Cannabis is a controversial subject that triggers strong emotions among doctors, scientists, researchers, policy makers, and the public. The questions surrounding it are complex and diverse, such as whether it is safe, legal, effective, addictive, and appropriate for certain medical conditions. Nonetheless, this text will focus on two areas: why patients find it useful and how they can discuss it with their doctors.

One of the least controversial components of marijuana is CBD (cannabidiol), which has little or no intoxicating properties. CBD-dominant strains of marijuana have little or no THC (tetrahydrocannabinol), which causes the “high” associated with marijuana consumption. Patients report many benefits of CBD, including relieving insomnia, anxiety, spasticity, and pain, as well as treating potentially life-threatening conditions such as epilepsy. Charlotte’s Web, a CBD-dominant strain of marijuana, has been shown to be effective in treating Dravet syndrome, a form of childhood epilepsy that is almost impossible to control.

The most common use for cannabis in Canada is for pain control, particularly chronic pain that plagues millions of Canadians as they age. Marijuana is safer than opiates, less addictive, and can replace NSAIDs such as Advil or Aleve for those who cannot take them due to kidney or ulcer problems or GERD. Marijuana appears to ease the pain of multiple sclerosis and nerve pain, which are areas where few other options exist. Patients claim that marijuana allows them to resume their previous activities without feeling completely out of it and disengaged. Marijuana is also said to be a fantastic muscle relaxant and can lessen tremors in Parkinson’s disease, as well as help patients suffering from pain and wasting syndrome associated with HIV, irritable bowel syndrome, and Crohn’s disease. Cannabis is also reported to manage nausea, weight loss, and glaucoma.

Patients who want to learn more about cannabis but feel embarrassed to bring it up with their doctors should be entirely open and honest with their physicians and have high expectations of them. Patients should tell their doctors that they consider cannabis to be part of their care and expect them to be educated about it and able to at least point them in the direction of the information they need. On the other hand, doctors should be non-judgmental and open-minded, regardless of whether they are pro, neutral, or against cannabis. Patients will seek out other, less reliable sources of information if doctors are dismissive of their concerns. While there is a lack of rigorous studies and “gold standard” proof of the benefits and risks of cannabis, doctors should be willing to learn about it and strengthen the doctor-patient relationship through trust and communication.

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