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"&amp;lt;p&amp;gt;Everyone on the internet seems to have an opinion about medical marijuana.\u00A0 Some claim it\u2019s an excuse for stoners to get high. \u00A0 Others claim it\u2019s a miracle drug\u00A0 kept under wraps by Big Pharma so they can peddle more dangerous and less effective treatments. I suspect most people, though, are just trying to find some truth amidst a lot of spin.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;As a doctor, I view marijuana as I do any drug-- it may have potential to help or harm, depending on how it&amp;amp;#39;s used. \u00A0Opiate\u00A0is likely to help certain disorders, and we should be able to know what those disorders are and prescribe it to people who truly need it. \u00A0Like other drugs, though, we must be aware of side effects\u00A0and\u00A0cautious about the potential for abuse.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The trouble is that there isn\u2019t much quality information on marijuana.\u00A0 Who was going to fund the studies while it was illegal?\u00A0 Even now, with some states having legalized marijuana use, can you imagine the federal government funding such a study?\u00A0 So we have usually have to make due with suboptimal research.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;That said, let\u2019s go forward first with what we know about marijuana with some confidence.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Potential Benefits:&amp;lt;/strong&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;&amp;lt;a href=&amp;quot;https://www.verywell.com/understanding-multiple-sclerosis-2440693&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;1&amp;quot;&amp;gt;Multiple Sclerosis&amp;lt;/a&amp;gt; Symptoms: &amp;lt;/strong&amp;gt;Oral cannabis extract (not smoked) has been clearly shown to be effective in reducing patient reported scores of pain or painful spasms after 12 to 15 weeks.\u00A0 That said, there is just as good evidence that the extract doesn\u2019t seem to help objective measurements such as the physical examination.\u00A0\u00A0Conversely, nabiximols (another cannabis extract) can reduce the number of time someone with MS and bladder complaints has to use the restroom, but doesn\u2019t lead to reports of improvement by patients.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Movement Disorders:\u00A0 &amp;lt;/strong&amp;gt;There\u2019s really not much evidence that cannabis or related products help symptoms in &amp;lt;a href=&amp;quot;https://www.verywell.com/huntingtons-disease-signs-causes-2488752&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;2&amp;quot;&amp;gt;Huntington\u2019s disease&amp;lt;/a&amp;gt; or &amp;lt;a href=&amp;quot;https://www.verywell.com/what-is-parkinsons-disease-2612163&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;3&amp;quot;&amp;gt;Parkinson\u2019s disease&amp;lt;/a&amp;gt;.\u00A0 In fact, there\u2019s some evidence that shows it isn\u2019t helpful in helping Parkinson\u2019s disease &amp;lt;a href=&amp;quot;https://www.verywell.com/dystonia-vs-dyskinesia-2612238&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;4&amp;quot;&amp;gt;dyskinesia.&amp;lt;/a&amp;gt;\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Epilepsy:&amp;lt;/strong&amp;gt; This is a hotly contested area, as there are some compelling reports of &amp;lt;a href=&amp;quot;https://www.verywell.com/what-causes-seizures-p2-2488650&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;5&amp;quot;&amp;gt;seizures,&amp;lt;/a&amp;gt; not treatable by any other means, which improve with marijuana products. \u00A0 \u00A0Early results from one well designed study suggests that seizures may be reduced by up to 54% in children treated with a purified cannabis extract.\u00A0This shouldn\u2019t be taken as saying marijuana is good for all seizures\u2014some prescribed anti-epileptic drugs can make certain seizures worse.\u00A0 The thing is, we know what those seizure types are, because those drugs are very well studied, unlike marijuana.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Anxiety:&amp;lt;/strong&amp;gt; While it\u2019s considered more a \u201Cpsychiatric\u201D than \u201Cneurological\u201D disorder, this division is ultimately artificial.\u00A0 Anxiety can make a lot of neurological symptoms worse, and a lot of neurological symptoms cause anxiety.\u00A0 And yes, at least anecdotally, marijuana makes people &amp;lt;a href=&amp;quot;https://www.verywell.com/does-marijuana-help-anxiety-1393002&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;6&amp;quot;&amp;gt;feel less anxious&amp;lt;/a&amp;gt;.\u00A0 That\u2019s the reason why many use the drug recreationally.\u00A0 That said, this is a very short term fix, there are other better understood medications available, and if your anxiety is so severe that you feel you need a medication like marijuana, you probably need more professional help like a psychiatrist or therapist.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;There is also some evidence to suggest that cannabinoids are useful with&amp;lt;a href=&amp;quot;https://www.verywell.com/the-role-of-cannabinoids-in-cancer-care-2252411&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;7&amp;quot;&amp;gt; nausea and vomiting due to chemotherapy&amp;lt;/a&amp;gt;, sleep disorders, and Tourette syndrome, though this evidence is not extremely strong.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Risks:&amp;lt;/strong&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Some believe marijuana to be perfectly harmless.\u00A0 Some consider it to be the gateway to all that is evil.\u00A0 Both positions are wrong.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;For one, the cognitive effects of marijuana, especially when high, are very well known.\u00A0\u00A0 It\u2019s probably not a drug you want to use if you are doing mentally challenging work, or if you\u2019re concerned about your memory or thinking already.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;The long-term effects of marijuana on memory and cognition are more debated.\u00A0 The most concerning evidence involves use by children and adolescents. Some studies even associate marijuana use with an &amp;lt;a href=&amp;quot;https://www.verywell.com/what-causes-schizophrenia-2953136&amp;quot; data-component=&amp;quot;link&amp;quot; data-source=&amp;quot;inlineLink&amp;quot; data-type=&amp;quot;internalLink&amp;quot; data-ordinal=&amp;quot;8&amp;quot;&amp;gt;increased risk of schizophrenia.&amp;lt;/a&amp;gt;\u00A0 While this may be rare, it\u2019s probably best to avoid use of marijuana in children and adolescents, unless there is a clear medication need.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Other, more transitory side effects include dry mouth, nausea, somnolence, euphoria, disorientation, drowsiness, weakness, mood changes, hallucinations and dizziness. Also, note that all the putative medical therapies above have not involved smoking marijuana, but taking it by other routes.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Summary:\u00A0&amp;lt;/strong&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;At this point, medical marijuana should only be considered when standard-of-care treatments have proven ineffective.\u00A0 As more data becomes available, the role of medical marijuana will probably expand. \u00A0\u00A0In the meantime, it is important to neither get swept away by hype, testimonials or marketing, and at the same time to also avoid rigid or paranoid thinking.\u00A0&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Sources:\u00A0&amp;lt;/strong&amp;gt;&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Leon\u00A0French,\u00A0Courtney\u00A0Gray,\u00A0Gabriel\u00A0Leonard,\u00A0\u00A0Michel\u00A0Perron,\u00A0Bruce\u00A0Pike, et al.\u00A0Early Cannabis Use, Polygenic Risk Score for Schizophrenia and Brain Maturation in Adolescence. \u00A0&amp;lt;em&amp;gt;JAMA Psychiatry&amp;lt;/em&amp;gt;. Published online August 26, 2015. doi:10.1001/jamapsychiatry.2015.1131&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Penny F.\u00A0Whiting,\u00A0Robert F.\u00A0Wolff,\u00A0\u00A0Sohan\u00A0Deshpande,\u00A0\u00A0Marcello\u00A0Di Nisio,\u00A0Steven\u00A0Duffy,\u00A0Cannabinoids for Medical Use:\u00A0A Systematic Review and Meta-analysis.\u00A0&amp;lt;em&amp;gt;JAMA.\u00A0&amp;lt;/em&amp;gt;2015;313(24):2456-2473. doi:10.1001/jama.2015.6358.&amp;lt;/p&amp;gt;&amp;lt;p&amp;gt;Selim R Benbadis, Juan Sanchez-Ramos, Ali Bozorga, Melissa Giarratanoa, Kavita Kalidasa.\u00A0Medical marijuana in neurology. Volume 14, Issue 12, 2014&amp;lt;/p&amp;gt;"^^<http://www.w3.org/2001/XMLSchema#string>
<https://www.verywell.com/medical-marijuana-in-neurology-2488890>