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What Are Medical Marijuana and Cannabidiol (CBD)? Everything You Need to Know

The cannabis plant, from which marijuana is derived, is often smoked for recreational purposes. But people are increasingly using marijuana to treat medical conditions — and this medical marijuana is not always smoked. It comes in many forms:

  • Marijuana cigarettes containing the cannabinoids (chemical compounds) tetrahydrocannabinol (THC) or cannabidiol (CBD), or both THC and CBD
  • CBD oils, edibles, tinctures, creams, and capsules
  • Cannabis-derived pharmaceutical products approved by the Food and Drug Administration (FDA)

Studies suggest that the medical use of marijuana may help treat the following conditions or help alleviate the following symptoms: (1)

  • Anxiety, particularly social anxiety disorder
  • Chronic pain

Some research has suggested that the cannabinoids in marijuana could also be useful in managing these conditions: (2,3,4,5,6,7)

  • Inflammation
  • Arthritis
  • HIV/AIDS like Crohn’s disease and irritable bowel syndrome (IBS)

According to a 2017 report from the National Academies of the Sciences, Medicine, and Engineering (NASME), the strongest scientific evidence so far has been found in support of using marijuana for chronic pain, cancer-related nausea and vomiting, and MS-related spasticity. (1)

This NASME report, one of the largest of its kind, looked at more than 10,000 studies published since 1999.

How Does Marijuana Affect the Body?

It depends on whether THC or CBD is the cannabinoid at work. They produce similar effects, but there are differences in intensity because they each affect a different neural pathway.

THC is thought to engage with the body’s endocannabinoid system, which helps regulate physiological functioning. THC is similar to a chemical that’s present in this system, and when these two chemicals meet, the similarity allows THC to exert an influence on the body and brain in ways that alter coordination, memory, decision-making, appetite, and mood.

The endocannabinoid system also helps regulate gastrointestinal functions, and this may explain why medical marijuana seems to help digestive disorders like IBS.

CBD, scientists think, affects the brain because of the way it interacts with the neurological pathways that regulate serotonin, the hormone that regulates anxiety, pain, nausea, and appetite.

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How Can Marijuana Help Opioid Use Disorder?

Some individuals use marijuana instead of addictive opioids to treat pain. In these cases, marijuana may actually be responsible for a decrease in the use of — and deaths from — these prescription drugs.

A study published in May 2018 in JAMA Internal Medicine reported that prescriptions for opioids decreased in states that have medical marijuana laws. Researchers looked at Medicare data from 2010 to 2015 and found that states with active dispensaries saw 3.742 million fewer daily doses of opioids filled by pharmacies. (8)

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Another study, published in October 2014 in JAMA Internal Medicine, found that states with medical cannabis laws had a 24.8 percent lower annual overdose rate than states without such laws. (9)

Some states, like Pennsylvania and New York, now consider opioid use disorder as a qualifying condition for medical marijuana use. New York, for example, allows people who qualify to use medical marijuana instead of opioids to treat pain.

What Is Cannabidiol and How Will It Affect Me?

Cannabidiol is the cannabinoid in marijuana that, along with interacting with the brain’s serotonin system, may also help relax and calm you, but it doesn’t alter your perception or affect physical reactions too much. CBD may be particularly effective for: (10)

  • Anxiety disorders
  • Nausea and vomiting
  • Psychotic disorders
  • Non-cancer-related pain
  • Depression
  • Addiction
  • Sleep problems (Dravet syndrome and Lennox-Gastaut syndrome)

Staci Gruber, MD , is an associate professor of psychiatry at Harvard Medical School in Boston and the director of the Marijuana Investigations for Neuroscientific Discovery program at McLean Hospital in Belmont, Massachusetts, which is researching the neurological effects of medical marijuana use.

In a large study that she’s conducting on the use of medical marijuana, Dr. Gruber says the second most commonly reported use of medical marijuana among subjects is for anxiety. She’s also about to begin an FDA-approved clinical trial of a CBD sublingual (administered under the tongue) tincture, consisting of CBD in a coconut oil base, for the treatment of anxiety. (Tinctures are medicines — in this case CBD — dissolved in a liquid like alcohol or glycerine.)

Indeed, anecdotal evidence points to the effectiveness of CBD as an anxiety and stress reducer, as well as a sleep aid. Eric*, a busy sales executive in San Francisco, has been sleeping more soundly since he started using a high-CBD, low-THC product via a vaporizer three months ago for work-related stress and anxiety.

“The quality of my sleep is better, I’m sleeping longer and deeper, and I now have no problem falling and staying asleep,” he says. “It has changed my life.”

In addition to being a potentially powerful treatment for anxiety disorders, a growing body of research is suggesting that CBD may help treat symptoms of neurological disorders such as Parkinson’s disease and Alzheimer’s disease . (11,12)

Scientists think that CBD acts in yet to be determined ways that protect the brain against inflammation and oxidative stress. (13)

Research also points to CBD as a potential treatment for psychosis and schizophrenia . (14,15)

Medical marijuana may also be effective in palliative care. In one Canadian case study, published in 2013 in Case Reports in Oncology, physicians reported that CBD oil, administered orally, was a successful treatment for a 14-year-old patient in palliative care with an aggressive form of leukemia. (16)

Where can you buy marijuana seeds legally in Virginia? Growing your own under new laws.

With the stroke of a pen, Governor Northam signed legislation to legalize personal cultivation of marijuana in Virginia as of July 1, 2021. Now, not in 2024.

On July 1, adults 21 and older will be legally permitted to grow up to four plants per household for personal use.

So, where can Virginians purchase pot seeds or clone plants? Legally?

Short answer: “Nowhere,” said Jenn Michelle Pedini, executive director of Virginia NORML and the national organization’s development director.

“No. There’s no way to buy it legally,” Pedini stated emphatically. “Unfortunately what Virginia failed to do in this piece of legislation is follow the same common sense pathway that states that have gone before us have done.”

What have other states done?

States regulate a pathway for adult consumers to shop at medical cannabis dispensaries. Until Virginia implements this, there will be no legal way for adults to obtain seeds or clones until adult-use retail cannabis locations are opened — potentially, in 2024, Pedini explained.

“Virginians ought to be able to shop at the already operational locations now — in 2021, not in 2024.”

The Virginia Board of Pharmacy cannot do anything about it through regulatory measures. The only way to fix this is through legislation, and nothing is being done by the current administration to resolve this, according to Pedini.

Virginia legislators approved a medical cannabis program and have actively chosen to maintain it.

“At some point, legalization has to be about Virginians. While there should absolutely be a focus on creating an equitable industry and one that prioritizes equal opportunity by those harmed by marijuana prohibition, that is not the only objective of legalization.”

This is the program legislators have saddled with Virginians, said Pedini. “Now, how can you make this program for Virginians? It can’t only be about how to make a buck on the backs of consumers.”

Not just consumers but Virginia as a whole. With regulations comes public safety, Pedini emphasized.

Solution to this problem?

A special legislative session now to create common sense next steps. Otherwise, Virginians are left waiting until the next General Assembly legislative session in 2022. Pedini points to statewide polling that indicates a majority of Virginians favor marijuana legalization.

“That same majority is not demonstrated in the legislature. Politics takes a front seat and policy takes a back seat.”

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It was unfair to say the current legislation passed was altruistic by the administration, Pedini said.

Nearly 9,000 constituent contacts were sent to the legislature and administration urging legalization take place in 2021 and not be delayed until 2024 as proposed.

“Ultimately, there was a big push by Virginians to say you need to stop the harm now. Decriminalization, as NORML long warned, was never going to be a solution. Data has shown it did nothing to reduce the disproportionate enforcement of marijuana laws between Black and white Virginians.”

When a state enacts marijuana legalization, typically it establishes a pathway through which it can rapidly license adult sales.

“Most states have a large robust medical cannabis program. When you hear concerns over Virginia’s current medical operators potentially dominating the future adult-use market, it’s laughable because there are only four of them.”

Currently, Virginia has four operational medical cannabis facilities in the state. The health region that serves the Shenandoah Valley remains tied up in a lawsuit between a cannabis company that lost its conditional license and the Board of Pharmacy.

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“Virginia missed the opportunity,” said Pedini. “The next opportunity will be the next legislative session in 2022 or a legislative special session.”

Most states that have legalized adult-use began with medical cannabis programs first.

“I don’t think anyone has taken three years to expand from medical to adult-use. It’s the standard practice: OK, we have dispensaries, now these dispensaries can sell to adults via regulations.”

The four medical cannabis dispensaries now open are the only places that potentially could sell pot seeds and clone plants to Virginians legally. This would not only allow consumers to make a legal purchase, it also allows them to grow the four pot plants without doing anything illegal to plant them in the first place.

“And that’s Virginia,” said Pedini. “What are you guarding against? You are only creating protections for the illicit Virginia operators.”

If the four (someday five) medical cannabis dispensaries can sell both medical and adult-use cannabis, it reduces illicit market activity.

The marijuana legislation also included a new agency, the Virginia Cannabis Control Authority, to oversee the establishment of regulations that will govern the adult-use market and determine cannabis policy in the Commonwealth.

What can Virginians do?

In the meantime, if Virginians can’t purchase anything legally in Virginia, can they get marijuana plants from outside the state and bring them in?

“It is illegal to transport any cannabis across any state lines,” answered Pedini.

If Virginians are cultivating those plants now or in the future for personal use, is that illegal?

“Now, yes, personal cultivation is illegal. After July 1, if they are 21 and up, then it is legal.”

If they buy pot out of state and bring it in state to roll/smoke, is that illegal?

“It is illegal to transport any cannabis across any state lines.”

So what exactly can Virginians do?

Vote wisely in November, said Pedini, and contact lawmakers and ask them to expedite access through Virginia’s already operational medical cannabis dispensaries.

“Dispensaries are already open and they’re not allowed to shop there.”

Monique Calello (she/her) is The News Leader’s health reporter. Story ideas? I want to hear them. Please email me at [email protected] Follow me on Twitter @moniquecalello.