Over half of the U.S. states have approved mail order medical cannabis for “medical” functions, with three states joining the list after the November 2016 elections. Although limited evidence indicates that marijuana has analgesic effects (Clin J Pain 2013; 29:162) and could replace for more dangerous long term prescription opioid use in people with long-term pain (J Pain 2016; 17:739), concerns remain that medicalization is frequently a gambit for legalized recreational use or that some patients use cannabis to “take the edge off” nonmedical misery. On the other hand, adverse effects, particularly with regular marijuana use (as is common in medical users), have been conclusively documented: damage to the teen brain,(J Neurosci 2014; 34:5529), reduced cortical gray matter in adults , decreased cognitive function (Biol Psychiatry 2016; 79:557), and increased risk for psychosis (Lancet Psychiatry 2015; 2:233) and vehicular mishaps (BMJ 2012; 344:e536).
A current evaluation of survey data on 96,100 adults in all 50 U.S. states farther advises the discussion (JAMA 2017; 317:209). Researchers compared the mental as well as physical health of past-year marijuana users (12.9% of participants) according to whether use was medical (0.8%), recreational (11.6%), or both (0.5%). In contrast to recreational users, medical- only users had higher rates of anxiety disorder, perceived poor health, and handicap; reported nonmedical use of stimulants and prescription analgesics and lower use of alcohol; and were more prone to utilize marijuana daily. Less use of nonmedical prescription-analgesics may be consistent with use for pain. Stress speeds that are higher could suggest periodic withdrawal responses due to day-to-day use, maybe heightened psychological distress, or the growth of stress caused by routine use due to poorer health, indicating that use might be directed at alleviating misery in the place of treating specific medical conditions.