Important Information about Using Medical Cannabis 

       This information is for patients and caregivers who have questions about medical cannabis use. It contains an overview of cannabis-related concerns for youth, people who are pregnant or breastfeeding, people at risk for dependence or addiction, people with mental health conditions, and those with heart or liver disease.

What to know before getting started with medical cannabis

       The cannabis-derived drug product: Epidiolex (cannabidiol), and three synthetic cannabis-related drug products: Marinol (dronabinol), Syndros (dronabinol), and Cesamet (nabilone). All other forms of medical cannabis are not approved by the FDA. 1 For most medical conditions, more study of medical cannabis is needed to understand its proper role in comprehensive medical care. Use of medical cannabis products may or may not relieve your symptoms. Existing studies of medical cannabis suggest symptom relief can vary from patient to patient. Side effects are common. Some of the most common side effects are dizziness, fatigue, dry mouth, light-headedness, drowsiness, and nausea. Side effects are usually mild or moderate and usually stop quickly, but sometimes severe side effects occur. Talk to a pharmacist at a Medical Cannabis Dispensary if side effects appear.


Talk with your health care practitioner about medical cannabis

       Like any drug, medical cannabis can interfere with other drugs you are taking. Blood levels of other medications might need to be checked, and doses of the medications might need to be adjusted to avoid any adverse side effects. Medical cannabis can also affect your body in other ways. For example, inhaled medical cannabis (whole plant or vaped product) can cause dry mouth, which can increase your risk for cavities or other dental issues. 


Startlow, go slow, stay low

       To avoid having unpleasant side effects, it is best to start at a low dose and then increase the dose slowly over time until symptoms are relieved, or side effects develop. Talk to the pharmacist at your Medical Cannabis Dispensary to follow this approach. Studies show that there is typically an upper limit to the effects of medical cannabis. Beyond 20-40 mg/day for THC and 50-100 mg/day for CBD, most patients will not get any additional benefit from a higher dose. Tip for new patients: You might want to purchase less than a 30-day supply of medical cannabis during your first few visits to a Medical Cannabis Dispensary until you learn how you respond to a particular medical cannabis product.

Some people are at increased risk of harm from use of cannabis

People in the groups listed in this section should generally not use medical cannabis due to the
risk of increased harm. Talk to your health care practitioner if you have concerns or questions.

Children, adolescents, and young adults

       Use of medical cannabis in children, adolescents, and young adults should be approached with special caution. Since the human brain is actively developing and continues to develop until approximately 25 years of age, cannabis use during adolescence may impact the developing brain and cause problems with attention, motivation, and memory.
       In addition, there are risks associated with exposure to secondhand cannabis smoke since it contains many of the same toxic and cancer-causing chemicals found in tobacco smoke.

Evidence shows links between recreational use of marijuana in children, adolescents, andyoung adults

 delays or declines in the ways the brain processes information
 the risk for future dependence on cannabis
 the onset of psychotic mental illness such as schizophrenia
       Much remains unknown about who is at risk for these outcomes, and whether these risks with recreational marijuana use apply to use of medical cannabis for children, adolescents, and young adults. For some people with serious disease and debilitating symptoms that are not controlled with conventional medical treatments, the potential benefits of treatment with medical cannabis may outweigh the potential risks, especially for medical cannabis products containing only CBD extracts. For more information, go to Dosing and Chemical Compositions

People who are pregnant or breastfeeding

       Avoid medical cannabis if you are pregnant, are planning to get pregnant, or are breastfeeding. There is some evidence that use of cannabis while pregnant may be linked to low birth weight or early delivery. However, it is difficult to separate out the harms caused by cannabis use from the harms caused by tobacco use in most studies.
       Using cannabis while pregnant may be linked to brain changes while the baby is developing, leading to memory, attention, and behavioral problems such as aggression and impulse control for the child in its early years and during adolescence. Children whose parent used cannabis during pregnancy are at increased risk of psychotic experiences during adolescence.

People at risk of dependence and addiction

       Use of medical cannabis could lead to cannabis dependence and addiction. Risk of addiction is higher for people who have experienced other addictions, or for people who use large doses of products with high THC levels.

For these reasons:

 Do not use medical cannabis, or use with great caution, if you have an addiction disorder
to any other substance, including tobacco/nicotine.
 If you are a regular, heavy user of medical cannabis, stopping use suddenly can lead to uncomfortable and serious withdrawal symptoms that can last for several days. Withdrawal symptoms are more likely with large doses of products with high THC content.

People with mental health conditions

       Recreational use of marijuana is known to sometimes cause psychotic These can be unpleasant and potentially dangerous. The following can increase the risk of psychotic

 Using medical cannabis extract products with high levels of THC, or high ratios of THC to CBD.
 Having a family history of schizophrenia or other psychotic disorder. For that reason, medical cannabis should not be used or should be used with great caution in patients with a family history of psychotic disorder, such as schizophrenia.

       A person who has a psychotic disorder such as schizophrenia or has a family history of schizophrenia or other psychotic disorder should not use medical cannabis. In particular, medical cannabis products with high levels of THC should not be used. When people with schizophrenia or a psychotic disorder stop using cannabis, their psychotic symptoms typically improve.

People with serious heart or liver disease

       A person who has serious heart or liver disease should not use medical cannabis or use it with great caution. There is some evidence that use of medical cannabis could cause a heart attack in patients known to have serious heart disease. Serious liver disease could cause problems with how the body metabolizes cannabis.


Cannabinoid hyperemesis syndrome

       People who develop hyperemesis syndrome have nausea, severe vomiting, and abdominal pain for days that repeats every week or every few weeks. A few patients enrolled in the Medical
Cannabis Program have been hospitalized for cannabinoid hyperemesis syndrome. Check with your health care practitioner or dispensary pharmacist if you experience any signs or symptoms of this syndrome.

Do not drive, operate machinery, or do work that could harm people while using medical cannabis

       Using medical cannabis can slow reflexes and reaction time, make it difficult to pay attention or make decisions, and change the way people perceive things around them. 17 This can make it dangerous to drive, operate machinery, or engage in any activity that could harm others or cause professional malpractice. How long these changes last depend on the person, the type
of medical cannabis product that was used, the dose of the product, and other factors. At a minimum, the changes can last several hours.

The impact of taking medical cannabis is greater when people:

 Use products with higher THC levels.
 Drink alcohol while using medical cannabis.

Keep medicationssecure and in their original containers

       When medications are not in their original containers, it is easier to mix up the identity of a drug. The label on the original container identifies the lawful owner of the product. As with any medication, medical cannabis should be kept in a secure place where others such as children cannot gain access to it.

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