As medical cannabis use continues to grow more widespread across the United States and the world at large, so is the realization that as beneficial as it is, cannabis is no “silver bullet.” Despite its clinical versatility and efficacy, cannabis and cannabinoid therapy have limitations, a major one being side effects, just like any other drug. In the end, it is up to the healthcare professional and the patient to weigh the risks and rewards of cannabis side effects versus other forms of treatment.
When Weighing Risk vs. Reward, Consider Cannabis’ Safety Profile
However, it is important to take into consideration the wide safety profile and therapeutic index that medical cannabis has, especially relative to many other drugs (both legal and illegal).1,2 For this reason alone, this believes medical cannabis should be considered as a first-line treatment before more dangerous drugs with more narrow therapeutic indexes and higher liabilities for abuse, dependency, and addiction (i.e., opioids, benzodiazepines, and barbiturates).
Since the term “cannabis” broadly describes a virtually infinite array of different strains, genetics, and phenotypes of the C. Sativa plant, it should be noted that side effects vary depending on the type of cannabis consumed (as well as the mode of administration, the patient’s tolerance, metabolism of cannabinoids, etc.) That said, a rough sketch of cannabis’ side effect profile can be outlined using the most recent scientific data. As per a 2016 comprehensive review of side effects associated with short-term and long-term/heavy cannabis use by Volkow and colleagues, here are some short-term and long-term side effects and adverse events related to cannabis consumption:
* = The effect is strongly linked with initial marijuana use early in development
Several studies have suggested concerning links about developmental abnormalities later in life when cannabis use, especially daily/heavy use, begins at an early age before the brain is fully developed.4,5 However, in cases of childhood epilepsy, CBD-rich cannabis has shown incredible promise in high-quality trials and has even led to the approval of the first cannabis-derived FDA-approved drug, Epidiolex.6,7
Since CBD isolates (such as Epidiolex) and CBD-rich extracts are becoming a common product that is more accessible than THC, it is important to explore some of the side effects presented by CBD itself. Since cannabis has so many different active components, it is important to observe the various compounds separately as well as studying adverse effects from their polypharmacy action when patients consume whole plant extract and/or full/broad-spectrum products.
A recent 2017 review investigated the side effects of cannabidiol in available clinical data as well as data available from in-vivo animal model research. The majority of clinical applications of cannabidiol are in the treatment of epilepsy and psychosis.
The most commonly reported side effects were: “tiredness, diarrhea, and changes of appetite/weight”.8 However, it is important to note that the authors of the study also reported that CBD had a much more tolerable side effect profile compared to other drugs commonly used to treat those same disorders.8
While cannabis isn’t generally associated with physical dependency and withdrawal syndrome upon cessation, the phenomenon is medically documented and not a comfortable one at that.
Chronic, heavy cannabis use will inevitably cause the individual’s physiology to adapt to a constant influx of cannabinoid compounds, thus altering one’s homeostasis and current physiological equilibrium. Therefore, it is not surprising that upon abrupt cessation of cannabis, some mild withdrawal and discomfort is expected.
One of the most commonly reported withdrawal symptoms from abrupt cannabis cessation is the inability to fall asleep.9 Other common withdrawal symptoms include lack of appetite, irritability, and mild anxiety.10
However, in comparison to the insidious and debilitating nature of opioid withdrawal or the life-threatening symptoms of alcohol or benzodiazepine dependence and detoxification are monsters to be reckoned with, causing cannabis withdrawal to pale in comparison.
One of the earliest uses of medical cannabis was in cancer patients. Indeed, the earliest synthetic cannabinoid drugs were used in the treatment of chemotherapy-induced nausea.3–5 What is colloquially known as “the Munchies” may be a nuisance for the cannabis patient looking to avoid sugar; however, this exact side effect is the primary reason cannabis is effective in patients with severe GI issues, generally chemotherapy-induced.
Such patients have difficulty enjoying their food, keeping it down, and developing an appetite. Luckily, cannabis is perfect at making just about anyone really, really hungry; A life-saving benefit from an already wondrous plant that can benefit the metabolism!
The best way to continue successfully integrating (or re-integrating, depending on how you look at it) cannabis into the modern medical pharm is by subjecting it to the same scrutiny and holding it to the same standards as other drugs.
While cannabis has certain unique features, such as the wide level of intra-species diversity, that limit the ability to generalize these findings to all types of cannabis and cannabis products, a general picture of what the adverse effects of cannabis looks like is available in this review.
By better preparing patients for potential side effects and educating them on proper dosing and titrations to mitigate and attenuate the intensity of these adverse effects, we can help more patients use cannabis to successfully reach their treatment goals!
If you enjoyed this article, you may be interested in…
Cannabis Basics Textbook: A Fun Evidence-Based Journey Into Cannabinoid Science Fundamentals
How Can Cannabis Help With Epilepsy?
What is Cannabis Hyperemesis Syndrome?
In this guide, you’ll learn how to make cannabis-infused coconut oil or MCT oil, decarboxylate cannabis, or choose to infuse cannabis into any oil of your choice.
This is a great no-fail recipe for beginners. The corn syrup in this recipe will help your gummy bears have that nice and chewy texture we’ve all come to love.
LA Confidential is a popular cannabis strain for homegrow. Here’s what you need to know to get started with these seeds.
Discover the simple yet detailed step-by-step process of obtaining your Pennsylvania medical marijuana card.
Phytol is frequently found in cannabis strains, but what function does it serve? Learn about the terpene Phytol and what you need to know about it.
LA Confidential is a popular cannabis strain for homegrow. Here's what you need to know… Read More
Discover the simple yet detailed step-by-step process of obtaining your Pennsylvania medical marijuana card. Read More
Phytol is frequently found in cannabis strains, but what function does it serve? Learn about… Read More
Eucalyptol is frequently found in cannabis strains, but what function does it serve? Learn about… Read More
Does having a North Carolina medical cannabis card restrict your ability to own firearms? Let’s… Read More
Unlocking the secrets of obtaining a New York Medical Marijuana Card has never been easier!… Read More
This website uses cookies.