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Marijuana as Medicine

The Florida legislature recently approved a bill that lifts condition in the same class as the list of qualifying conditions, to
the state’s ban on smokable marijuana. Florida is among 33 patients who are terminally ill, or to patients who have chronic
states nationally that allows medical marijuana. pain related to a qualifying condition.
Denise C. Vidot, an assistant professor in the University There are various ratios of CBD (cannabidiol) and THC
of Miami’s School of Nursing and Health Studies, is con- (tetrahydrocannabinol) used within medical marijuana based on
ducting extensive research on the use of medical marijuana the condition.
to manage HIV comorbidities in the context of cardiovascu- Medical marijuana works via cannabinoids (CBD and THC),
lar disease risk. She provided some insights below: engaging with the patient’s endocannabinoid system. The body
naturally produces cannabinoids; and the endocannabinoid sys-
What research have you con- tem has been documented to play a role in regulating common
processes such as appetite and pain. There are two main cannabi-
ducted on medical marijuana? noid receptors found in the body, CB1 and CB2 receptors, to
which cannabinoids in marijuana attach and activate.
Currently, collaborators and I are conducting a study on CB1 receptors are found throughout the body (i.e., brain and
the use of medical marijuana to manage HIV comorbidities nervous system). THC typically binds with CB1 receptors, which
in the context of cardiovascular disease risk. HIV is a qual- can be associated with the psychoactive and mental health effects.
ifying condition to obtain medical marijuana in Florida; Denise C. Vidot CBD typically binds to CB2 receptors found in the immune system,
therefore, there is a portion of HIV patients with an active which can be associated with reduced inflammatory effects.
prescription for medical marijuana. In this study, funded by
the National Institutes of Health as a Center for AIDS Research Supplement, we How much evidence exists on the benefits
are examining differences in cardiovascular disease risk among patients who
have an active prescription for medical marijuana compared to those who use of medical marijuana?
marijuana not prescribed by a health care professional. I also recently complet-
ed two other studies on medical marijuana. One examined differences in respi- Evidence on the benefits of medical marijuana is growing. This is particularly
ratory and cardiometabolic disease among medical and recreational marijuana true in oncology, and other fields that include medical marijuana qualifying
users via a population-based sample of adults in the United States. The second conditions identified in the states that have legalized its medical use. I am
study was a qualitative study that sought to examine stigma and perceptions of examining differences in the health impact of marijuana use by route of admin-
medical marijuana use by current users and those who have never used mari- istration, including various ways to smoke marijuana.
juana.
We’ve heard a lot about the benefits of
What is the difference between medical medical marijuana. But what are the side
marijuana and recreational marijuana? effects?

In Florida, the differences include the composition of marijuana, how it is There are patients who report side effects after using marijuana. Effects vary
obtained, and the route of administration (until the ban on smokable marijuana as a function of CBD and THC ratio, non-active ingredients, and route of
was repealed). Marijuana is composed of compounds called “cannabinoids.” administration. Furthermore, there are limited prospective studies examining
The two main cannabinoids that have been studied are cannabidiol (CBD) and the long-term impact of medical marijuana on health outcomes.
tetrahydrocannabinol (THC). In general, medical marijuana contains a high
concentration of CBD and a low, if any, concentration of THC. CBD has been
associated with the medically beneficial effects, such as reduced inflammation. What impact do you see medical marijuana
Recreational marijuana tends to have a high concentration of THC, which has having on health care, and could it help
been identified as the psychoactive ingredient causing the “high” feeling.
solve the opioid crisis?
What is medical marijuana used for and
As marijuana becomes part of the clinician’s “toolbox” to provide care for
how does it work? patients, I believe health care professionals will become more engaged in the
marijuana research community. In Florida, medical marijuana has begun to
In Florida, medical marijuana can be prescribed for qualifying conditions make an impact on pain management. Preliminary results from a pilot study I
such as cancer, HIV/AIDS, epilepsy, glaucoma, post-traumatic stress disorder, conducted found that the majority of patients who use medical marijuana do
ALS, Crohn’s disease, Parkinson’s disease, and/or multiple sclerosis. Licensed so to manage pain and/or anxiety. In the context of the opioid epidemic in the
physicians are also able to prescribe medical marijuana to patients who have a U.S., studies have suggested that medical marijuana may be an alternative to
prescribing opioids.

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