Healthcare Workers: Do You Know These 5 Medical Marijuana Myths?
Updated: Feb 12
Education is the single most important factor when it comes to medical cannabis.
But compared to the tremendous surge in industry, everyday knowledge lacks dangerously behind. As we confirmed in our previous article, cannabis is quickly becoming mainstream, and medical professionals like nurses must be able to disprove misconceptions to provide the best quality care.
Let's take a look at five common myths and what they mean for the future of safe, responsible use.
Myth #1: Cannabis has no Healing Potential
While this myth may seem obvious, it is important to acknowledge that the federal government still considers cannabis to have no accepted healing potential. However, a quick look into history reveals that cannabis has had recognized medicinal benefits throughout history and that its demonization has more to do with politics than fact.
In 1937 when the Marihuana Tax Act began prohibition, a man named William C. Woodward spoke out by saying cannabis should be regulated, not prohibited, for it had "substantial medical uses." Woodward was a doctor, lawyer, and public health advocate on the legislative council for the American Medical Association. His insights were ultimately ridiculed and rejected.
Flash forward to the creation of the Controlled Substance Act in 1970 that started the infamous War on Drugs and restricted cannabis as a Schedule 1 narcotic. Members of Congress sent a letter to President Nixon titled Marihuana: A Signal of Misunderstanding, pleading with him not to schedule cannabis so strictly, citing its medicinal potential and the benefits of legalization. It went ignored by Nixon.
We've come a long way since then. Cannabis is finally getting the medical attention it deserves, and there are numerous qualifying conditions physicians can recommend– and in some cases – prescribe medical marijuana for patients. As research into cannabinoid medicine continues and as scientists learn more about novel cannabinoids like CBG, CBC, and CBN, these qualifying conditions will likely expand.
As suggested by increased dispensary sales during the COVID-19 pandemic, mental health conditions could also apply, as people sought cannabis to cope with heightened anxiety and uncertainty.
Myth #2: Cannabis is a Gateway Drug
Rhetoric influences perception, and the statement that cannabis is a gateway drug is probably the most devastating misconception about cannabis. This myth was at the forefront of the failed War on Drugs and directly impacted the herb's demonization.
Correlation does not mean causation. If a person is willing to try drugs, odds favor them trying cannabis first – as cannabis is the most widespread substance in the United States, behind alcohol and tobacco. But this does not mean cannabis use elicits someone to move on to harder drugs or that without cannabis, they never would have tried anything else, as the myth implies.
In fact, evidence suggests cannabis might be an "exit drug." In states where cannabis is legal, both alcohol and opiate abuse has decreased. Furthermore, cannabis can help wean opiate addicts off heroin. While some people will inevitably have an issue with replacing one substance use with another, cannabis is safer than traditional alternatives like methadone or buprenorphine.
Hopefully, in the future, we will see more consideration of addiction's underlying physiological causes and replace punishment and judgment with compassion and treatment.
Myth #3: Cannabis is Addictive
As with any mind-altering substance, botanical or otherwise, there is potential for addiction. However, many cannabis users assume it is not addictive because it is 'natural' – a term that rhetorically suggests safety.
Cannabis can be addictive. Evidence shows how 7-9% of cannabis users will become addicted, a rate that increases four to seven times if someone starts using it as a teenager or before their brain has had a chance to reach maturity, which does not happen until age 25. The clinical definition of cannabis addiction is called Cannabis Use Disorder.
Put into context, 15% of heroin or cocaine users will become clinically addicted. Furthermore, Cannabis Use Disorder is mostly psychological, and discontinuation does not risk extreme physical danger, unlike heroin, cocaine, or alcohol withdrawal. Discontinued, chronic cannabis use will usually result in symptoms like sleeplessness, irritability, and loss of appetite.
THC targets the part of the brain associated with memory and cognition. Since this brain region develops last, young people are discouraged from THC. However, there is not enough evidence to confirm or deny that adverse effects on learning and cognition last after discontinued use.
Myth #4: Cannabis is Completely Safe
Compared to other substances, cannabis is relatively safe and has low abuse potential. In reality, there are risks, particularly with THC.
A THC high commonly causes anxiety, paranoia, increased heart rate, and dry eyes and mouth. Fortunately, CBD might counteract these adverse effects by inhibiting the size of the CB1 receptor in the brain responsible for intoxication.
More concerning, however, is Cannabinoid Hyperemesis Syndrome (CHS), characterized by chronic cannabis use, followed by nausea, vomiting, and abdominal pain. While the exact cause is unknown, it is most likely driven by an idiosyncratic mechanism, as a recent study examining cannabinoid levels in hair revealed CHS is not merely a direct consequence of chronic use as previously thought.
While there are no reported cases of death by cannabis use alone, "greening-out" can cause death if the user mixes the cannabis with sedation medications or alcohol. "Greening-out" is similar to CHS but also includes dizziness, increased heart rate, reduced blood pressure, cold sweats, anxiety, paranoia, and in some cases, hallucinations. Discontinued use is the only cure for CHS or greening-out.
Finally, there is the misconception that cannabis causes madness or psychosis. Here, we revisit the concept that correlation does not equal causation. Incidents of psychosis resulting from cannabis use can occur in people who were already susceptible to such episodes through existing neurological conditions. Physicians should examine a patient's psychological history before recommending medical marijuana, as high THC levels can exacerbate their susceptibility.
Myth #5: Cannabis Doesn't have Drug Interaction
The assumption that cannabis is entirely safe extends to assuming it is safe to use on other substances. However, numerous botanicals are well known to interact poorly with each other and especially with prescription medications.
Both THC and CBD have the potential to interact badly with several prescription drugs. CBD interacts with them the same way grapefruits do – so if your prescription has a grapefruit warning, avoid using CBD.
What happens is cannabinoids affect metabolism in the liver, affecting how the liver breaks down meds. It can either inhibit the breakdown, leading to fewer results from the med, which can interfere with someone's recommended dose, or increase the effects of the drugs and lead to an overdose. With some meds like warfarin (also known as Coumadin), mixing it with THC can cause dangerous levels of bleeding.
Physicians and nurses will need to know what medications their patient is on before recommending marijuana, and cannabis consumers should make sure to consult their doctor about potential drug interactions. A list of interactions can be found here.
Prove Your Cannabis Expertise
While cannabis is remarkable in many ways, aspiring cannabis nurses must recognize and evaluate the risks. This due diligence will legitimize the plant and make it easier for both society and regulatory bodies of government to accept it as a valid alternative medicine.
Are you ready to further your knowledge and become a cannabis nurse? At the Training Academy of Medical Cannabis, we offer several certificate courses. Check out our classes to get started.