medical marijuana

In the recent election, voters in several more states approved the use of medical marijuana. Now more than half the states in the US accept the medicinal use of cannabis, but the federal government does not. As a recent New York Times article about a cannabis company in California illustrates, that creates a certain amount of tension. But what do we really know about the value of medical marijuana?

Marijuana (Cannabis sativa) has been both glorified as a mind-expanding agent and vilified as evil weed. Most doctors are skeptical about its usefulness for medical purposes. Our guest, David Casarett, MD, certainly doubted that there was much evidence to support medical applications of marijuana. But as a palliative care physician, he was curious. The evidence he found convinced his that there is a case to be made in some situations.

What Are the Benefits and Risks of Medical Marijuana?

Find out how marijuana could be helpful and when it may be harmful. Which conditions have the best evidence on the medical applications of marijuana?

This Week’s Guest:

David Casarett, MD, MA, is a palliative care physician and health services researcher whose work focuses on improving systems of care for people with serious, life-threatening illnesses. He recently relocated from the University of Pennsylvania where he was a tenured professor of medicine. Dr. Casarett is now Chief of Palliative Care at the Duke University School of Medicine. He received the Presidential Early Career Award for Scientists and Engineers. This is the highest honor the US government gives to researchers in the early stages of their careers.

Dr. Casarett has written three non-fiction books. His first novel in the Ethical Chiang Mai Detective Agency series, Murder at the House of Rooster Happiness, will be published in September 2016.

His non-fiction works include Shocked: Adventures in Bringing Back the Recently Dead. His most recent book is Stoned: A Doctor’s Case for Medical Marijuana.

He is launching a website,, where medical marijuana users can report their experience and connect with each other. It also serves as a database for medical professionals trying to learn more about this topic.

The photo of Dr. Casarett is copyrighted by Joe Chielli, Church Street Studios.

Listen to the Podcast:

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Air Date:November 26, 2016

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  1. Brent

    Wow. You are obviously an older, Republican hipocrit who has no chronic pain issues and has not had 8 major joint surgeries and needs 3 more replacements. It’s people like you that have never been on opiates that completely rule your life. And yes, I’ve been dealing with this since 1976 and have a high pain tolerance in the first place.. So if you don’t have an educated opinion, please stay out of this forum.. BTW, the only time I was off diabetes meds was when I was on mmj..

  2. Jane

    My Pulmonary doctor died after 3 years of suffering from Lung cancer (he never smoked). His last few months would have been totally unbearable if it were not for his cannibus edibles (for his nausea/vomiting and pain).

  3. Cheryl

    My state just passed the medical marijuana law and i asked my pain management dr what he thought of it because i was thinking of trying it due to the fact i am on tons of opiates and other medication for pain and to control symptoms of medical issues i have. His response to me was he didn’t think it is beneficial and i actually had to sign a paper stating if i failed a drug test that showed thc in my system i would be dropped as a patient. I was shocked and i asked what he meant by medical marijuana would not be beneficial and he couldnt give me a direct answer. To me it seems to be all about the all mighty dollar and not about what is best for the patient.

  4. Bryan
    Missouri usa

    If everyone could afford it , just move or set up a residence in a state where it is legal for recording use or medical and spend your time and money in that state, sooner or later the other states will fall in line and make it legal.

    I have been on about every pain med out there from the tramadol hydro oxy fentenyl daluid, for over 10 years I have been mainly on oxycodone and oxycontin 12 hr, they do good for pain maintenance , I had over 60 percent compression of cervical spine from c4 to c7 , had the c4 5 c5 6 , discs totally rupture and extrude the juice onto spine cord , caused Alot of major left side pain from base of neck to and down leg and arm. That’s when I asked for the 12 hour pill. Lomg story short my nexk is bolted together with plates and replacement bone where discs were pain was Alot better than before but still am left with constant pain that the Oxy helps maintain.. but after 8 months to a year streight on the 12 hour pills they lose effectiveness due e to tolerance , so I usually try to plan a vacation to Colorado or a recreational state if I can afford it at all , I will buy the local dispencery pot , Charolettes Web acdc or maui wowie , and enjoy for a couple weeks using them instead of the Oxy regiment , I notice no withdraws , and a much more significant reduction in pain , even if I am sleeping on the ground in a freaking tent or the back of my van, then when it is time to go home the weed stays in Colorado , and I head back to the Oxy life in missouri it sucks to be stuck in just enough pain that everything one does is a strenious one , even performing husbandry duties results in very limited activity the next day or so ….. I guess I should concentrate less on looking down while taking care of business lol.

    But the break does give the body a chance to forget it is tolerant to oxy so when I do go back on it I don’t need as much , but it would be much better to just smoke a nugget and not have to worry about pain all day , a nugget I say is about the size of a pencil eraser.
    Anyhow too long winded sorry for that.

    • Bryan

      O do ,btw, geek for everyone out there that is in the spot I’m in , it seems like the end of the world sometimes , and it’s very hard to keep a positive outlook on things.

      A trip from missouri to Colorado in my van costs about 700 bucks round trip , and if we camp the only expense is food and gas for generator if we use it. Pretty cheap vacation and very beneficial for me at least I have a week or two to look forward to being able to live pain free and be in nature at its best.

      We all should do a group gathering and form a small camping community to help others to be able to do this as well, we could probably even run it through a charitable not for profit organization… just a thought.

      • Jesse

        Why not just buy the cannabis in Missouri? Why go to Colorado? I live in a backward Republican state, Texas, and it is not legal but that apparently doesn’t stop anyone. There are countless shops selling cannabis items such as bongs and vapes. Seems I can’t drive more than 6-8 blocks without seeing such a shop. These shops would not be so abundant if people weren’t using cannabis. Sure, it would be better to grow your own (Walmart sells on line a grow booth for $75 to put in a closet) or buy from a licensed pharmacy than to buy cannabis of unknown origin or quality. But you are spending a lot of money and energy driving to Colorado. My large Texas city is not Republican so small amounts of cannabis are not prosecuted. I don’t read of anyone being arrested for personal use. Just check the laws where you are. And write letters to Missouri politicians and newspapers to educate them on your need for pain relief with cannabis and the politicians need to vote for it if they want to be re-elected! That will get it done!

  5. Ruth

    I’m wondering how this could work for someone like me who suffers from chronic migraines and bad headaches that come from having severe arthritis in my neck with stenosis.

    I am presently taking anticonvulsants prophylacticly for years, but I still have my headaches and these meds have their side effects. My state does not approve of medical marijauna yet.

  6. Frankie b

    The politicians are the problem. They are foolish and misinformed. Marijuana does not make you do heroine coke or anything else. If you are in chronic pain you need help. Furthermore let’s face it it’s all a money game. States could get relief from their hugh financial woes. All states need to be like coloroda. I do think it needs to be monitored so one can get it in it’s pure form and not treated.

  7. Thomas K

    While I’d be happy to find out there is evidence for the medical usefulness of marijuana, it’s unfortunate that the underlying issue driving this debate has little to do with the medicinal properties of the herb.

    The underlying issue is the government’s insistence that, despite clear evidence, marijuana should be a Schedule 1 substance. Indeed, going even deeper is the notion that by attempting to control certain substances, we are safeguarding society.

    Alcohol, particularly in the form of spirits, also could be said to meet the three Schedule 1 criteria: “potential for abuse”, “lack of medicinal use as a treatment”, and “lack of accepted safety for use” – yet alcohol is no longer prohibited, and Prohibition led, just like our current “War on Drugs” to horrible, unintended consequences. These include devoting vast resources to control, interdiction, prosecution and imprisonment.

    The War on Drugs is a huge and very expensive failure. I suggest you devote a program (public health) to how Portugal has successful de-criminalized all drugs and provide addiction treatment to the minority who become addicted. It’s been working for 16 years now.

    • Betsy

      I have seen and experienced success in using Marijuana medically. 1.) Look up what it does for people with severe seizure disorder. There are some stunning videos out there that show the change. I have seen an example of seizure control within my own friendship group. 2.) I have used it successfully for many years to control my restless leg syndrome.

      Controlling this allows me the possibility of sleep and sometimes the marijuana also helps with getting to sleep as well. Lastly I have also seen it help control an angry temperament. I know a man that goes from violent to gentle when he uses marijuana. When he drinks it’s really bad.

  8. Teresa

    My daughter, like Roseanne’s son as stated above, was having difficult to control “cluster seizures” and was taking 2 medications, one of which, was badly affecting her balance, reducing her appetite and producing bruises on her body. I was really worried.

    Since she started taking cannabidiol oil three months ago, her balance and appetite returned to normal, and her bruises disappeared. She is almost off the most dangerous medication (currently taking 50 mg. as opposed to 600 mg daily before cannabidiol). I expect to successfully wean her off from the offending seizure medication in about a month -under medical supervision, of course-

    If possible, I would like to communicate with Roseanne to exchange ideas and info about the similarity of our cases. Please feel free to pass on my e-mail to her. If she is agreeable to this and decides to e-mail me, please tell her to put in the subject Cannabidiol – The People’s Pharmacy, so her e-mail does not go to the spam folder.

    Thanks very much in advance for the invaluable service you are doing.

  9. Frances
    Chapel Hill NC

    A lot more physicians might be open-minded if they could continue to treat patients who use cannabis oil. Instead they see “miracles” or credit their chemo belatedly for the “cure” and suggest giving more just to be sure the good outcome continues. Patients need to have continued screenings and they’re afraid they’ll be dropped if they say what’s really going on.

    It doesn’t work for everything, but nothing else works for, say, pancreatic cancer, and it’s worth researching.

  10. Debra
    Burlington, NC

    I smoked marijuana for recreational use for about 47 years until I realized it’s beneficial use in my pain relief for my chronic pain. I’ve been smoking it since 1973 and still do today. I know the risks and am willing to take them for the benefits. I’ve had 17 major surgeries in the past 38 years (3 in the past 10 months) and I’ve only recently had to stop for my pain clinic that I’m in now. I hope soon that they legalize it in my state. It’s benefits more than outweigh the consequences… God bless

  11. Maf
    Full-time on the road

    I am 69 years old. I have used marijuana for 51 years mostly recreational but over the years have come to realize it’s medical benefits. upset stomach or insomnia Been a good 15 years since I’ve even had a cold. I do not find any addictive qualities. If I want to stop I can and have for weeks or even months at a time . The only side effect that I find stopping is a few nights of mild insomnia. As far as hallucinations I’ve never seen anything like “dancing patio furniture.” I don’t know how much you would have to smoke to have hallucinations. I only smoke in the evenings kind a like having a glass of wine. I do not drink if I am going to smoke. The two together are very intoxicating.

  12. Lula
    So. Calif

    My son has “intractable seizures,” meaning they are extremely difficult to control. The top neurologists in a large HMO put him on 3 different seizure medications. His seizures were under control but his blood work showed problems, including easy bruising. He also lost tons of weight (so skinny that his bony little bottom would get bruised just sitting on a wooden chair). His behavior deteriorated drastically. I finally got him on medical marijuana oi with CBD (the component used for seizures) and it made a HUGE difference. I just give him a dropper full twice a day and we’ve been able to cut his pharmaceutical drugs in half. I will continue to decrease them even more, very slowly and carefully. This oil does NOT have THC in it (the component that gets you high). His blood levels are back to normal, as is his weight, his behavior has improved and he hasn’t had any seizures in nearly 30 months. It’s been a God-send for us!

  13. Roseanne

    When I was a student nurse back in the early seventies, I was assigned an obstetric patient to follow from early clinic visits through the delivery of the baby. When she went into labor, she was required to call me to accompany her to the hospital. On the way, she lit a marijuana joint and I was appalled. She had given no indication that she smoked anything during the pregnancy. Her husband asked me not to tell and stated it was for pain relief as she was part Native American. I watched her go through the entire delivery in a joyful state with NO OTHER pain medication or epidural anesthesia. It was intriguing to say the least as I remembered my own experience with labor and delivery as being extremely painful. Now that I am 74 years old and have rheumatoid arthritis I am angry that I have been deprived of the opportunity to obtain pain relief from this plant but have been prescribed Plaquinil, a drug that can cause blindness. I also have been given the option of Methotrexate, another poison, or steroids, an unfortunate choice with many side effects. This is not right.

  14. Shalbhadra B

    As a board certified MD I am allowing medical use of Marijuana(MI) and help most patients for muscle joint pain., good for patients taking chemotherapy, glaucoma ( need to take eye drops also) …increases,appetite gives good sleep and cuts, down use of narcotics having lethal side effects.

    It can be used as eatableble also takes,time to act but avoids bad smell….dose starts, with mnm amount and thus to avoid cognitive effect….more can be found by Google search…side effects are there so be cautious, as no long term use study have been done

  15. Kevo
    Ottawa, Canada

    Nonsense: Pot may help lower intraocular pressure for a time, which is what most, if not all, glaucoma medications do. But it does not cure glaucoma, a sight-threatening disease. On the scale of effective medications to lower pressure, marijuana is much less effective than at least 25 existing commercial products. This post should be taken down as glaucoma can cause blindness.

  16. Joyce

    I’ve been told that 2 women my daughter knows (one is her sister-in-law) were diagnosed with uterine cancer 3 years ago. One recently died, sister-in-law us using what I’m guessing is tincture…they said “oil”. She is still alive and doing okay if not well. I’m thinking if it as relief for sciatica and hip arthritis…now getting steroid shots.

    • Patricia

      I believe it’s the patients call on the treatment they decide to choose because not me not you are anyone else knows how medical marijuana helps each person can be great for one person and not a other person so I say it should be left up to the patient if it helps them an who has more say over your body I no it’s not right that anybody has the right to tell me that I have no say so on the treatment of my on body as long as I’m mentally and physically able to make the decisions about my health and physical well-being I’m so tired of everyone trying to take away my constitutional rights

      • Patricia

        I forgot to tell about my medical problems I have arthritis of the spine I have fibromyalgia an three back surgeries one was to put a pain pump in two hand surgeries for carpal tunnel I need a third one it’s like every five years I have to have hand surgery an I have osteoporosis I have.

        Dagenetic disc disease my hips hurt so bad that it’s very hard to get out of bed are just to walk the blood flow from my right hip an leg is only a 80% left hip is only 50% I’ve got plates and pins and screws in my back and I got a cage and a plate in my throat where they replaced 3 disc with donor bone and many more things that would take all day two list so people like me an others on this site doesn’t need the Federal government are DEA that needs to be checking on them selfs to see if there’s any corruption in there offices in stead of the law biting Americans that are in great pain that we can’t even live a normal life because of horrible pain we have everyday an now your trying to take the only thing that helps with the pain so we can be part of Society so please I’m asking you to not take what’s helping us to have somewhat of a life

  17. Pat

    There just has to be a very simple explanation why with all the claims
    of helping and healing in countless cases where even well known highly
    rated Physicians like Sanjay Gupta and Mehmet Oz, both have given
    shows on there changing opinions of ‘medical marajuana’!
    It stands to reason ‘big pharma’ is not going to let a Natural Plant rob
    them of the ‘Billions of dollars’ they consume from us all.
    Like when we lived during ‘prohibition’ how did they really stop all the
    crime and deaths? They legalized it! There will always be people who
    misuse whatever they can. But it would help and solve so many problems for so many. Who is preventing it?

  18. Edith Abrams
    Franklin, NC

    As long as a drug is under control, and in the phamacy hands, $signs is all over the place. I mean I think a $sign should have to be stamped on every prescription. Don’t know it many of you has ever heard of the cough syrup Cheratussin AC. Some time ago you could get it for $5, now sicne its went behind the counter and you have to sign for it all becuase its got a little dab of codiene in it. I paid $22.95 for a 4oz. bottle. I would have thrown it back if I hadn’t needed it so bad at the time for my hacking cough. Even a bank robber is not a big a thief as this.

    • Jane

      You hit the nail on the head. After all, the LOVE of money is the root of all evil (1 Tim 6:10). And where the money is, you’ll find Big Pharma.

      I’m totally convinced that Cannabis has many wonderful benefits we only know about 10% of right now. Too bad it’s got such stigma as it’s so much safer than doing alcohol…but our culture is all addicted to booze so there you go.

      We can grow our own medicine now in Colorado. I’m positive Big Pharma hates that idea!

      The only negative about have a Medical license for Cannabis in Colorado is…if you have that license you’ll never again get to buy another gun for self-protection or anything else. But…if you don’t have that Med license but use Marijuana 24/7 Recreationally…just to get high, then you can buy all the guns you want. Just another good example of the stupidity of our lawmakers.

    • Kara S.
      Scottsdale, AZ

      Big Pharna & Congress: we need to pressure our CongressMen/Women & Senators. Legislation & the DOJ are all that will change it!!!! VOTE for pro-Cannabis candidates!!! Even conservatives like me have CHANGED THEIR MINDS!!!

  19. Paul

    It works for many problems, the drug companies don’t want to see its use advanced because they don’t have their hooks into it yet, profits will go down!

  20. Gerry

    My problem is the smell. I am extremely sensitive to many odors, regular cigarettes are bad enough but marijuana I can smell 4 houses away. It bothers me to the point that I have to go inside my house to get away from it. Are there any studies on the effects of second hand marijuana smoke?

  21. Rose Marie

    My son has been diagnosed with a form of muscular dystrophy and medication he was taking upset his system so he decided to try medical marijuana. He has a medical prescription from his doctor and fortunate that he lives in a state that allows for medical marijuana. It gives him some relief.

  22. sam

    I am wondering if the Dr is aware of the studies GW Pharmaceuticals out of the UK is doing with Marijuana

  23. Karmel

    Medicinal Cannabis/Medical Marijuana has been known as a healing herb for thousands of years for animals and humans. In my student days I travelled through the Middle & Far East. Cannabis plants grow wild, tall and strong, often along the roadside I guess hence the name weed. It needs less water than other plants. Some say Kaneh Bosum is a gift of healing from God and there is mention of it in Xodus as same. The ancients used the oil – a base of olive, with Cannabis, cinnamon and myrhh all anti-inflamatories and infection prohibitive. Drawings of the leaf and plant on the walls of many temples as it was held in great esteem. I hear from many Cannabis Oil not smoked does heal auto immune disease, rheumatoid, fibromyalgia, MS by people who are lucky enough to have it their country. I keep hoping and praying my country Austalia will join most of the rest of the world in legalizing Medical Marijuana and let it begin its healing here. Grown to Standards not by criminals who mix with ice and other things.

  24. mickey
    Cincinnati, OH

    Hooray for Dr. Cassaret!

  25. Bonnie

    As a health professional and admittedly a user of medical marijuana in a tincture form, I have first hand experience to the efficacy of it. I have multiple lower back injuries, including herniated discs, spinal stenosis, arthritis, and degenerative discs. A doctor informed me a lot of this is genetic in nature – my twin brother is going through similar miseries. Also, an MVA in 2008 pretty much put me on the road to permanent back problems and pain. I now use a cane for support, but without the tincture, the neuro pain would be intolerable. NSAIDS upset my stomach, and narcotics are out of the question because of the terrible constipation they cause in addition to the slower bowel motility from nerve compression. Yes, I am a definite advocate for medical marijuana

  26. BobK

    Anyone suffering from a chronic pain condition should consider (and have available to them) all methods of relief. Drugs are drugs regardless if they are manufactured by a drug company or if grown in the fields. People pop down pills by the billions each day and think nothing of it but still have a stigma about potential pain relievers such as marijuana! Is this another case of the major drug companies down playing a natural cure for an illness because it would eat into their bottom line profits?

  27. Marianne

    It is incredibly effective to treat inflamed eyes-edema caused hard contact lens for keratoconus. In the past, even with a good fit, the old time GP lens were very uncomfortable. Current lens are much better. Great medicine but not that good for your lungs,

  28. Wayne
    St Augustine, FL

    Why is marijuana not distributed through pharmacies like other drugs? Most medical marijuana laws are just a cover or loophole for recreational use. Stoned is a good title for a book on medical marijuana.

  29. Steve Schott
    SLC, UT

    The title is misleading. Both my parents were on palliative care prior to their deaths a few years ago. In palliative care Schedule 1 drugs should be available. Our nurse visited at least 3 times a week. We went I’ve the med log and Scheduled meds were tightly accounted.
    Palliative care is in its own classification for treatments and were for life ending circumstances. Horrible title!

    • Donna
      Tampa FL

      It is not possible to get stoned on “medical” marijuana.
      If you are uninformed, it is best to keep your opinions to yourself. If you have never tried it, you have no basis for an opinion.

      • Jane

        You certainly can get stoned on “medical” marijuana. There’s no difference whatsoever in the cannabis flower they sell for medical or recreational use. The recreational users simply get the same medical benefits, but buying it recreationally is more expensive.

        You can buy 1:1 THC/CBD in the edibles like the gummies or tinctures or cookies, etc, so that you won’t get so high. You can use the cannabis oil in capsules and use as suppositories, by-passing the liver so you don’t get high at all. But…if you’re vaping/smoking it, yes…you will get high, you just need to control how much you inhale/ingest if you don’t want to be pretty stoned.

    • Anna
      Colorado Springs CO

      False. Medical marijuana laws are absolutely NOT just a “cover or loophole for recreational use. States like Colorado have extremely strict standards for the production, sale, & use if MMJ. Plants are tracked from seed to sale, licenses are harder to obtain than a driver’s license, access to dispensaries is more difficult than entering Fort Knox, limits on amounts one can purchase, strict labeling requirements, onerous training, background checking, & regulation of dispensary staff, strict zoning requirements, limits where it may be used, and of course, 20% tax – which ALL goes to fund schools. Everyone’s entitled to his opinion, but it’s wrong to make false statements based on myth and propaganda when one has a complete lack of factual information. Clearly you do mot live in a legal state of either type, so you do mot have accurate or first-hand knowledge.

  30. D Y

    Physicians try everything else. Why not medical Marijuana? I’m sure almost everyone has tried it for recreational activities. This is a game changer! Imagine the relief a person could get from debilitating painful problems.

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