David Bearman, MD
David Bearman, MD, vice president of the American Academy of Cannabinoid Medicine and author of the forthcoming book Abridged Guide to Cannabinoid Medicine Practice. He is in private practice in Goleta, California.
Bottom Line: Often, the most therapeutic cannabis formulation means both CBD and THC
The Food and Drug Administration has paved the way for drugs derived from the cannabis (marijuana) plant. But these won’t work as well as they could. Example: Epidiolex, the first such US prescription drug, treats the childhood seizure disorder Dravet syndrome. The active ingredient is cannabidiol (CBD), a compound that doesn’t produce a “high,” and it has only trace amounts of tetrahydrocannabinol (THC), which does. While CBD itself has therapeutic benefits, it often is more effective when combined with THC and other cannabis compounds. Studies show that’s true for seizure disorders.
The CBD/THC combination is particularly important in treating a much more common medical dilemma—chronic pain. Consider nabiximols (Sativex), a spray medication with a 1:1 CBD/THC ratio. US clinical trials find that it effectively treats intractable pain, and it does it as well as the narcotic codeine. Sativex is legal for doctors to prescribe in 28 countries but not the US. Sativex only rarely causes patients to feel uncomfortably euphoric or “stoned.” Many other cannabis formulations also reduce the amount of narcotics needed to relieve pain.
The truth is, cannabis has a wide range of therapeutic applications, including stimulating appetite, preventing nausea, bringing down chronic inflammation and even treating certain cancers.
What to do? While neither Sativex nor any other whole-cannabis medication is legal on a federal level, similar products are available in states where medical cannabis is legal. For some conditions, a high-CBD/low-THC formulation may be best. For others, a product with a 1:1 ratio may best serve you.
If you are considering using a medical marijuana dispensary, find a qualified cannabinoid medical practitioner who can guide you to the right formulation and who will adequately discuss the possible side effects of euphoria. To find one, go to the website of the American Academy of Cannabinoid Medicine, The Society of Cannabis Clinicians or the Association of Cannabis Specialists.
