The Straight Dope on Marijuana: Health Benefits and Negative Impacts

Medicinal and recreational cannabis (commonly known as marijuana or weed) is more widely and legally available today than at any other time in US history. In fact, Forbes projects that the marijuana industry will create more jobs than manufacturing by 2020. Its increasing widespread use has broad legal, social, health, and commercial implications.

Marijuana laws are rapidly changing. It is legal for medical use in 33 states and the District of Columbia, and can be used recreationally in 11 states. It remains an illegal drug at the federal level and some larger players continue to be prosecuted. Nonetheless, in states where it is legal, marijuana dispensaries carry a wide variety of ingestion equipment and products, which are analyzed and labeled for dosage of the known active ingredients tetrahydrocannabinol (THC), cannabidiol (CBD), and other compounds.

Because of its unique effects, history of use, wider availability, and continued designation as a controlled substance at the federal level, marijuana remains controversial. Both proponents and detractors are vocal in their opinions and advocacy regarding how it should be handled legally and commercially. This makes for an environment in which it’s difficult to determine the facts, and to make an informed decision on the use of cannabis for personal health.

Here’s what to be aware of as you consider incorporating marijuana products into your medicine—or kitchen—cabinet.

A Little Background on Cannabis Biochemistry

The body has natural receptors for cannabinoids, and the phytochemicals of marijuana operate within a complex system called the endocannabinoid system (eCS). The eCS plays a role in regulating many basic functions of the central nervous system and peripheral nervous system. The eCS is involved in appetite, cancer development, cardiovascular disease, fertility, immunity, memory, and pain regulation.

Cannabis sativa and Cannabis indica plants (the most common strains of marijuana) contain more than 400 phytochemical compounds, about 60 of which are cannabinoids. THC and CBD are the most studied and best understood cannabis compounds.

Marijuana as Medicine

THC is the most prevalent and most psychoactive cannabis component (it gets you high), and has wide-ranging and sometimes contradictory effects—relaxation and paranoia, tolerance and dependence—along with analgesic properties.

CBD, the second most prevalent phytochemical in the plant, has milder psychoactive effects. While the mechanisms by which it acts are not as well known, it is being studied for a wide array of applications, from managing stress and anxiety to addressing neurologic and metabolic issues.

The evidence that cannabis helps manage a variety of types of pain is strong. Cannabis is being explored as a safer alternative to opioids for pain management. In addition, boosting appetite—particularly for those with cancer—is a well-researched application.

Recently the National Academies of Sciences, Engineering, and Medicine published a report that reviews and summarizes the state of the rapidly evolving literature with regard to cannabis use and its impact on health. It offers a clear idea of what we really know right now about the risks and benefits of using cannabis. While cannabis is highly promising for a range of other health issues, the evidence for many applications is not as strong as has been suggested in the popular press. Stay tuned.

How Cannabis Is Ingested

Cannabis is smoked and inhaled as hand-rolled cigarettes (joints), in tobacco pipes, or in water pipes (bongs). Vaporizers pull the active ingredients of the cannabis into a storage compartment for inhalation. Some vaporizers use a liquid form of marijuana extract.

Marijuana extracts and resins are also used in a wide variety of edibles. In fact, the creation of innovative commercial edibles and an entire “cannabis cuisine” is one of the nation’s hottest food trends. Cannabis cookies, treats, candy, and beverages are flying off the shelves. Bong appetit!  

As the commercialization and use of cannabis expands, extracts have more precise doses, and the effective compounds can be isolated and used for different applications. CBD products such as creams, tinctures, and candies are popular as analgesics, with mild nerve-soothing and possibly restorative benefits, without being intoxicating. This is why older folks are lining up for CBD products; people are finding relief without impairment, with fewer side effects and less dependency risk relative to other pain medications, including opioids. There are programs using CBD as an alternative to these highly addictive and often life-destroying drugs.

Cannabis is also delivered as THC suppositories in larger doses, as in some experimental cancer treatments. As we gain experience and quality studies are expanded and repeated, we will have a more balanced understanding of just how to use marijuana. In the meantime, experimentation on a personal level is happening everywhere.

Potential Negative Impacts

Before using marijuana, it’s important to have the following awarenesses.

• Potency is higher than it used to be. The concentration of THC in marijuana has increased, so if you smoked years ago, be aware that modern marijuana tends to be more potent, with a high that can last up to four hours. Edibles, in particular, can provide a much larger dose of THC than smoking, lasting for up to 12 hours.
• It can be habit forming. This is particularly true because the characteristic high of THC seems to be particularly appealing for alleviating stress. As with any substance, the user is often the last to awaken to the negative effects their use is having on their life, work, and relationships.
• Marijuana use impairs driving. Driving under the influence of marijuana is illegal and dangerous.
• The methods for ingesting marijuana can have a negative impact on health. Inhaling smoke elevates respiratory risks (vaporizers and edibles aim to address this risk).
• It may impact brain development. Because of the range of effects of marijuana on the brain, including some areas of brain development, there have been several high-quality studies suggesting that use by adolescents and young people can have long-term, negative effects on adult IQ and other measures. While there is less evidence of negative effects on the adult brain, there are studies that suggest changes in the adult brain occur with long-term use, as well.
• It may impact reproduction. A recent study in women suggested a reduction in conceptions for those with marijuana in their systems.

If you’re considering cannabis for support with a health condition, first chat with your healthcare provider—physician, nurses, dietitians, and other health professionals are rapidly gaining experience and insight. Cannabis provides new (for many) options for treating common ailments, aches, and pains. Ultimately, your reactions to the specific compounds in marijuana are as individual as you are.

Annie B. Kay, MS, RDN, E-RYT 500, C-IAYT, is a leading integrative dietitian, yoga therapist, and Kripalu faculty member.