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JAMA Internal Medicine Patient Page
February 11, 2020

What Should I Know About Medical Cannabis?

JAMA Intern Med. Published online February 11, 2020. doi:10.1001/jamainternmed.2020.0018

Most states have legalized cannabis use for medical conditions. Some states have legalized cannabis for recreational adult use. The federal government considers cannabis use to be illegal. However, clinicians and patients who act in accord with state laws on medical use of cannabis are are not likely to be federally prosecuted. Typically, cannabis contents, potency, and safety are not regulated by the government even in states where it is legal.

Patients with spasticity related to multiple sclerosis, rare forms of childhood epilepsy, or nausea associated with chemotherapy have been shown to benefit from medical use of specific cannabinoids. Substantial evidence demonstrates that cannabis helps to modestly reduce pain. The most consistent benefit is seen in nerve pain. Cannabis is often portrayed as a treatment for conditions like anxiety, opioid addiction, and insomnia. There is not conclusive evidence to know if it helps with these conditions.

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    1 Comment for this article
    Labelling laws and over the counter CBD oils
    Katherine White, MA (Hons), ACIS | University of Würzburg, Department of Political Science and Sociology
    To my frustration, one of the underrecognized problems with current licensing of over the counter CBD products arises from cross-contamination. A bottle of low strength (2.75%) CBD oil purchased through a retail high street vitamin and health food products store gave me a nasty gluten reaction with an extremely itchy dermatitis herpetiformis rash. A self-conducted skin prick test confirmed the source of the gluten reaction.

    I had been taking around half the recommended daily maximum dose of this brand of CBD oil to ease inflammatory spinal arthritis symptoms, to see if this would help me reduce my use of
    prescribed opiate pain relief. It worked for transitory pain relief - but one of the side effects of a gluten reaction is, for me, an increase in peripheral joint pain. Not so good.

    Surely the same labelling standards should apply to over-the-counter supplements as for ordinary food products, ie a warning that a product may contain trace gluten or other factory cross-contamination?