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Marijuana refers to the dried leaves, flowers, stems, and seeds from the hemp plant, Cannabis sativa. The plant contains the mind-altering chemical deltatetrahydrocannabinol THC and other related compounds. Extracts can also be made from the cannabis plant. Read the DrugFacts. A summary about cannabis concentrates, how they are made, how they are used, and the health effects. A plain-language summary about cannabis, how people use it, its effects on the brain and overall health, and treatment Explores the latest research on cannabis, including the scope of marijuana use in the U. Cannabis for use in research can be obtained through the NIDA drug supply program. Learn about the brain reward system and the biochemical processes that occur during marijuana use. National Institutes of Health. Research Topics. More Research Topics. Quick Links. About NIDA. Cannabis Marijuana. Source: Monitoring the Future Survey. Looking for Treatment? Featured Image. Cannabis Marijuana Concentrates DrugFacts A summary about cannabis concentrates, how they are made, how they are used, and the health effects. Cannabis Marijuana DrugFacts A plain-language summary about cannabis, how people use it, its effects on the brain and overall health, and treatment Research Report. Cannabis Marijuana Research Report Explores the latest research on cannabis, including the scope of marijuana use in the U. The Reward Circuit: How the Brain Responds to Marijuana Learn about the brain reward system and the biochemical processes that occur during marijuana use.

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Cannabis (Marijuana) and Cannabinoids: What You Need To Know

The FDA has not approved the cannabis plant for any medical use. However, the FDA has approved several drugs that contain individual cannabinoids. In addition, some evidence suggests modest benefits of cannabis or cannabinoids for chronic pain and multiple sclerosis symptoms. Research on cannabis or cannabinoids for other conditions is in its early stages. The following sections summarize the research on cannabis or cannabinoids for specific health conditions. Unlike Epidiolex the purified CBD product sold as an FDA-approved prescription drug , over-the-counter CBD products may contain more or less CBD than stated on their labels, and because of less rigorous regulatory oversight than prescription drugs, they may also contain contaminants, such as THC. CBD may have side effects, including decreases in alertness, changes in mood, decreased appetite, and gastrointestinal symptoms such as diarrhea. In addition, CBD use has been associated with liver injury, male reproductive harm, and interactions with other drugs. Some side effects, such as diarrhea, sleepiness, abnormalities on tests of liver function, and drug interactions, appear to be due to CBD itself rather than contaminants in CBD products; these effects were observed in some of the people who participated in studies of Epidiolex before its approval as a drug. Several NCCIH-funded studies are investigating the potential pain-relieving properties and mechanisms of action of substances in cannabis, including minor cannabinoids those other than THC and terpenes substances in cannabis that give the plant its strain-specific properties such as aroma and taste. The goal of these studies is to strengthen the evidence regarding cannabis components and whether they have potential roles in pain management. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners. Email: info nccih. NCCIH and the National Institutes of Health NIH provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information. To provide resources that help answer health questions, MedlinePlus a service of the National Library of Medicine brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations. Craig Hopp, Ph. This publication is not copyrighted and is in the public domain. Duplication is encouraged. NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider s. We encourage you to discuss any decisions about treatment or care with your health care provider. Pain: Considering Complementary Approaches eBook. Multiple Sclerosis and Complementary Health Approaches. Is marijuana the same thing as cannabis? The cannabis plant contains about chemical substances. Some cannabis plants contain very little THC. Under U. What are cannabinoids? Cannabinoids are a group of substances found in the cannabis plant. What are the main cannabinoids? How many cannabinoids are there? Has the U. Epidiolex, which contains a purified form of CBD derived from cannabis, was approved for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome, two rare and severe forms of epilepsy. Dronabinol and nabilone are used to treat nausea and vomiting caused by cancer chemotherapy. Are cannabis or cannabinoids helpful in treating health conditions? Research has been done on the effects of cannabis or cannabinoids on chronic pain, particularly neuropathic pain pain associated with nerve injury or damage. A review looked at 47 studies 4, participants of cannabis or cannabinoids for various types of chronic pain other than cancer pain and found evidence of a small benefit. The difference may be too small to be meaningful to patients. A review of 16 studies of cannabis-based medicines for neuropathic pain, most of which tested a cannabinoid preparation called nabiximols brand name Sativex; a mouth spray containing both THC and CBD that is approved in some countries but not in the United States , found low- to moderate-quality evidence that these medicines produced better pain relief than placebos did. However, the data could not be considered reliable because the studies included small numbers of people and may have been biased. People taking cannabis-based medicines were more likely than those taking placebos to drop out of studies because of side effects. A review of 28 studies 2, participants of cannabinoids in which chronic pain was assessed found the studies generally showed improvements in pain measures in people taking cannabinoids, but these did not reach statistical significance in most of the studies. However, the average number of patients who reported at least a 30 percent reduction in pain was greater with cannabinoids than with placebo. Helping To Decrease Opioid Use. A review looked at studies in people in which cannabinoids were administered along with opioids to treat pain. These studies were designed to determine whether cannabinoids could make it possible to control pain with smaller amounts of opioids. There were 9 studies total participants , of which 3 participants used a high-quality study design in which participants were randomly assigned to receive cannabinoids or a placebo. The results were inconsistent, and none of the high-quality studies indicated that cannabinoids could lead to decreased opioid use. The findings have been inconsistent. States with medical marijuana laws were found to have lower prescription rates both for opioids and for all drugs that cannabis could substitute for among people on Medicare. However, data from a national survey not limited to people on Medicare showed that users of medical marijuana were more likely than nonusers to report taking prescription drugs. An analysis of data from to indicated that states with medical marijuana laws had lower death rates from overdoses of opioid pain medicines, but when a similar analysis was extended through , it showed higher death rates from this kind of overdose. An analysis of survey data from to found that passing of medical marijuana laws was not associated with less nonmedical prescription opioid use. Thus, people with access to medical marijuana did not appear to be substituting it for prescription opioids. A small amount of evidence from studies in people suggests that cannabis or cannabinoids might help to reduce anxiety. One study of 24 people with social anxiety disorder found that they had less anxiety in a simulated public speaking test after taking CBD than after taking a placebo. Four studies have suggested that cannabinoids may be helpful for anxiety in people with chronic pain; the study participants did not necessarily have anxiety disorders. Cannabinoids, primarily CBD, have been studied for the treatment of seizures associated with forms of epilepsy that are difficult to control with other medicines. Epidiolex oral CBD has been approved by the FDA for the treatment of seizures associated with two epileptic encephalopathies: Lennox-Gastaut syndrome and Dravet syndrome. Epileptic encephalopathies are a group of seizure disorders that start in childhood and involve frequent seizures along with severe impairments in cognitive development. Early treatment can often prevent severe loss of vision. Lowering pressure in the eye can slow progression of the disease. Studies conducted in the s and s showed that cannabis or substances derived from it could lower pressure in the eye, but not as effectively as treatments already in use. One limitation of cannabis-based products is that they only affect pressure in the eye for a short period of time. A recent animal study showed that CBD, applied directly to the eye, may cause an undesirable increase in pressure in the eye. This approval was based primarily on a study of people that assessed effects of dronabinol on appetite and weight changes. Inflammatory Bowel Disease. Inflammatory bowel disease is the name for a group of conditions in which the digestive tract becomes inflamed. Symptoms may include abdominal pain, diarrhea, loss of appetite, weight loss, and fever. The symptoms can range from mild to severe, and they can come and go, sometimes disappearing for months or years and then returning. Some people using cannabis or cannabis oil had improvements in symptoms, but some had undesirable side effects. It was uncertain whether the potential benefits of cannabis or cannabis oil were greater than the potential harms. A review examined 2 studies 92 participants that compared smoked cannabis or CBD capsules with placebos in people with active ulcerative colitis. In the CBD study, there was no difference between the two groups in clinical remission, but the people taking CBD had more side effects. In the smoked cannabis study, a measure of disease activity was lower after 8 weeks in the cannabis group; no information on side effects was reported. Irritable Bowel Syndrome. Irritable bowel syndrome IBS is defined as repeated abdominal pain with changes in bowel movements diarrhea, constipation, or both. Movement Disorders Due to Tourette Syndrome. A review of 2 small placebo-controlled studies with 36 participants suggested that synthetic THC capsules may be associated with a significant improvement in tic severity in patients with Tourette syndrome. Multiple Sclerosis. Evidence-based guidelines issued in by the American Academy of Neurology concluded that nabiximols is probably effective for improving subjective spasticity symptoms, probably ineffective for reducing objective spasticity measures or bladder incontinence, and possibly ineffective for reducing multiple sclerosis—related tremor. Based on two small studies, the guidelines concluded that the data are inadequate to evaluate the effects of smoked cannabis in people with multiple sclerosis. A analysis of 3 studies participants of nabiximols in people with multiple sclerosis and spasticity found that nabiximols reduced subjective spasticity, usually within 3 weeks, and that about one-third of people given nabiximols as an addition to other treatment would have at least a 30 percent improvement in spasticity. Nabiximols appeared to be reasonably safe. Nausea and Vomiting Related to Cancer Chemotherapy. A review of 23 studies 1, participants on the cannabinoids dronabinol or nabilone for treating nausea and vomiting related to cancer chemotherapy found that they were more helpful than a placebo and similar in effectiveness to other medicines used for this purpose. More people had side effects such as dizziness or sleepiness, though, when taking the cannabinoid medicines. The research on dronabinol and nabilone for treating nausea and vomiting related to cancer chemotherapy was done primarily in the s and s and reflects the types of chemotherapy treatments and choices of antinausea medicines available at that time rather than current ones. In one very small study 10 people , the cannabinoid nabilone was more effective than a placebo at relieving PTSD-related nightmares. Sleep Problems. Many studies of cannabis or cannabinoids in people with health problems such as multiple sclerosis, PTSD, or chronic pain have looked at effects on sleep. Are cannabis and cannabinoids safe? Several concerns have been raised about the safety of cannabis and cannabinoids: The use of cannabis has been linked to an increased risk of motor vehicle crashes. Smoking cannabis during pregnancy has been linked to lower birth weight. Some people who use cannabis develop cannabis use disorder, which has symptoms such as craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities. Adolescents using cannabis are four to seven times more likely than adults to develop cannabis use disorder. Cannabis use is associated with an increased risk of injury among older adults. The use of cannabis, especially frequent use, has been linked to a higher risk of developing schizophrenia or other psychoses severe mental illnesses in people who are predisposed to these illnesses. Marijuana may cause orthostatic hypotension head rush or dizziness on standing up , possibly raising danger from fainting and falls. Products of this type have been implicated in many of the reported cases of serious lung injuries linked to vaping. There have been many reports of unintentional consumption of cannabis or its products by children, leading to illnesses severe enough to require emergency room treatment or admission to a hospital. Among a group of people who became ill after accidental exposure to candies containing THC, the children generally had more severe symptoms than the adults and needed to stay in the hospital longer. Some long-term users of high doses of cannabis have developed a condition involving recurrent severe vomiting. Can CBD be harmful? NCCIH is also supporting other studies on cannabis and cannabinoids, including: An observational study of the effects of edible cannabis and its constituents on pain, inflammation, and thinking in people with chronic low-back pain. Studies to develop techniques to synthesize cannabinoids in yeast which would cost less than obtaining them from the cannabis plant. Research to evaluate the relationship between cannabis smoking and type 2 diabetes. More To Consider. Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions. For More Information. Toll-free in the U. MedlinePlus To provide resources that help answer health questions, MedlinePlus a service of the National Library of Medicine brings together authoritative information from the National Institutes of Health as well as other Government agencies and health-related organizations. Key References. Cochrane Database of Systematic Reviews. Cannabis for the treatment of ulcerative colitis. Cannabis-based medicines for chronic neuropathic pain in adults. National Academies. Opioid-sparing effect of cannabinoids: a systematic review and meta-analysis. Unintentional cannabis ingestion in children: a systematic review. Journal of Pediatrics. Association of US medical marijuana laws with nonmedical prescription opioid use and prescription opioid use disorder. Association between medical cannabis laws and opioid overdose mortality has reversed over time. Proceedings of the National Academy of Sciences. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Assessment of efficacy and tolerability of medicinal cannabinoids in patients with multiple sclerosis. A systematic review and meta-analysis. Food and Drug Administration. Vaping illness update: FDA warns public to stop using tetrahydrocannabinol THC -containing vaping products and any vaping products obtained off the street. Cannabinoids for medical use. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the Guideline Development Subcommittee of the American Academy of Neurology. Other References. Pharmacology of medical cannabis. Advances in Experimental Medicine and Biology. Medical cannabis laws and opioid analgesic overdose mortality in the United States, Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of Pain and Symptom Management. Labeling accuracy of cannabidiol extracts sold online. Association between US state medical cannabis laws and opioid prescribing in the Medicare Part D population. Medical marijuana laws reduce prescription medication use in Medicare Part D. Health Affairs. Cannabinoids for epilepsy: what do we know and where do we go? Caputi TL, Humphreys K. Medical marijuana users are more likely to use prescription drugs medically and nonmedically. Journal of Addiction Medicine. Journal of Psychoactive Drugs. Cannabis for the treatment of epilepsy: an update. Current Neurology and Neuroscience Reports. Role of cannabis in cardiovascular disorders. Journal of Thoracic Disease. Prevalence of marijuana use disorders in the United States between and JAMA Psychiatry. The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: a preliminary randomized, double-blind, placebo-controlled cross-over design study. Khattar N, Routsoloias JC. Emergency department treatment of cannabinoid hyperemesis syndrome: a review. American Journal of Therapeutics. The use of cannabinoids for sleep: a critical review on clinical trials. Experimental and Clinical Psychopharmacology. Cannabis, cannabinoids, and health. Dialogues in Clinical Neuroscience. National Cancer Institute. National Institute on Drug Abuse. NIH research on marijuana and cannabinoids. Novack GD. Cannabinoids for treatment of glaucoma. Current Opinion in Ophthalmology. Cannabinoids in treatment-resistant epilepsy: a review. Benefits and harms of plant-based cannabis for posttraumatic stress disorder. A systematic review. Annals of Internal Medicine. FDA regulation of cannabis and cannabis-derived products: questions and answers. Cannabinoid dose and label accuracy in edible medical cannabis products. Cannabis intoxication case series: the dangers of edibles containing tetrahydrocannabinol. Annals of Emergency Medicine. Adverse health effects of marijuana use. New England Journal of Medicine. Meta-analysis of the efficacy and safety of Sativex nabiximols , on spasticity in people with multiple sclerosis. Likelihood of developing an alcohol and cannabis use disorder during youth: association with recent use and age. Drug and Alcohol Dependence. Share Email Facebook Twitter.

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