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The United States of Marijuana: Part 6

Title: Medical Marijuana Products
Written By: Dr. Kamal Morar, MD, MBA

This blog post is the sixth in a series of posts from Dr. Kamal Morar, co-founder of Duber Medical and interventional pain specialist. In this series, Dr. Morar examines current day hurdles and solutions that medical marijuana can offer patients as they seek alternative and effective solutions to their chronic medical conditions.

 

It would seem that once someone becomes a Medical Marijuana patient, treating their medical condition should become as straightforward as going to the pharmacy and picking up an Over-The-Counter or prescription medication specifically designed to alleviate their particular symptoms. But as any current MMJ patient can tell you, it’s not that easy!  

Too many medical marijuana products are flooding the market without a focus on specific symptoms/diseases

The explosion in cannabis popularity has meant an explosion in cannabis products this decade. Marijuana today is different from the marijuana of yesterday. There are over 700 varieties of cannabis and each contain hundreds of compounds. Because THC and CBD can enter the body in so many ways (smoking, vaping, ingesting, through skin) the number of products that can be made with it are almost endless.

Products available in dispensaries or “compassion centers” are laboratory tested and feature labels similar to what is found on packaged foods. However, according to a survey in 2019, 60% of people say either there is no difference between Hemp derived CBD and marijuana, or they do not know the difference. Consumer education is therefore lacking and needed, specifically around what a product is designed to provide, such as pain relief, anxiety reduction or sleep aiding. Additionally, many patients are worried about unexpected side effects of using Medical Marijuana in conjunction with other prescribed medications.

Since cannabis is legal at the state level in many cases, but still illegal at the federal level, the oversight and monitoring of it can vary greatly and potentially put patient safety at risk.  Different products can have different clinical effects on patients, variables such as patient medical history, and other current prescriptions have to be taken into account. A major concern with the current status is that legalization/decriminalization of cannabis is being advocated in a way that circumvents the normal FDA testing and regulatory processes whereas this is required for all other drugs. Businesses involving sales of cannabis are flourishing primarily by taking advantage of this obscure legal status of cannabis.

Additionally, most groups currently conducting clinical trials that are registered with the FDA are aiming to explore the clinical benefits of CBD only and whether it can be safely used in the long-term reduction of the use of painkillers and other dangerous opioids. Very little research is being done with THC and other terpenes, even though we know many patients use THC products with good results. 

This lack of oversight and science-based research can leave patients confused when buying products because products have no branding based on symptoms and or diseases targeted. Instead, products are named based on obscure naming strategies around strains, many having nonsensical names based on their recreational branding value. To really understand the results and value of medical marijuana, an important step is the decriminalization of cannabis at the federal, to move toward a more uniformed, consistent oversight of product quality and labeling. 

Since this area is still evolving and it’s unlikely that product development and labeling will become more medically focused in the short term, it becomes even more important that patients work with doctors who are certified and educated in recommending medical marijuana. Trained physicians can not only verify patient medical conditions that can be treated with cannabis, but more importantly, they can identify and educate patients on potential complications such as drug interactions and how to avoid products that can lead to high risk behavior. Educated physicians are more important than ever for Medical Marijuana patients, because they can explain combination therapies with different routes of administration to provide the best results.

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