The Long Read: The Story of Cannabis, Its Medical and Recreational Use

It’s a plant that goes by many names. Some call it cannabis. Others like to say marijuana or marihuana, Mary Jane, ganja, grass, pot, dope, or even the ‘holy plant.’

Humans have cultivated cannabis since the dawn of civilization. The uses of the plant throughout history are diverse, to say the least. However, thousands of years of recreational and medical use were reversed in the first decades of the 20th-century as distasteful propaganda on cannabis acutely plagued public perception.

A major setback in the U.S. was the Marijuana Tax Act of 1937, which prohibited individual possession and sale of marijuana. Even more damage to the image of cannabis was done during the 1970s when the Nixon administration launched the notorious War on Drugs, and the United States Drug Enforcement Administration (DEA) listed cannabis as a Schedule I drug. Basically, the classification scheme placed cannabis on the same list with far more dangerous substances like heroin, cocaine, ecstasy, and LSD.

The stance on cannabis was no better in Europe, where an international drug conference held in Geneva in 1928 fiercely denounced pot, describing it “as dangerous as opium” and claiming that it posed “a threat to society.” The post-war world era was determinative to cement the status of marijuana as “a risk to public health” due to its “strong addictive properties.”

Although some medicinal qualities of the plant were already known to science, in 1969, the World Health Organization determined that the “medical need for cannabis as such no longer exists.” However, today the picture is changing. Scientific research on the medical qualities of cannabis has been mounting. California became the first U.S. state to legalize medical cannabis in 1996, triggering a slow but steady domino effect where multiple other states followed suit with medical legalization, fewer also with recreational use.

At the federal level, cannabis still remains illegal, albeit the “green rush” is challenging such a legal stance, as is the growing number of countries around the world that are stepping forward and expanding legalization. Medical cannabis is legal in countries like the United Kingdom, the Netherlands, Germany, Italy, Israel, Brazil, Argentina, New Zealand, Switzerland, and Norway, to mention some.

While fewer countries have adopted legislation for recreational cannabis, their number is also growing, Canada being one of the most recent examples. The past three decades have demonstrated the huge economic impact a legal cannabis industry can bring.

The “green rush” has opened thousands of jobs in the field and brought myriad opportunities for both small and large-scale businesses, investors alike.

Medical cannabis helps over two million Americans with various conditions they might struggle with, ranging from rare forms of epilepsy to anorexia, anxiety, and pain control.

Historical mentions of cannabis

Some of the earliest mentions of cannabis can be traced to Chinese herbal texts from the third millennia B.C. According to one Chinese legend, Emperor Shen Nung, also known as the Father of Chinese medicine, discovered the healing qualities of cannabis sometime around 2700 B.C. Among other herbs widely used in traditional Chinese medicine, like ephedra and ginseng, cannabis was no exception.

As a food, cannabis oil and seeds have been used in China even earlier than that, or what evidence suggests the plant has been cultivated for at least 6,000 years. It was not only the ancient Chinese civilization that benefited from the medicinal qualities of cannabis, however. Traces of the plant have been found in ancient Egypt and the ancient Middle East as well.

The mummy of Egyptian pharaoh Ramesses II itself carried traces of cannabis pollen, while deciphered ancient Egyptian hieroglyphs suggest the plant served anti-inflammatory purposes; it treated glaucoma and was even used in rectal injections to cleanse the bowels (enema). According to ancient Persian texts, cannabis was on a list that featured the most important medicinal herbs and plants in the region.

There's evidence humans have grounded and inhaled marijuana since thousands of years ago.

Historical applications of cannabis

From treating inflammation to various maladies, people have been aware of and practiced multiple medical cannabis applications. While cannabis was usually consumed externally as a balm or smoked, some records from the 19th-century show the plants' tips were sometimes used internally for treating conditions such as angina pectoris and gonorrhea, according to Britannica. 

A recent excavation from 2019 in China confirms that humans have been smoking cannabis for thousands of years already. In a western province of the country, archeologists uncovered 2,500-year-old wooden braziers. These vessels were found to carry the traces of highly potent cannabis and could aggregate huge fumes, suggesting that the ancient Chinese burned and inhaled the plant.

As hemp, cannabis has been cultivated as one of the first and oldest known human agriculture crops. Ancient textiles of hemp have been found in China and Kazakhstan. Hemp use in pottery dating back 10,000 years have been found in Taiwan. From Asia, the plant traveled to Europe via trade routes, at least 5,000 years ago. 

In the words of eminent American scientist Carl Sagan, there’s real possibility cannabis may have been the first agricultural crop in the world, contributing to the rise of civilization. The evidence the plant was farmed, traded, and used in textile and pottery is overwhelming.

When was cannabis introduced into Western medicine?

During the 19th-century, cannabis was often used as an analgesic. Physicians used it to treat general pain, migraine, stomach pain, and muscle spasms. It was also used as an anti-seizure medicine or to help those with insomnia and depression. Cannabis introduction into Western medicine has been attributed to the 19th-century Irish physician, Dr. William Brooke O’Shaughnessy, whose extraordinary career led him also to find the cure for cholera. 

Perhaps one of the most entertaining episodes in the history of medical cannabis use relates to the British royal family. As the story goes, the crude and conservative British monarch, Queen Victoria, famously dubbed as the ‘grandmother of Europe,’ may have been prescribed marijuana as pain relief for her menstrual cramps. The alleged source of cannabis to the Queen was her private physician, Sir J. Russell Reynolds, who wrote in 1890 that “when pure and administered carefully, [cannabis] is one of the most valuable medicines we possess.” While the Queen was a far cry from being a pothead, she was likely prescribed tinctures, the plant's liquid alcohol-based concentrations that are seeing a resurgence in interest today. Which brings us to the various forms of how cannabis can be consumed in the body. 

Different names, different ways to use cannabis

Marijuana, also spelled marihuana, usually refers to the unrefined plant material of the cannabis plant, the genus of which belongs to the family Cannabaceae. However, a lot of people synonymously use the words marijuana, cannabis, and hemp. Three plants—Cannabis sativa, Cannabis indica, and Cannabis ruderalis—belong to the cannabis plant genus, as far as classifications are concerned. Marijuana, the smokable output of the cannabis plant, goes by plenty of other names, including grass and pot.

Geographically speaking, cannabis has many local names, so it’s dagga in South Africa where locals don’t have an emotional attachment to the name cannabis. In the Indian subcontinent, it’s ganja and kush. Even in Europe, you are more likely to catch designations such as skunk or blunt rather than cannabis, the plant's scientific term.

The processes to prepare marijuana for consumption are specific yet simple. By drying and curing the harvested plant material—flowers and buds—marijuana is prepared as a smokable substance, rolled in joints, which is one of the most common ways of consuming it.

With the rise of the cannabis industry in the last two decades, there has been a rise of infused cannabis products, ranging from chewable foods, beverages, tinctures, cannabis powders, and pills. There are also cannabis-infused topicals, ointments, bath salts, and even tampons to treat period cramps.

Depending on how cannabis is administered into the body, users can anticipate different effects. Medical products often offer relief, whether for pain, anxiety, or another symptom, while the type of strain would be determinative whether a user will experience euphoria, increased appetite, or calmness when smoked.

Smokable cannabis

By all means, smoking pot is the most popular way people use cannabis. The effects of smoking cannabis are immediate, with a single joint often being enough to catapult the user’s high. 

First-time users sometimes report that they don’t feel anything from their first smoke, so it may take a few turns for some individuals to get the warm rush to the head and cerebral ‘high’ often associated with smoking. Habitual smokers are known to develop tolerance to smoking, so continual use may require increasing the dosage but also taking a break to rewire how the body reacts to cannabis.

Rolling a joint is as easy as it gets—you don't need to be a pothead expert to roll one. All you have to do is grind the nugs of dried marijuana flower and roll it in a king-size rolling paper. Spliff is another common name for rolled cannabis cigarettes, as is ‘blunt,’ a hollow cigar filled with ground weed. 

Using a pipe or glass bong is another increasingly popular method for taking or vaporizing smokable cannabis.

Vaping

A pretentious cousin of smoking, vaping is a more discreet way to consume cannabis. A burning joint is an immediate giveaway that somewhere someone is smoking a joint, as the skunky, earthy aroma of the burning weed is hard to conceal. Vaping, on the other hand, involves inhaling heated cannabis oil. It’s done with hand-held vape pens, which can be carried in the pocket, or any other vaping device like the famous Volcano.

While any excessive smoking might injure the lungs, vaping tends to be less harmful as the oil used in the vape pens is free of any harsh compounds found in raw marijuana or tobacco. However, you get much higher from vaping than from a joint because you vaporize high-concentrated THC that gets into your blood quicker. Due to the growing interest in vaping cannabis, companies are perfecting vaping pens, cartridges, and other vaping-related devices. Users can also choose vaping devices in various sizes, from pens to table models.

Cannabis edibles

While it takes minutes to feel the effects of smoking marijuana, it may take up to an hour for cannabis edibles to work their way around the body's gastrointestinal tract. There’s an array of edible cannabis products, from solid foods to all kinds of liquids, powders, and capsules, all categorized as edibles as their administering route is through the mouth cavity and stomach. Most cannabis edibles have delayed but also extended effects. 

THC-infused fat is a common ingredient used for preparing cannabis foods. THC, a cannabinoid and the main psychoactive component of cannabis, easily binds with fatty compounds, so butter and oil products are ideal ingredients to prepare chewable cannabis foods like muffins, cookies, cakes, gummies, or even ice cream. Preparing cannabis edibles entails the process known as decarboxylation, in which the different marijuana cannabinoids are activated with heat, making them bindable with fats. The same method is used for preparing cannabis drinks that can range from coffee, tea to soda.

Cannabis tinctures are alcohol-based extracts where alcohol has been used as a solvent. Unlike other cannabis-containing liquids, tinctures are commonly ingested sublingually (below the tongue), with few drops being enough to generate the desired effect.

Dissolvable cannabis powder that could be stirred in a cup of water or juice is another type of cannabis edible, as are cannabis capsules. Powders and capsules are often tasteless. Together with tinctures, these types of cannabis products are perfect for users who want to have greater control of the cannabis intake in their bodies and who like to do it discreetly. While all kinds of ready-made edibles can be purchased in dispensaries, a lot of people opt to prepare cannabis foods by themselves. Recipes for preparing a traditional space cake are among the most popular, however, there are as extravagant recipes as cooking a lobster with cannabis.

Why have edibles delayed, extended effects?

The smoke-free way of consuming cannabis means that THC needs to be digested in the body. Instead of hitting the blood through the lungs, it needs to go through the liver where the byproduct of the metabolic processing is another compound called THC-COOH. This compound is more potent than THC, which is why users feel delayed but extended effects from ingesting cannabis edibles. So, THC needs some time to process in the body, transforming into a more robust version of itself. Not all edibles are dominant with THC, however. There is a varsity of hemp-based cannabis products containing a larger CBD dose, which is the cannabinoid praised for its medicinal qualities.

THC, CBD, and other cannabinoids found in cannabis

You may have heard about THC or CBD already. These are the two most famous cannabinoids extracted from cannabis plants. They are unique to the plant, although there are hundreds of other cannabinoids produced by cannabis. Scientists keep discovering new compounds, and we are just merely beginning to understand the exact function each has. One difficulty is that some cannabinoids are sometimes hard to detect in the cannabis plant, so they are virtually untraceable due to their low levels. 

THC and CBD are the byproducts of two different cannabinoid acids that cannabis generates, THCA (Δ9-tetrahydrocannabinolic acid) and CBDA (Cannabidiolic acid). Heat (or decarboxylation) is what transforms the acids into the compounds appreciated by users worldwide. Both THC and CBD have similar chemical compositions, but their effects on the human body are reasonably different. THC is praised for its psychoactive properties, giving a good high to those who smoke, vape, or ingest cannabis. CBD, on the other hand, does not produce ‘high’ and can be tolerated in greater dosages than THC. Both are used in medicine.

THCVA (Tetrahydrocanabivarinic acid) is another cannabinoid source, the medical properties of which are increasingly catching industry-wide attention. Unlike THC, a well-known appetite stimulator, THCV (the byproduct of THCVA) lowers the appetite, so it’s billed as the future cannabinoid that could help weight loss. 

When THC-rich flowers are left to degrade, i.e., when a grower is late with the harvest, the byproduct of the degrading process is yet another cannabinoid - CBN, observed for its sedative dimension or couch lock effect. Both THCV and CBN are examples of understudied cannabinoids. While the first promises a cure for obesity, the second might hold unknown analgesic and calming potentials. 

It’s the task of cannabis scientists to research, make discoveries, and develop novel ways to use the cannabis plant in medicine.

Cannabinoids and our endocannabinoid system

Cannabinoids interact with the human body endocannabinoid system (ECS), a complex cell-signaling system identified by scientists during the 1990s. The two primary endocannabinoid receptors identified within this specific system in the human body include CB1 and CB2 receptors. The first dominates in the central nervous system, while the second dominates in the peripheral nervous system, especially immune cells. These receptors determine our response to cannabis intake.

While the ECS is still shrouded in mysteries, from what we know, it has been linked to almost all and any systems in the human body. For instance, the endocannabinoid system is present in the digestive tract, so it affects appetite. It’s interlinked with the immune system, so it affects inflammation and other responses linked to immune cells. It’s in the brain as weed affects mood change, body coordination, learning, and memory. Of all cannabinoids, THC is the single most ‘intoxicating’ cannabinoid that can enter our body.

Other cannabinoids are not as intoxicating as THC, but they can still influence how THC interacts in your body. For instance, CBD might not be recognized for giving the user a ‘high,’ but it influences the way THC interacts with the CB1 receptors and may have a decisive role in how a particular cannabis product will affect someone’s body.

What other parts cannabis plants have?

Cannabis users appreciate the medical and recreational effects they get from consuming the plant and its array of cannabinoids. Different parts of the cannabis plant govern the production of cannabinoids. 

Essentially, cannabinoids originate in the resin-secreting flowers of the female cannabis plants. The large clusters of buds that define the cannabis plant are known as colas. The apical bud is the main cola at the top of the plant, plus several smaller colas are usually found on the plant's lower parts.

On the cannabis buds, there are pistils that contain the reproductive parts of the cannabis flowers, including the stigma—the vibrant, hair-like extensions of the pistils that cover the buds. Stigmas collect pollen from male cannabis plants during pollination. Also, stigmas continually change their color, displaying different shades depending on the stage of the growth process. From milky white, they become yellow, orange, and brown, signaling to growers if the buds should be plucked from the plant.

Bracts are another component of the flower. Shaped like tears, bracts encase the female plant reproductive parts. Each bract contains resin glands that leach out significant concentrations of cannabinoids, more than any other part of the cannabis plant. At the base of the flower, the calyx serves as an additional layer of protection to the reproductive parts. Each marijuana flower also has translucent trichomes, bulb-like glands found on both the flower and stem of the cannabis plant.

Trichomes also produce cannabinoids. They also leach out rich, aromatic essential oils that give the smell and flavor of the cannabis. The scent of cannabis is further determined from the terpenes, another aromatic compound, which, evolutionarily speaking, has helped cannabis plants adapt against pests, fungi, or grazing animals.

An intriguing terpenes-cannabinoid interaction has been highlighted by recent research, one that could be further exploited for medical purposes. Like many other plants, cannabis also has nodes and internodes. While the nodes on the main stem are the areas where the newer branches separate from the plant's main stem, the internodes are the spaces between the nodes. Nodes have a critical role in manipulating the growth of the cannabis plant. 

Growing cannabis

For most of the time, growers cultivate female cannabis plants for the sole reason that it's the female flowers that are abundant with the much sought-after THC. Male plants, which are important to breeding, but could also be substituted if the grower relies on cloning techniques, are generally less valued than female plants. Male plants are not entirely obsolete, however. 

Cannabis can be grown indoors and outdoors, with growers utilizing various methods to make the best yield, ranging from the use of fertilizers to optimizing light, temperature, and humidity in the setting chosen for the growing. Cannabis demands nutrients rich soil to thrive, as well as specific temperature or light schemes like 12 hours of daylight and 12 lights of total darkness. Keeping a few plants for personal use is legal in most states where recreational cannabis is regulated, although such an act is persecuted under federal law. Growing a few plants is similar to growing any other crops as plants can be interplanted between other crops in an existing outdoor garden. 

For a more significant number of cannabis plants, growers may invest in more substantial grow equipment such as hydroponics or aeroponics, methods usually reserved for indoor cultivation. Additional equipment may involve LED lights for indoor growing, setting ventilation for the grow facility, or a water system to optimize water and nutrient intake of the seedlings. 

Determinative to the growing process is also what kind of cannabis strains is being cultivated in the garden or grow room. Growers decide on the strain they’re growing depending on their needs. Or, they grow commercial strains that are easy to grow and sell quickly, like Skunk varieties. 

What are cannabis strains?

Cannabis strains are the result of selective breeding of different cannabis plants, to the point they generate very specific effects on the user.  Some cannabis strains are ultra-popular for the euphoric ‘high’ they stimulate or are craved for the extra calming effect they bring. And some strains are particularly useful for treating specific medical conditions. 

Generally speaking, there are three main categories of strains—indicas, sativas, and hybrids. However, these designations simply refer to a broad set of effects the strain will have on the user. 

Indicas are commonly attributed to giving calm, relaxing effects on the user. Here's a list of some of the best indica strains, along with some handy cultivation tips for the green-thumbed among you. Sativas, on the other hand, are more energizing. A hybrid is a mix of both Indica and Sativa strains. The most popular strains today are Sativa-dominants (>70%). Here's a list of the best sativas to try out. 

Technically speaking, most commercial strains available on the market today are genetic hybrids. They were developed through crossbreeding original or “landrace” cannabis strains. 

For instance, the genuine Indica landrace strains originate from South Asia. Indica cannabis plants developed in this part of the world for centuries, without human intervention. The name is associated with the Indian subcontinent, where it’s most commonly found. 

Cannabis landrace strains often carry a geographic reference in their name, so another example would be Durban Poison, which is a pure Sativa traced to Durban, South Africa.  Landrace strains are perfectly adapted to the original environment‒or "terroir," where they have evolved over the course of many centuries. As growers moved these strains from one geographic region to another, they sometimes cross-bred them with other strains, creating new strains/hybrids or augmenting their pure forms (e.g., breeding out bad characteristics of the strain). For instance, take Northern Lights, which is one of the most popular cannabis strains of all time. This strain is a pure Indica, derived from indigenous Afghani and Thai landrace strains. Descendants of Northern Lights strains are famous hybrids such as Super Silver Haze and Shiva Skunk. 

THC strains

Another way to classify cannabis strains is to indicate whether they are more abundant with THC or CBD, the two most popular cannabinoids. Therefore, THC strains contain more of the psychoactive, high-inducing cannabinoid. Most THC strains will have less than or around 1% CBD, although this proportion is different in some varieties. Each strain also carries other cannabinoids. Recreational users are the most common users of THC-dominant strains, however, THC has its uses in pharmacology and medicine.

Examples of some of the most potent THC-dominant strains as of 2020 would include Godfather OG, an indica dominant hybrid that roughly has 34% THC content, Chemdawg with a reported THC content of around 32%, or Girl Scout Cookies and Gelato aka Cookies Gelato with approximately 28% THC content. Needless to say, these types of strains are not for the fainthearted. They are better in the hands of experienced users.

Over the years, strains have grown their THC potency, meaning, the average THC strain of the 1990s was less potent than the average THC strain in 2020. THC-dominant strains also serve as the raw material for cannabis edibles that some users prefer over smokable cannabis.

CBD strains

Suppose THC strains are the go-to options for recreational cannabis users. In that case, CBD strains are the go-to options for medical users of cannabis. CBD strains lack the psychoactive effects of THC strains. Still, they can help patients treat an array of conditions, ranging from anxiety, stress to anorexia, or chronic pain. The effects of taking a CBD strain feel more like a narcotic buzz than a high. CBD-dominant strains are also sourced for different CBD products, including edibles, tea, massage oils, balms, and moisturizers. There are CBD products now on the market even for cats and dogs. Many cannabis health products sources their CBD from hemp strains, which are rich in CBD, contain less than 3% THC and are easier to obtain due to the legality of hemp. 

The effects of cannabis on the human body

Whether cannabis is inhaled or ingested in the body for medical or recreational purposes, its effect will differ from person to person. Also, there’s a need for more scientific research to comprehend the full effects of cannabis on different biological systems. Some of the noticeable effects from smoking marijuana include relaxation and euphoria, although, depending on the THC strength of the product, some users may experience affected body coordination and cognition, cottonmouth (dry mouth), or dry eyes. The more THC there is in the strain, the more any such side effects may be noticeable on the user.

Respiratory system

It’s a frequently asked question whether smoking cannabis may have a harmful impact on the lungs. While extensive medical research has not substantially linked smoking marijuana with severe lung health (e.g., lung cancer), it’s worth noting that any smoking can impact the respiratory tract.  For any type of smoking, both recreational and medical, the following complications of smoking might be felt by the user: 

• Phlegm accumulation
• Chronic cough
• Difficulty breathing
• Tightness/pain in the chest
• Hoarse voice 

In most cases, a pause from smoking will lead to withdrawal from any such symptoms. On the other hand, heavy smoking might increase lung inflammation risks and lead to further complications such as bronchitis or chronic obstructive pulmonary disease (COPD). Smoking is not recommended for users who may suffer from conditions like asthma. If a user has asthma before starting to smoke cannabis, they increase their chances of worsening asthma with smoking. 

For recreational use, it’s best to smoke marijuana moderately and avoid heavy consumption. For medical use, it’s best to opt for other means to consume cannabis like vaping or taking cannabis in capsule or tincture form. That is, if smoking may additionally impair the health of the medical user.

Cardiovascular system

It might be a well-known sensation to some users that marijuana increases their heartbeat after finishing a blunt. According to medical estimates, cannabis use boosts the heart rate by 20 to 50 beats per minute on average, a sensation that lasts up to 3 hours. 

Other medical study results on cannabis use and cardiovascular health suggest mixed results. According to some observational studies, some chemicals found in marijuana have been linked to a higher risk for atrial fibrillation, a condition that could lead to heart failure. However, no study has managed to prove that the chemicals were the cause of the increased risks. 

THC products stimulate the heart, can cause oxidative stress and promote vascular inflammation, which may lead to increased blood pressure and heart palpitations. However, any adverse reactions to cannabis are more likely if a product has higher THC concentrations, has been taken in a short period of time, and if the user has an existing medical condition. 

On the other hand, CBD has all the opposite effects on the heart. Unlike THC, CBD eases inflammation and reduces the risks of any heart conditions. Users who notice that they regularly experience heart palpitations from smoking weed are best to succumb to only light to moderate use of the substance, observe how their heart reacts to weed, and pause from smoking if palpitations persist. Also, avoid mixing alcohol and cannabis, as alcohol is likely to boost the THC levels in the blood.

Digestive system

Another common reaction from smoking weed is the boost in appetite or what recreational users like to refer to as the “munchies.” Depending on the strain, the food cravings induced by marijuana will range from mild to ‘Hold on, I have a hole in the stomach and now I am going to empty the entire fridge.’ However, there’s more to cannabis effects on the digestive system than being a remarkable appetite stimulant. Some research suggests that cannabis helps preserve gut health by altering how the endocannabinoid system works and preventing inflammatory conditions that might occur in the bowels.

Brain, nerves, and mental health

When it comes to the brain, nerves, and mental health, the body's relationship with cannabis becomes even more complicated. Millions of people who suffer from mood disorders, anxiety, or depression find comfort in medical cannabis.

People who’ve suffered through trauma may also find comfort in cannabis since the plant affects memory and cognition and could help them recover. However, some studies highlight the fact that the use of cannabis may play a part in some conditions that concern our mental health.

In some cases, marijuana can stimulate the presentation of serious schizophrenia-like psychiatric disorders. Knowing that THC is a mind-altering chemical should discourage people who are susceptible to developing psychiatric disorders from taking any cannabis (e.g., family history of a form of the disease such as paranoid schizophrenia). Or at least they should never overconsume cannabis.

Some cannabis strains are associated with the frequent onset of slight paranoia and anxiety in some users. Those who repeatedly experience paranoia from consuming a particular strain should change their source or carefully choose the setting where they consume cannabis (e.g., look for strains that elevate the mood and cause laughter, or avoid smoking in crowded places). You might be surprised to know that simple things like drinking lemonade or taking a whiff of pepper could help you tackle marijuana paranoia. Despite THC being a mind-altering compound, sometimes ‘managing the smoking experience’ is necessary to optimize the best effects for your mental wellbeing. 

On the other hand, CBD is scientifically demonstrated to offer protection to the body’s neurological network. In addition, it also improves the health of the brain’s hippocampus region, critical to learning and memory, and whose poor function has been linked to anxiety and depression. 

Due to its overall qualities, CBD is the most promising cannabinoid to counteract not only anxiety and depression but also neurodegenerative disorders like Alzheimer’s and Parkinson’s.

Mild to moderate use of cannabis is generally harmless and should not cause any negative effects on the user.

The promise of medical cannabis

Approximately 2.1 million Americans are reported to use medical cannabis, prescribed by their doctor to treat certain conditions they’re struggling with. Add to this the unknown hundreds of thousands, if not millions of people who also rely on cannabis to medicate themselves. The figures speak volumes of the popularity of medical cannabis as the go-to solution for an array of physical and/or mental health conditions. The medical use of cannabis is also one of the major arguments that push forward legislators to adopt new laws that ease access to the plant and its products. 

From treating chronic pain, depression, anorexia, epilepsy to an array of inflammatory diseases, medical cannabis presents as a new trusted alternative to various common prescription medications. It’s also seen as an alternative to tackle the opioid crisis, which is taking the lives of approximately 130 Americans every day.  Below is a review of the specific conditions medical cannabis has shown to be an effective treatment. This list may only expand as our scientific understanding of the plant advances, hopefully on a par with legalization.

Medical cannabis as a viable treatment option

From smokable raw plant material to specific pharmacological drugs based on CBD or THC, medical cannabis products are available in many forms for patients in need. U.S. patients are required to consult with a physician and obtain a medical marijuana card (MMJ) before they are given the green light to use medical cannabis for their condition.

Chronic pain

Roughly 65% of medical users in the U.S. rely on cannabis to treat chronic pain. By far, chronic pain is one of the most common uses of the plant. While cannabis may not offer relief from severe pain, such as from a broken leg, it has shown to be an effective medicine for lingering, chronic pains. 

Cannabinoids, in particular CBD, ease pain sensations by interacting with the endocannabinoid receptors in the brain and adjusting pain perception. In addition, cannabis can dissolve muscle tension as well as any discomfort in the body. But perhaps its greatest asset is that it presents as a much safer option than opioids. 

Migraine 

According to some research, cannabis could help ease migraine symptoms or, in some users, prevent them from occurring. CBD oil is one of the products people suffering from migraines can take to comfort migraine attacks. Alternatively, some cannabis strains work particularly well for migraines. 

CBD works in similar ways as to treat other forms of chronic pain. By interacting with pain receptors in the body, CBD lowers the pain threshold and reduces migraine pain and any accompanying symptoms like nausea, vomiting, or light and sound sensitivity.  Critical Mass, White Widow, and Tangerine Dreams, all of which hybrids, are some of the most popular strains that could help alleviate migraine symptoms.

Arthritis

Aching muscles and joints are well-known manifestations of osteoarthritis, the most common form of arthritis, or rheumatoid arthritis, which is an autoimmune disease.  While the disease may erode joints, inflicting pain and stiffness and limiting our body's ability to move with ease, cannabinoids are scientifically demonstrated to heal painful joints. By promoting nerve protection, cannabis can also prevent arthritis complications such as joint neuropathy (nerve dysfunction). Here's what The Arthritis Foundation has to say on CBD for arthritis pain.

Stress and anxiety

The most common medical reason people reach out to cannabis is its uncanny ability to offer relief from stress and anxiety.  The leading cause for anxiety and even depression is neuroinflammation, and CBD counteracts nerve damage, reduces inflammation, and preserves the brain’s nervous tissue. CBD oil may be incredibly helpful for patients who need to lift their spirits. The concoction acts as a regulator of natural serotonin levels and poses as a safer alternative to many antidepressants which are known to cause psychosis. A study published in the journal Neuropsychopharmacology found that CBD appeared to decrease cognitive impairment and agitation in people with social anxiety. 

Smoking cannabis can be a very social moment, making new friendships and enhancing existing relationships. Therefore, it's a nice activity that could boost mental well being.

Insomnia 

Insomnia and dream-disturbed sleep can be the consequences of various medical conditions, including anxiety, chronic pain, and rare diseases such as restless leg syndrome.  Thanks to some of its sedative qualities, cannabis can help those who struggle to keep an eye shut in the evening and wake up grumpy in the morning, utterly unenergetic for the day ahead.  Both CBD and THC are used to treat sleep disorders. Recreational users usually seek strains with sedative qualities to help with recurring sleep issues.

Multiple Sclerosis 

Cannabis can aid notorious medical conditions such as Multiple Sclerosis (MS). The lifelong autoimmune disease takes its toll on the central nervous system, causing muscle spasms, numbness, weakness, fatigue, pain, vision issues, and can also have other manifestations. As it progresses, the neurological disease can lead to disability.  Cannabis can help treat neuroinflammation in MS patients and is incredibly useful in treating the majority of MS-associated symptoms. Research from the National Multiple Sclerosis Society suggests that up to 66% of MS patients use cannabis and its health benefits to treat MS symptoms.  The National Multiple Sclerosis Society supports the rights of people struggling with the disease to work with their health care provider to access medical cannabis in accordance with legal regulations in those states where such use has been approved.

Crohn’s disease

Accompanied with nasty symptoms like bloody diarrhea, rectal bleeding, stomach pain and fever, Crohn’s disease (CD) is one of the two types of inflammatory bowel diseases that involve chronic inflammation of the bowels. Existent therapies can only alleviate symptoms and, at best, bring long-term remission. Unfortunately, there's no known treatment method to cure the disease.  Recent Israeli research gives hope for people who are suffering from CD, billing cannabis oil as a treatment option for CD symptoms. The study, which probed the severity of the disease in 30 patients with Crohn's disease, found that 70% of the patients experienced a decrease in CD symptoms after trying out cannabis as a treatment option. Some of them also reported that they were able to reduce or entirely eliminate the medications they were using prior to trying cannabis, according to the Canadian Society of Intestinal Research. Around 3 million Americans suffer from inflammatory bowel diseases such as Crohn’s disease.

Cancer 

Last but not least, cannabis can comfort those who also have cancer. As research suggests, 25 percent of all cancer patients use medical cannabis. While cannabis can’t cure cancer, it can at least help manage several of its symptoms, such as pain, appetite loss, anxiety, and insomnia.  Scientific research is ongoing to understand the precise effects of the substance on cancer cells. For instance, British scientists have found that THC and CBD, the two most common cannabinoids in the cannabis plant, could weaken cancer cells, thus increasing radiation therapy effectiveness.  A batch of other studies suggests that medical cannabis can slow cancer cells' progress and diminish their spread around the body. Also, it’s the potential go-to drug for treating chemotherapy-related nausea and vomiting.

Choosing the right strain

The range of medical uses of cannabis is undoubtedly extensive. And as you may have already figured out, there's a correlation between specific cannabis strains and some particular ailments and diseases that could be better treated with the specific strain. Medical users should inform themselves about the possible side effects of the strain they use, and implement strategies to address any bodily reactions that might result from using that strain. For instance, most strains available could cause cottonmouth and dry eyes. Ramping up with water drinking and using eye drops may be a good idea in such cases. 

An important notice: Don’t try to self-medicate with cannabis any serious, long-term, and/or life-threatening conditions you might have. Always discuss your condition with a physician and see if medical cannabis is an option treatment that could improve your health and wellbeing.

What are some of the most popular medical cannabis strains?

Northern Lights

A pure Indica with 16.5% relative THC content. It’s one of the most famous strains of all time. It’s also one of the more prominent commercial strains. Northern Lights strains pacify the mind and relax the body, so people use it to medicate an array of medical conditions. 

Cultivating: if growing indoors, wait for 45-50 days flowering time to perform the harvest
Taste and aroma: sweet, spicy, pungent
Properties: relaxing, sleep-inducing strain, improves the mood 
Medical uses: for treating insomnia, pain, stress, depression
Side effects: a third of users report dry mouth, some of them also dry eyes

Blue Dream

A sativa-dominant hybrid with up to 18.5% levels of THC and less than 1% CBD. It’s known to relax the body and invigorate the brain and central nervous system. 

Cultivation: in most cases, Blue Dream plants should be ready for yield after around a 2-month flowering time  Taste and aroma: sweet berry 
Properties: relaxing and comforting, to a certain degree it acts as a sedative, can improve the mood slightly Medical uses: eases pain, cramps, inflammation 
Side effects: a third of users report dry mouth, some of them also dry eyes

Purple Kush 

A pure indica with up to 16% THC content. It gives users a soothing state of bliss, relaxing the body and helping them fall asleep. 

Cultivating: it’s usually ready to yield after a 2-month flowering time 
Taste and aroma: subtly earthy, subtly sweet
Properties: sedative, mood-improving
Medical uses: can treat insomnia, can alleviate pain and muscle tension
Side effects: almost 50% of users report dry mouth, a third report dry eyes. A small fraction of users have also said that they feel paranoid after taking the strain

For more strains favored by medical users, check out the following list of 7 best medical strains. 

Cannabis in pharmacology

Cannabis flowers are only one option to use the therapeutic benefits of the cannabis plant. Upon physical examination, your doctor may propose the use of pharmacological solutions based on cannabis. Products that have CBD content are more common among medical cannabis patients, however, some of the medicine is derived from THC as well.

Cannabidiol (Epidiolex) 

In pharmacology, anticonvulsants are a group of agents used in the treatment of epileptic seizures. Cannabidiol in the form of Epidiolex is an available treatment method for epilepsy (based on CBD). It can be found in most states, regardless of whether medical cannabis is legal in the state.  Epidiolex is the only FDA-approved prescription CBD, used to treat rare forms of epilepsy such as Dravet syndrome or Lennox-Gastaut syndrome.  In fact, Epidiolex is the first drug approved by the FDA for treating Dravet syndrome, a severe type of epilepsy where seizures are prolonged and start shortly after birth.

Dronabinol

Dronabinol is a pharmacological cannabis solution based on THC. Notably, the drug helps AIDS patients with weight loss and loss of appetite as well as cancer patients who struggle with severe nausea and vomiting due to chemotherapy. It’s also prescribed for sleep apnea as well as in cases with insomnia or dream-disturbed sleep resulting from other medical conditions. Dronabinol is available in capsule and liquid forms and must be taken exactly as instructed by the physician.

Other medical cannabis products

Since any kind of smoking is frowned upon, there’s a lingering perception that smoking cannabis, even for medical purposes, is against health and wellbeing. Nevertheless, the industry has rapidly shifted to offer a range of all the different cannabis products that could substitute smoking. So, those who really want to avoid any impact on the lung from smoking often opt for edibles in food, capsules, powders, oils, or tincture forms. Vaping cannabis would make for another smoke-free method increasingly popular among medical cannabis users. In addition, there is the emerging trend of cannabis topicals or products orientated toward health, beauty, and skin improvement. That is since cannabinoids can be absorbed through the skin without inducing any psychoactive reaction. Essential oils, shampoos, deodorants, balms, moisturizers, and bathing salt based on cannabis are all available skin treatment options.

Are there any limits on medical cannabis research?

Due to the federal prohibition of cannabis and its status as a Schedule I substance along with notorious drugs such as heroin, research on cannabis in the U.S. falls behind. The research on the medical use of cannabis in the U.S. has not advanced, even though there has been a decent expansion of legislation that eases legal access to medical cannabis in recent years. Regulatory barriers, low-quality cannabis samples, funding limitations, and logistical issues are all factors that contribute to the state of limited solid research on the health and therapeutic benefits from cannabis in the U.S. Most information on the health and therapeutic effects of cannabis come from research facilities abroad, from countries where medical cannabis has a regulated legal status, such as Canada, Germany, and Israel, with governments authorizing millions for reliable cannabis research projects.

What’s the “green rush”?

In recent years, cannabis has grown into a billion-worth industry. Despite that cannabis is persecuted under federal law, when it was legalized in 2012 in the US states of Washington and Colorado, the event marked a new era, opening up the cannabis market to unprecedented financial opportunities, and has since been famously dubbed “the green rush.” By popular projections, the cannabis market is expected to hit $90+ billion in value worldwide by 2027. 

Although it had some impact, particularly on further expanding legalization, not even the coronavirus pandemic outbreak challenged the status of the cannabis industry as one of the fastest-growing consumer industries in the U.S. and abroad. 

Legal cannabis companies have generated hundreds of thousands of new jobs across the U.S., in sectors that range from cultivating the crops, manufacturing medical and recreational products, and selling in dispensaries.  The boom of the industry has, in the meantime, introduced many emerging trends that are taking root among recreational and medical cannabis users alike. For instance, the surge in cannabis concentrate sales has meant that many recreational users are now opting to vape instead of smoking. Or they are chasing after new strains of cannabis that contain unheard of amounts of THC. The rise of health and wellbeing products has meant that even the most unlikely Hollywood celebrities are now launching their own product lines, with California naturally being the epicenter of the fad.

With federal legalization pending on the horizon, an already hot boiling market such as cannabis is said to become even more competitive than it is now.

Has the public perception of cannabis changed in the United States?

While there always will be disapproving folks who frown upon even if you barely mention the word cannabis or marijuana, the public perception of the ‘controversial’ plant in the U.S. has changed positively over the last decade. Polls suggest that the share of U.S. adults against marijuana legalization has fallen from 52% in 2010 to 32% in 2019. In addition, an overwhelming majority of U.S. adults (91%) approve the legalization of medical cannabis, and a fewer but still significant percentage (59%) support recreational legalization, according to a survey conducted on Pew Research Center’s American Trend Panels. 

According to a 2017 Gallup poll, 64% of respondents said they stand for fully legalizing marijuana. 

What are some common misconceptions about cannabis?

Although cannabis legalization has been expanding worldwide, and there’s a growing majority that approves the use of cannabis for either medical or recreational use, many people have a twisted perception of cannabis use, including habitual users who smoke cannabis relatively often. Below are some of the most common misconceptions.

Recreational use of cannabis is harmless. True or false?

The correct answer is partly false. Cannabis is not entirely harmless. While cannabis can’t lead to overdose, it’s worth remembering that it’s still a mind-altering substance that at least temporarily can change the perception of reality in users. Overusing cannabis might influence the emotions and behavior of some users, and although rare, it may even lead to erratic behavior. Long-term, heavy use may impact physical health and has been further associated with unemployment, a decline in social class, and increased chances for road accidents. Different people will react differently to cannabis, as well as that different cannabis strains generate differing effects among users. User reports suggest that at least a fraction of users experience anxiety or paranoia (at least slight to mild) from taking certain strains. 

Cannabis can be harmless when there’s moderate use and where the user has found the right strain that matches their emotional and mental well-being. Staying informed on the strength, properties, and provenance of strains can help users determine whether their weed is worth their money. Taking tolerance breaks is highly recommended for habitual users. 

Cannabis is a miracle drug for any condition. True or false?

While the medical qualities of cannabis are unquestionable and while pot can help treat various conditions or at least some of the symptoms of the disease (e.g., nausea in patients with cancer), it’s overestimating that cannabis is adequate for every condition or that it should be used as the sole method of treatment. Truth be told, we need more scientific research to determine the comprehensive effects of cannabis use on human health. There are also misconceptions about specific conditions like glaucoma that many people believe cannabis can help tackle. Such a misconception may follow as various cannabis publishers often mention glaucoma on lists of conditions where cannabis can help. 

However, according to the American Academy of Ophthalmology (AAO), “cannabis and currently available compounds derived from marijuana ‒ like CBD ‒ are not an adequate treatment for glaucoma or any eye condition.” As AAO explains, treating glaucoma/eye pressure must be managed 24 hours a day, and while marijuana can offer relief temporarily, it’s not practical for constant use. AAO suggests that there are several other effective treatments for glaucoma currently available that are more reliable and safer than marijuana. 

So, folks, don’t bet all your health on marijuana. Always refer to your physician when you face a health issue, discuss with your physician the use of medical cannabis if you believe this is something that can help you, and take care of your health.

Where has cannabis been legalized in the U.S.?

As of early November 2020, 33 states and the District of Columbia allowed the medical use of cannabis. Eleven of these states, including D.C., further regulated the plant's legal recreational use and its products. These numbers were slightly tweaked as five states came forward with legalization initiatives on the election ballot in the 2020 elections, including South Dakota, Mississippi, New Jersey, Arizona, and Montana. As all cannabis ballot measures passed in the 2020 elections, Montana, New Jersey, South Dakota, and Arizona became the latest states to greenlit recreational use of marijuana. At the same time, Mississippi and South Dakota voters approved the legalization of medical cannabis. Conservative South Dakota became the first U.S. state to approve both recreational and medical cannabis during the same election. The move has been interpreted as a nod that Americans are abandoning prohibitionism when it comes to substance use.

The most significant year so far in terms of cannabis legalization in the U.S. remains 2016,  when nine states expanded their legislation to regulate medical or adult use of cannabis. On December 2, the United Nations has voted to reclassify cannabis from its list of dangerous substances in what cannabis advocates have hailed as a "historic victory."