Note to readers: Dr. Mitch Earleywine is professor of psychology at the University at Albany, State University of New York, and a licensed clinician at Health Psychology Associates. He is the author of over 150 publications on psychology, addictions, and marijuana, including Understanding Marijuana (Oxford University Press, 2005).

My state just legalized medical marijuana. Is it really a medicine?

Marijuana can help alleviate symptoms for people who suffer from many illnesses and diseases. The plant acts rapidly, costs relatively little, and has few side effects. Marijuana works extremely well in easing the nausea and vomiting associated with cancer and AIDS treatments; that has made lives better for tens of thousands of patients. It works to control intractable seizures.

Opponents of the idea of medical marijuana point to legal drugs currently available that provide comparable relief of the same symptoms. An unbiased assessment of the drug’s costs and benefits requires extensive research. Scientists have done some of this work, but not all of it. All reputable doctors keep an open mind about such things, but for now the plant’s medical value is irrefutable.

Yes, but isn’t it just a cagey first step to legalization?

Folks who are losing weight drastically or unable to keep their medications down need help right away. Children who are seizing hundreds of time per day risk brain damage with each passing minute. They can’t wait to alleviate their symptoms while we split hairs about what is or isn’t a slippery slope to legalization.

Colorado and Washington began with medical-marijuana laws and later moved to tax-and-regulate policies, but these are very different markets. Citizens sometimes pass medical-marijuana laws, realize that marijuana isn’t as dangerous as they might have been taught in junior high, and sometimes subsequently pass tax-and-regulate laws. But other areas stick to medical-marijuana laws only.

A smoked “medicine.” Get real!

That’s not really a question, but I think I see what you mean. Many people use cannabis in a tincture or other edible form, so they don’t end up inhaling any smoke anyway. Medical marijuana is also vaporized. A vaporizer is a gizmo that heats the plant to a temperature just high enough to let the cannabinoids boil off in a fine mist but not so high that it ever catches fire. Without fire, there are none of the respiratory irritants that usually accompany smoke. Cannabis smokers who switch to the vaporizer decrease the chances of pulmonary problems and improve their lung function. Long-term medical users should definitely turn to the vaporizer rather than smoking.

But what about lung cancer?

Is smoking anything good for you? No—and there have been studies that show marijuana smoke isn’t either. But believe it or not, even smoked cannabis does not lead to lung cancer in folks who stay away from tobacco. Cannabinoids make any lung cancer cell essentially kill itself, where nicotine increases tumor growth.

What about that marijuana pill? Wouldn’t that be better?

Synthetic THC is available as a pill, but it has a ton of disadvantages related to cost, side effects, and impact. First off, the pills are pricey. The best deals on the internet usually run $500 for 60 of the 10 mg pills, or about 83 cents per mg of THC. Although fancy edibles are more expensive because of the gourmet chocolate or other elaborate ingredients, medical cannabis bought in bulk is $10 a gram or less, and most grams provide about 200 mg of THC, or about a nickel a mg.

The second issue concerns side effects. Synthetic THC has nothing but THC—no other cannabinoids. THC by itself can cause a lot of weird thoughts, disorientation, and angst. Medical cannabis contains a whole host of cannabinoids, including THC and cannabidiol (CBD). Cannabidiol tends to take the edge off of THC, and other components of the plant make it a much gentler medicine.

Finally, THC alone simply doesn’t help as many ailments. Plants with lots of CBD have caused legendary improvements for seizure in children.

Uh, I know what cannabinoids are, but I forgot.

You’re in good company. Chemicals that are unique to the cannabis plant are called cannabinoids. Over 100 of them have been isolated from the plant, but the most popular and researched include THC (tetra-hydrocannabinol)—the source of the subjective high—and CBD (cannabidiol)—the anticonvulsant responsible for helping kids with epilepsy.

Hello! Addiction!

Again, not a question, but let me explain that medical cannabis is unlikely to lead to symptoms of dependence or problems. Mental health professionals and drug experts tend to view cannabis as a little less addictive than caffeine, and markedly less problematic than alcohol or tobacco. As medicines go, it’s not even close to opioids or anxiety drugs that are prescribed to millions.

But what about the medical effects? Is marijuana really any good?

Is it perfect for every ailment? Of course not! It is, however, extremely good for several problems. Remember that many of the most popular medications in this country treat symptoms of only one disease or disorder. The plant helps sleep and relives pain; it eases gastrointestinal disorders like irritable bowel syndrome or Crohn’s disease, as well as nausea and vomiting associated with chemotherapy. It can reduce seizures in children with a special form of epilepsy as well.

Medical marijuana seems to be particularly helpful for patients who have not responded well to other medications, in part because it works through the cannabinoid system. Other medications have a different mechanism of action. Adding medical marijuana to a list of potential treatments helps physicians treat as many patients as possible.

Is this really a “cure” or just a way to make people happy while they are ill?

Eliminating seizures with a medicine is as close as we’ve ever come to a cure for some forms of epilepsy. Cannabinoids shrink human cancer tumors and have the potential to become a real cure, but the research has been stymied by prohibition. Helping people hold down their other medications is an indirect cure for hepatitis.

Eliminating these symptoms is more than just a distraction; it can mean the difference between life and death. The plant ends neuropathic pain in HIV patients, too, making an intolerable existence much more enjoyable. This isn’t like getting drunk to take your mind off a hangnail. We have compelling evidence that medical marijuana works.

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