Research Supports Cannabis Use for Specific Disease States | APhA 2025
Kari Franson, PharmD, PhD, BCPP, senior associate dean for academic and student affairs and professor of clinical pharmacy at the University of Southern California, discusses the risks associated with cannabis use.
The FDA's recent literature review reveals nuanced insights into cannabis's therapeutic potential across various medical conditions. While the research supports cannabis use for specific scenarios like anorexia secondary to HIV or cancer, nausea and vomiting from chemotherapy, and neuropathic pain, it also highlights significant limitations, according to Kari Franson, PharmD, PhD, BCPP, senior associate dean for academic and student affairs and professor of clinical pharmacy at the University of Southern California.
Neuropathic pain treatment shows moderate relief using THC-type cannabis at doses between 2 and 10 milligrams, though it's not recommended for acute pain management due to potential complications. Franson emphasizes the complex pharmacological profile of cannabis, particularly distinguishing between THC and CBD types. THC-type cannabis can produce notable adverse effects, including increased heart rate, dizziness, euphoria, and potential anxiety or panic attacks. CBD-type cannabis generally demonstrates better tolerance at lower doses, with minimal adverse effects. However, long-term use of THC-type cannabis raises substantial concerns, including potential development of cannabis use disorder, cannabis hyperemesis syndrome, decreased sperm count in males, and increased risks of psychosis and depression.
Most critically, the research unveils significant cardiovascular and mental health risks associated with cannabis use. Epidemiological data indicates nearly 50% increased risk of myocardial infarction, 2-fold stroke risk, and small increases in arrhythmias. Mental health considerations are particularly nuanced, with heightened risks for individuals with pre-existing substance use disorders, depression, or anxiety.
A particularly alarming finding involves patients with major depressive disorder using cannabis: while providing temporary symptomatic relief, long-term use can paradoxically worsen underlying depression, creating a potentially dangerous reinforcement cycle. Franson underscores the importance of health care providers carefully evaluating individual patient contexts, monitoring long-term cannabis use, and maintaining a cautious, informed approach to its therapeutic application.
"Let's say [a patient] got depressed; they would utilize cannabis, and if they smoked it, 20 minutes later, they're feeling better, right?" Franson said. "What [researchers] found is, over the months that they were following these patients, that their baseline symptoms continued to decline over time."
