiety, and many other ailments. While the concentration of THC has increased, in many marijuana strains the amount of CBD has dropped.
Along with THC and CBD, marijuana products have many other compounds, including biologic and chemical contaminants that may themselves have health effects, either good or bad.
The bottom line is that unlike traditional medications—pharmaceuticals, pills, or things made by drug companies—cannabis products are a complex mix of ingredients that may vary tremendously from different suppliers.
That might not matter as much when it’s used recreationally, but if we’re talking about using marijuana as a serious medication to treat serious ailments, we need to be honest. Most people buying and using medical marijuana have no way of knowing what they’re getting.
Therefore, while it’s understandable to be optimistic about these reports, we need to approach medical marijuana use with caution.
Common Questions About Medical Marijuana
Marijuana is already legal in many states and countries across the world. It is considered a potent medicine for many ailments.
Marijuana is used for a vast number of ailments from insomnia to chronic pain and inflammation.
CBD is the non-psychoactive component of the marijuana plant. It stands for Cannabidiol and is used for many illnesses including cancer and inflammation.
It is not currently known whether marijuana cures cancer, but it has been shown in studies that it treats nearly all ailments concerned with the disease, such as nausea.
