Nowadays, more and more patients are turning to medical cannabis for their ailments because of cannabis’ potential therapeutic effects. However, there are many medical cannabis myths out there, mainly because of the large amount of misinformation available online.
Debunking 6 Medical Cannabis Myths will address common myths associated with medical cannabis to provide accurate information.
This blog post is intended for anyone interested in learning more about medical cannabis including patients, caregivers, physicians, nurses, and other healthcare professionals who work directly with patients or might have questions regarding its use.
What is Medical Cannabis?
Medical cannabis describes products derived from the whole cannabis plant or its extracts, which the patient takes for medical reasons following authorization from a healthcare provider1.
Medical cannabis is used to alleviate symptoms while minimizing intoxication. In contrast, recreational users may be taking cannabis primarily for the “intoxicating or euphoric” effects.
How Can Medical Cannabis Help You?
Some of the conditions that scientific research has shown medical cannabis being helpful for include:
• Arthritis and other rheumatic disorders2,3
• Chronic pain3
• Spasticity and other symptoms associated with Multiple Sclerosis4,5
• Improvements in nausea and vomiting due to chemotherapy6
• Symptom related to HIV/AIDS7 Weight gain in HIV infection
• Sleep disorders8,9
• Post-traumatic stress disorder3,10
6 Most Common Medical Cannabis Myths
There are several common myths and misconceptions about the cannabis plant that you need to know about before considering medical cannabis.
MYTH #1: Consuming medical cannabis leads to other drug use.
FACT: Some studies suggest that medical cannabis is actually safer than other prescribed pharmaceutical medicines5.
Medical cannabis is often called a “gateway drug.” This theory suggests that cannabis use is the first step on the path leading to “harder” drugs. However, there is little to no evidence to support this statement.
This myth has likely occurred due to the idea of “correlated vulnerabilities.” This is the idea that some people have a pattern of substance use where multiple drugs are used due to a general predisposition to use drugs or engage in other risky behaviors13.
Research shows that cannabis can act as an add-on therapy or a substitution for opioids (high abuse liability) in pain management, reducing opioid dosages and/or replacing opioids entirely14–16.
MYTH #2: If I get prescribed medical cannabis, I have to smoke it.
FACT: Medical cannabis can be consumed in multiple ways besides smoking.
There are several common routes of administration that include inhalation, ingestion, and sublingual/oromucosal (absorption in the mouth). Let us break them down for you:
Inhalation (i.e. vaporizing):
• Absorption of cannabis occurs through the lungs.
• There’s a quicker onset (effects felt within seconds to minutes of dosing and peak within 30 minutes)17,18, with shorter duration of effects (lasting up to 6 hours)18.
• Because the effects are felt almost immediately, this route of administration may help those experiencing acute symptoms like breakthrough pain.
• What’s the advantage? Inhalation is a more efficient delivery of cannabinoids than other product formats17.
Ingestion (i.e. capsules, edibles):
• This method has slower onset of action, with effects first felt within 0.5-24 hours and peaking around 4 hours. However, there’s a longer duration of effects (effects may last up to 12 hours or longer10,11 ).
• You will also have lower peak blood levels of cannabinoids18,19 if you choose to ingest your cannabis.
• What’s the advantage? Ingestion is useful for chronic conditions that can benefit from a long duration of effects such as chronic pain or sleep issues.
Oromucosal/sublingual (i.e., sprays, oils):
• When sprays or oils are held inside the mouth, the absorption occurs through the cheek or under the tongue.
• Both the onset and duration of the effects is quicker and shorter than ingestion but slower and longer than inhalation20.
• What’s the advantage? Oromucosal or sublingual method has faster onset and shorter duration than oral ingestion but does not require inhalation.
Topicals (i.e., creams, lotions):
• Topicals are applied on the skin to the area you want to be effected.
• What’s the advantage? The THC or CBD will only act locally at the point of application.
MYTH #3: All Medical cannabis produces the 'high' effect.
FACT: Your level of intoxication will depend on the concentration of THC and CBD in your medical cannabis product.
The two most abundant and well-studied phytocannabinoids are THC and CBD. Both THC and CBD have different physiological and pharmacological properties.
CBD does not seem to have intoxicating effects when you’re consuming it at medically relevant doses21.
THC is the principal intoxicating compound in the plant. At high doses, it’s responsible for the “high” that’s often associated with the use of cannabis21.
This means that not all medical cannabis will result in an euphoric feeling, especially if the product of your choice contains high CBD concentration and little to no THC.
MYTH #4: Potency is an important indicator of medical cannabis quality.
FACT: More potent cannabis does not mean that it will work better - it depends on the effects and dosage of cannabinoids you’re seeking.
There is more to medical cannabis than just looking for products with the highest potency of THC or CBD.
When choosing a product, you want to think about what symptom or condition you are looking to treat and what dosage of cannabinoids your healthcare practitioner has suggested. Then, once you have the recommended dose, you can see what products would give you that dose in the easiest manner possible.
For instance, if a healthcare practitioner recommends you need a higher THC dose, then you would likely want to find a higher THC (higher potency) product so you can consume less product to get the desired amount and effect However, if you were recommended a lower dose of THC, a low to medium THC product may be best option for you to get the dose you need.
It is also good to consider if any compounds other than THC and CBD may be helpful for your treatment. This is because the compounds in cannabis are thought to work together to give the overall effect you feel when you consume cannabis. This effect is called the Entourage Effect and is a hypothesis that cannabinoids are more effective when combined with each other and/or terpenes, than on their own. For example, CBD extracts have been found to be more effective than CBD alone at reducing pain and inflammation22,23.
MYTH #5: There's no need for a Medical Cannabis prescription, and you can use recreational cannabis to self-medicate.
FACT: You could use recreational cannabis to self-medicate, however you might not achieve the results that you are looking for.
Finding a medical cannabis product that is right for you is a highly individualized process that requires medical oversight for the best results. If you have multiple medical conditions or are consuming multiple pharmaceuticals, you’ll need a review of potential drug-drug interactions, making it especially important to work with a healthcare professional16.
There are several advantages to having a medical cannabis prescription:
• There is support and education available to medical cannabis patients.
• Not all medical cannabis products are found in the recreational market (especially edibles and CBD products), so you may be missing out on products that could be helpful for you by purchasing recreational cannabis.
• Patients can claim their medicinal cannabis prescriptions as a deductible medical expense.
• There may be insurance coverage for select conditions (some group benefit plans cover medical cannabis under healthcare spending account).
MYTH #6: You can never take too much medical cannabis.
FACT: If not dosed correctly, medical cannabis can cause you to “green-out”.
If you consume too much cannabis accidently, it could cause you to “green-out” regardless if your intent was to consume for medical or recreational purposes. The signs of using too much cannabis can include:
• Extreme confusion
• Fast heart rate
• Delusions or hallucinations24.
These are typically associated with taking too much THC24.
You can avoid overconsumption by starting low and going slow19. When ingesting an edible product for the first few times, it is important to wait a minimum of two hours before consuming more. This will help you avoid consuming too much as you figure out what dosage is best for you 19. We recommend working with a Health Care Practitioner who will provide professional advice and recommendations specific to you.
The estimated lethal human dose of THC has been extrapolated to be >15,000 mg THC, which works out to consuming 75,000 mg of 20% THC cannabis simultaneously25. To get close to consuming this much THC, you would have to consume 75x1 gram 20% THC pre-rolls in a row! It is highly improbably a person could consume this much cannabis quick enough to get close to the estimated lethal dose of THC and to date, there have been no reports of a human death directly caused by phytocannabinoid overdose26.
- Canadian Pharmacists Association. Medical Cannabis - English. Accessed October 31, 2021. https://www.pharmacists.ca/advocacy/issues/medical-cannabis/
- FitzcharlesM, Rampakakis E, Sampalis J, et al. Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada. ACR Open Rheumatology. 2020;2(5):286-293. doi:10.1002/acr2.11138
- Cahill SP, Lunn SE, Diaz P, Page JE. Evaluation of Patient Reported Safety and Efficacy of CannabisFrom a Survey of Medical Cannabis Patients in Canada. Frontiers in Public Health. 2021;9. doi:10.3389/fpubh.2021.626853
- IskedjianM, Bereza B, Gordon A, Piwko C, Einarson TRT. Meta-Analysis of Cannabis Based Treatments for Neuropathic and Multiple Sclerosis-Related Pain. Vol 23. Curr Med Res Opin; 2007:17-24. doi:10.1185/030079906X158066
- Turcotte D,Doupe M, Torabi M, et al. Nabilone as an Adjunctive to Gabapentin for Multiple Sclerosis-Induced Neuropathic Pain: A Randomized Controlled Trial. Pain Medicine. 2015;16(1):149-159. doi:10.1111/pme.12569
- GrimisonP, Mersiades A, Kirby A, et al. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Annals of Oncology. 2020;31(11):1553-1560. doi:10.1016/J.ANNONC.2020.07.020/ATTACHMENT/7B607EA2-B114-40B1-B96A-5BE56A01F889/MMC1.DOCX
- Phillips TJC, Cherry CL, Cox S, Marshall SJ, Rice ASC. Pharmacological Treatment of Painful HIV-Associated Sensory Neuropathy: A Systematic Review and Meta-Analysis ofRandomised Controlled Trials. Pai NP, ed. PLoS ONE. 2010;5(12):e14433. doi:10.1371/journal.pone.0014433
- Bonn-Miller MO, Babson KA,Vandrey R. Using cannabis to help you sleep: Heightened frequency of medical cannabis use among those with PTSD. Drug and Alcohol Dependence. 2014;136(1):162-165. doi:10.1016/J.DRUGALCDEP.2013.12.008
- Piper BJ,Dekeuster RM, Beals ML, et al. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. Journal of Psychopharmacology. 2017;31(5):569-575. doi:10.1177/0269881117699616
- RoitmanP, Mechoulam R, Cooper-Kazaz R, Shalev A. Preliminary, Open-Label, Pilot Study of Add-On Oral D 9-Tetrahydrocannabinol in Chronic Post-Traumatic Stress Disorder. Published online 2014. doi:10.1007/s40261-014-0212-3
- Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.JAMA. 2015;313(24):2456-2473. doi:10.1001/JAMA.2015.6358
- Black N, Stockings E, Campbell G, et al. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis.The Lancet Psychiatry. 2019;6(12):995-1010. doi:10.1016/S2215-0366(19)30401-8
- Health Canada. Prevalence and correlates of non-medical only compared to self-defined medical and non-medical cannabis use, Canada, 2015. Accessed October 31, 2021. https://www150.statcan.gc.ca/n1/pub/82-003-x/2018007/article/00001-eng.htm
- Corcoran L, Roche M, Finn DP. The Role of the Brain’s Endocannabinoid System in Pain and Its Modulation by Stress. In:International Review of Neurobiology. Vol 125. Int Rev Neurobiol; 2015:203-255. doi:10.1016/bs.irn.2015.10.003
- BoehnkeKF, Litinas E, Clauw DJ. Medical Cannabis Use Is Associated with Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients with Chronic Pain. Journal of Pain. 2016;17(6):739-744. doi:10.1016/j.jpain.2016.03.002
- Lucas P, Boyd S, Milloy MJ, Walsh Z. Cannabis Significantly Reduces the Use of Prescription Opioids and Improves Quality of Life in Authorized Patients: Results of a Large Prospective Study.Pain medicine (Malden, Mass). 2021;22(3):727-739. doi:10.1093/pm/pnaa396
- Huestis MA. Human Cannabinoid Pharmacokinetics. Published online 2007. doi:10.1002/cbdv.200790152
- Cannabis health effects - Canada.ca. Accessed October 31, 2021. https://www.canada.ca/en/services/health/campaigns/cannabis/health-effects.html
- Access to Cannabis for Medical Purposes Regulations - Daily Amount Fact Sheet (Dosage) - Canada.ca. Accessed June 8, 2021. https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/cannabis-medical-purposes-regulations-daily-amount-fact-sheet-dosage.html
- Millar SA, Stone NL, Yates AS, O’Sullivan SE. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans.Frontiers in Pharmacology. 2018;9(NOV):1365. doi:10.3389/FPHAR.2018.01365
- EP B. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science.Headache. 2018;58(7):1139-1186. doi:10.1111/HEAD.13345
- Pamplona FA, da Silva LR,Coan AC. Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis. Frontiers in Neurology. 2018;0(SEP):759. doi:10.3389/FNEUR.2018.00759
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