D61: Potential Risks and Side Effects of Medical Cannabis

Potential Benefits, Risks, and Side Effects of Medical Cannabis

The medical use of cannabis has elicited much attention due to its broad therapeutic potential along with a set of associated risks and side effects. The most prevalent cannabinoids—THC and CBD—have different risk-benefit profiles that vary among individuals due to genetic, metabolic, and other factors.

Categories and Specific Types of Benefits:

  1. Anti-Inflammatory: Beneficial for conditions like Crohn’s disease and psoriasis (1).
  2. Anxiety Relief: Proven to be effective for generalized anxiety disorder (2).
  3. Seizure Control: Especially useful in drug-resistant epilepsy in children (3).
  1. Pain Management: Effective for chronic pain relief (4).
  2. Appetite Stimulant: Beneficial for cancer patients undergoing chemotherapy (5).
  3. Anti-Emetic: Helps in controlling nausea and vomiting (6).

Categories and Specific Types of Risks:

Common Risks:
  1. Memory Impairment: Generally temporary but concerning for adolescents (7).
  2. Dry Mouth: Common but not serious (8).
  3. Coordination Issues: Risk of accidents, especially if operating machinery (9).
Rare Risks:
  1. Psychotic Episodes: Especially in predisposed individuals.
  2. Cardiovascular Effects: Tachycardia, palpitations.

Comparison Tables:

CBD Benefits:

Anti-InflammatoryCommonTemporaryModerateMay reduce symptoms in conditions like Crohn’s and arthritis (1).
Anxiety ReliefCommonTemporaryModerateDemonstrates anxiolytic effects in GAD and PTSD (2).
Seizure ControlLess CommonPermanentHighEffective in drug-resistant epilepsy, especially in children (3).
NeuroprotectiveLess CommonPermanentModeratePotential for protecting neurons in conditions like Alzheimer’s (4).
Anti-OxidantLess CommonTemporaryLowMay combat oxidative stress (5).

THC Benefits:

Pain ManagementVery CommonTemporaryModerateUseful for chronic pain relief including neuropathic pain (6).
Appetite StimulantCommonTemporaryLowBeneficial for patients suffering from loss of appetite (7).
Anti-EmeticCommonTemporaryModerateControls nausea and vomiting, often related to chemotherapy (8).
Mood ElevationCommonTemporaryLowMay boost mood in controlled settings (9).
Sleep AidLess CommonTemporaryLowMay aid in sleep disorders like insomnia (10).

Common Risks and Side Effects:

Memory ImpairmentCommonTemporaryModerateCould affect cognitive function (11).
Dry MouthVery CommonTemporaryLowIncreased thirst and dry oral conditions (12).
Coordination IssuesCommonTemporaryModerateIncreases the risk of accidents (13).
Increased Heart RateCommonTemporaryModerateMay increase tachycardia (14).
Red EyesCommonTemporaryLowCommon but generally harmless (15).

Rare Risks and Side Effects:

Psychotic EpisodesRareTemporaryHighHigh doses may trigger in predisposed individuals (16).
Cardiovascular IssuesRareTemporaryHighMay increase heart rate excessively, concern for heart patients (17).
DependencyRarePermanentModerateIn heavy, prolonged use (18).
Liver ToxicityRarePermanentHighIn extremely high doses (19).
Allergic ReactionRareTemporaryModerateSome people may be allergic to cannabis compounds (20).


  1. Kafil, T. S., et al. “CBD in Inflammatory Bowel Diseases: A Brief Overview.” Phytotherapy Research (2018): 1770-1773.
  2. Blessing, E. M., et al. “Cannabidiol as a Potential Treatment for Anxiety Disorders.” Neurotherapeutics (2015): 825-836.
  3. Devinsky, O., et al. “Cannabidiol in Patients with Treatment-Resistant Epilepsy.” The Lancet Neurology (2016): 270-278.
  4. Lynch, M. E., et al. “Cannabinoids for Treatment of Chronic Non-Cancer Pain.” British Journal of Clinical Pharmacology (2011): 735-744.
  5. Walsh, D., et al. “Cannabis for Therapeutic Purposes.” CMAJ (2010): E72.
  6. Parker, L. A., et al. “Cannabis and Nausea.” Psychopharmacology (2011): 571-579.
  7. Schweinsburg, A. D., et al. “Effects of Alcohol and Cannabis on Adolescent Brain Development.” Neuropsychology (2011): 609.
  8. Abrams, D. I., et al. “Cannabinoid-Opioid Interaction in Chronic Pain.” Clinical Pharmacology & Therapeutics (2011): 844-851.
  9. Ramaekers, J. G., et al. “Cannabis and Tolerance.” Neuropsychopharmacology (2011): 229.
  10. Kafil, T. S., et al. Phytotherapy Research, 2018.
  11. Blessing, E. M., et al. Neurotherapeutics, 2015.
  12. Devinsky, O., et al. The Lancet Neurology, 2016.
  13. Hampson, A. J., et al. Annals of the New York Academy of Sciences, 2000.
  14. Burstein, S. Anti-inflammatory potential of CB1-mediated cAMP elevation in mast cells. Biochem Pharmacol, 2018.
  15. Lynch, M. E., et al. British Journal of Clinical Pharmacology, 2011.
  16. Walsh, D., et al. CMAJ, 2010.
  17. Parker, L. A., et al. Psychopharmacology, 2011.
  18. Sarris, J., et al. Journal of Affective Disorders, 2012.
  19. Babson, K. A., et al. Substance Abuse, 2017.
  20. Schweinsburg, A. D., et al. Neuropsychology, 2011.
  21. Abrams, D. I., et al. Clinical Pharmacology & Therapeutics, 2011.
  22. Ramaekers, J. G., et al. Neuropsychopharmacology, 2011.
  23. Gorelick, D. A., et al. J Clin Pharmacol, 2006.
  24. Tashkin, D. P., et al. Archives of Ophthalmology, 1984.
  25. Di Forti, M., et al. Lancet Psychiatry, 2019.
  26. Thomas, G., et al. J Clin Pharmacol, 2014.
  27. Budney, A. J., et al. Psychopharmacology, 2004.
  28. Ewing, L. E., et al. Molecules, 2019.
  29. Larramendi, C. H., et al. J Investig Allergol Clin Immunol, 2008.

Cautionary Note:

Individuals with the following medical illnesses and diagnoses should exercise caution when considering cannabinoid therapies and contact Dr. Caplan at CED Clinic for expert guidance:

  • Cardiovascular Diseases
  • Psychiatric Disorders like Schizophrenia
  • Liver Disease

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Cover of The Doctor-Approved Cannabis Handbook featuring a green medical plus symbol
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