“Doc, I’ve got a question about… well, marijuana.” I hear this quite a bit in my clinic these days. Someone leans in, maybe a little hesitant, and wants to know the real deal. With all the talk out there – some folks praising it, others warning against it – it’s easy to get confused. So, let’s chat about marijuana, what we know, and what we’re still figuring out. It’s a complex topic, and like many things in medicine, the answers aren’t always black and white.
What Exactly Are We Talking About? Marijuana, Cannabis, THC, and CBD
Alright, first things first. You’ll hear a few terms thrown around, and it’s good to know what they mean.
- Cannabis: Think of this as the parent plant, Cannabis sativa. It’s packed with over 500 different chemical compounds. One of these is cannabidiol, or CBD, which you might have seen in various products. CBD itself doesn’t cause a “high.”
- Marijuana: This term usually refers to the parts of the cannabis plant (like the dried flowers, leaves, stems, and seeds) or products made from it that contain significant amounts of tetrahydrocannabinol, or THC. THC is the main psychoactive compound – the one that makes you feel “high.”
So, while all marijuana comes from cannabis, not all cannabis products are considered marijuana (meaning, not all of them have enough THC to have those mind-altering effects). It’s a bit like saying all apples are fruit, but not all fruit are apples. Makes sense?
Marijuana is one of the most commonly used substances, especially among younger adults. And honestly? We’re still learning a lot about its full effects, both in the short run and over many years.
Some people ask if marijuana is a hallucinogen. Historically, scientists did classify THC this way. But it’s not quite that simple. While some people might experience altered perceptions, it’s often different from what you’d get with classic hallucinogens like LSD. It seems the way marijuana affects the brain in this regard might be unique.
What About Medical Marijuana?
This is a big one. You’ve probably heard about medical marijuana. In many places, laws now allow its use for certain medical reasons. Usually, it’s to help manage symptoms, not to cure a condition outright. Some uses I’ve seen discussed or that patients ask about include:
- Easing chronic pain, especially nerve pain (neuropathic pain). This can sometimes help folks reduce their reliance on opioid medications.
- Helping with nausea (antiemetic effects), particularly for people undergoing chemotherapy.
- Managing symptoms of multiple sclerosis (MS), like muscle stiffness (spasticity).
- Stimulating appetite, which can be helpful in certain situations.
Now, it’s important to know that the U.S. Food and Drug Administration (FDA) still classifies marijuana as a Schedule I substance. This means, from their perspective, it doesn’t have currently accepted medical uses and has a high potential for misuse or addiction. Because of this, as doctors, we can’t “prescribe” marijuana in the traditional sense. However, in states where it’s legal, we might be able to certify its use for specific conditions.
The FDA hasn’t given a green light to marijuana itself for treating medical conditions. But, they have approved certain medicines that are derived from or are synthetic versions of compounds found in marijuana.
- Cannabidiol (Epidiolex®): This is a prescription medication used to control seizures in rare forms of epilepsy like Lennox-Gastaut syndrome or Dravet syndrome. It’s very different from the CBD you might buy over the counter.
- Dronabinol (Marinol®) and nabilone (Cesamet®): These can help with nausea and vomiting from chemotherapy. Dronabinol is also used for appetite loss and weight loss in people with HIV or AIDS.
It’s worth noting that not every hospital or doctor will certify medical marijuana, even where it’s legal. A lot of that hesitation comes from the fact that we still need more large-scale, thorough research on its benefits and risks.
How Marijuana Might Affect You
How marijuana affects someone is really individual. It can depend on so many things:
- Your own body chemistry and genetics.
- Your age and sex.
- How much you use, and how strong it is.
- The way you use it – smoking, vaping, or eating it.
- How long you’ve been using it, and how often.
- Whether you’re taking other medications or substances.
So, your experience might be totally different from your friend’s, and even your own experiences can vary from one time to the next. Weird, right?
Those Immediate Feelings: Short-Term Effects
When marijuana is smoked, THC gets into your bloodstream pretty quickly through your lungs, heading to your brain and other organs. If you eat or drink it, the effects take longer to kick in, usually 30 minutes to an hour.
THC is interesting because it’s similar in structure to a natural chemical our brains make called anandamide. THC can sort of “hijack” the receptors meant for anandamide, especially in parts of the brain where these receptors are plentiful. This over-activation leads to the effects people feel.
Some common short-term effects on brain function can include:
- Senses might feel heightened – colors seem brighter, smells stronger.
- Your sense of time and space can get a bit skewed.
- Feelings of euphoria or mood shifts.
- Trouble with thinking clearly or solving problems.
- Impaired memory.
- Feeling disoriented or confused.
- Relaxation or sleepiness (sedation).
- Dizziness.
- Problems with coordination.
- Slower reaction times.
- Sometimes, it can even trigger a panic attack.
If someone uses a very high dose, they might experience:
- Hallucinations (seeing or hearing things that aren’t there).
- Delusions (believing things that aren’t true).
- Psychosis, especially if they regularly use high-potency marijuana.
Other common short-term physical effects can be:
- Dry mouth.
- Nausea (though sometimes it helps with nausea, it can also cause it).
- An increased heart rate (this can last for up to three hours after smoking).
- The “munchies” – an increase in appetite.
Looking Down the Road: Long-Term Effects of Marijuana
We’re still piecing together the full picture of long-term marijuana use. It’s an active area of research. Here’s some of what studies suggest so far:
- Using marijuana heavily during teenage years or young adulthood – while the brain is still developing – might affect how the brain wires itself for things like attention, memory, and learning. These effects could be long-lasting, or even permanent.
- Smoking anything, including marijuana, isn’t great for your lungs. It can damage them, raise your risk of bronchitis, and scar small blood vessels. Smoking marijuana has also been linked to a higher risk of stroke, heart disease, and other vascular issues. Vaping products with THC has also been connected to serious lung injury.
- For people who might already be predisposed to conditions like schizophrenia or other psychoses, frequent marijuana use could increase their risk of developing these conditions.
- Long-term, high-dose THC users can sometimes develop something called cannabis hyperemesis syndrome, which involves repeated, severe vomiting. Not pleasant.
Other studies have linked long-term marijuana use to:
- Periodontal disease (gum disease).
- More frequent pain crises for folks with sickle cell disease.
- Issues with sperm development, which could affect fertility.
What Are the Benefits, Really?
This is where it gets tricky. As a medical community, we can’t point to clear, universally accepted benefits of marijuana with absolute certainty. Why? Because we just don’t have enough solid, long-term research yet. Plus, as I mentioned, it affects everyone so differently.
While some individuals might tell you they experience personal benefits, and I believe them, it’s hard to make broad scientific claims without more data. We need more studies to really understand.
Understanding the Risks of Marijuana
Beyond the health effects we’ve talked about, there are other risks to keep in mind:
- Driving under the influence of marijuana is dangerous and increases the risk of car accidents. No question there.
- For older adults (over 65), marijuana use has been linked to an increased risk of injuries, like falls.
- Sometimes, marijuana products can be contaminated with things like microbes, pesticides, or other unwanted stuff.
- And, labels aren’t always accurate. Some products might have very different amounts of THC or CBD than what they claim.
When Use Becomes a Problem: Cannabis Use Disorder
It’s important to talk about cannabis use disorder. This is a type of substance use disorder (SUD), which is a recognized mental health condition. It happens when someone’s marijuana use becomes problematic, causing them distress or making it hard to function in their daily life. If it’s severe, we sometimes call it addiction.
About 1 in 10 adults who use marijuana may develop this disorder. For teenagers, the risk is even higher – they’re four to seven times more likely than adults to develop it. If you or someone you know is struggling, it’s really important to reach out for help.
Marijuana, Pregnancy, and Breastfeeding: A Word of Caution
If you’re pregnant or breastfeeding, the official advice from the FDA and medical groups like the American College of Obstetricians and Gynecologists is very clear: avoid using CBD, THC, and marijuana in any form.
- During pregnancy, THC can cross from your bloodstream to your baby’s developing brain. Studies suggest this exposure might lead to issues with attention, memory, and problem-solving skills later on.
- Marijuana use during pregnancy has also been linked to a higher risk of having a baby with low birth weight, premature birth, and possibly even stillbirth.
- THC can also pass into breastmilk and stay there for up to six days after use. This could affect your baby’s brain development.
And just like with tobacco smoke, marijuana smoke contains harmful components. So, it’s best to avoid smoking marijuana around babies and children. Their little lungs are sensitive.
Take-Home Message: Key Things to Remember About Marijuana
Phew, that was a lot of information! If you’re trying to make sense of marijuana, here are a few key things I hope you’ll take away:
- It’s complex: Marijuana (with THC) has mind-altering effects, and how it impacts you can vary a lot.
- Short-term effects are common: These can range from altered senses and mood changes to impaired memory and coordination.
- Long-term effects are still being studied: But we know there are potential risks to brain development (especially in young people), lung health, and mental health.
- “Medical marijuana” is evolving: While some cannabis-derived medications are FDA-approved for specific conditions, marijuana itself isn’t. State laws vary, and more research is needed.
- Risks are real: These include impaired driving, potential for cannabis use disorder (addiction), and serious concerns during pregnancy and breastfeeding.
- Talk to us: If you have questions or concerns about marijuana use, please talk to your doctor. We’re here to provide information and support, not to judge.
You’re not alone in trying to navigate this. It’s a conversation many of us are having. My best advice is to stay informed, be honest with yourself about how it might affect you or your loved ones, and always feel comfortable asking for help or more information.