Medical Marijuana -- A Primer

Leslie Citrome, MD, MPH


October 30, 2013

Medical Marijuana and Related Legal Aspects

Marcoux RM, Larrat EP, Vogenberg FR
P T. 2013;38:612-619

Article Summary

This article provides a review of the current use of medical marijuana in the United States and the implications of its use for healthcare professionals and pharmacy and therapeutics committee members. A brief history of the legal status of medical marijuana is provided, demonstrating a large divide between the US federal government and the 18 states that currently allow the use of medical marijuana. The physiologic effects of marijuana are briefly reviewed, including the potential for adverse outcomes. Especially useful in this review is a state-by-state summary of approved uses, methods of dispensing, the year that medical marijuana was approved, and whether a registry is required. For example, in California, approved uses include "AIDS, anorexia, arthritis, cachexia, cancer, chronic pain, glaucoma, migraine, persistent muscle spasms (including spasms associated with multiple sclerosis), seizures (including seizures associated with epilepsy), severe nausea, and other chronic or persistent medical symptoms." The approved method of dispensing in California is through "individual caregivers or compassion centers; a single licensee may possess up to 8 ounces of dried marijuana and/or 6 mature or 12 immature plants at one time. A patient may register to possess a greater quantity under a physician's recommendation." Issues related to use of medical marijuana at the worksite are also discussed.


Marijuana is not benign. Regular use in early adolescence has been linked to the development of severe mental disorders in vulnerable individuals who are perhaps genetically predisposed. Acute use can cause coordination difficulties, impaired memory, and poor judgment. Chronic use can be associated with respiratory disorders similar to those observed with tobacco smoking. Endocrine abnormalities may also develop. Risk vs benefit must be carefully considered when evaluating the appropriateness of medical marijuana. Medical marijuana may also be diverted for recreational use, which in some instances can be a significant obstacle to the treatment of persons with serious and persistent mental disorders, especially when combined with use of other street drugs.


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