Medicinal marijuana is expanding rapidly and recreational marijuana is making a serious, and perhaps inevitable, run at being legal. So where do we stand from a medical perspective? In this session at WCI’s 2016 Workers’ Compensation Educational Conference, Donald Bucklin, MD, Medical Review Officer at U.S. Healthworks, provided a marijuana status update.
There are 483 chemicals in marijuana, 84 are cannabinoids including THC and 50+ are known carcinogens. THC has to be dried or burned to be active. Today’s marijuana (21%) is far more potent than that used by a generation ago (3%).
Marijuana has been illegal for 85 years. In 1996, California passed proposition 215 to make it legal for medical use. The problem is that states are using the “figure it out as we go” approach. There is no real organization. Now 25 states have legalized marijuana for medicinal use and four have legalized marijuana for recreational use.
Currently marijuana is a Class 1 drug (along with heroin and LSD) with no plans to reschedule it this year. This is putting a damper on the ability to research it. Marijuana cannot be prescribed by a doctor. It can only be recommended.
There are currently no methods to test impairment related to marijuana. There is no marijuana breathalyzer because the THC volatilizes at 285 degrees – far hotter than our body temperatures. It is insoluble in water and highly soluble in fat.
It is considered to be good for wasting diseases like AIDS because it increases appetite. It has also been known to reduce nausea associated with chemotherapy, improves muscle spasm and pain related to multiple sclerosis, and reduces seizure activity in epileptics. Although there is no research to medically prove any of this, it has been known to work and there is no real risk because you can adjust the amount of intake without overdosing.
Most recently, the most exciting findings are currently related to neuroprotection. If you have a tiny bit of THC in your blood, it seems to offer significant protection to brain injury.