Cannabis (Marijuana) and Cannabinoids

Is marijuana the same thing as cannabis?

People often use the words “cannabis” and “marijuana” interchangeably, but they don’t mean exactly the same thing.

• The word “cannabis” refers to all products derived from the plant Cannabis sativa.
• The cannabis plant contains about 540 chemical substances.
• The word “marijuana” refers to parts of or products from the plant Cannabis sativa that contain substantial amounts of tetrahydrocannabinol (THC). THC is the substance that’s primarily responsible for the effects of marijuana on a person’s mental state. Some cannabis plants contain very little THC. Under U.S. law, these plants are considered “industrial hemp” rather than marijuana.

Throughout the rest of this fact sheet, we use the term “cannabis” to refer to the plant Cannabis sativa.

What are cannabinoids?

Cannabinoids are a group of substances found in the cannabis plant.

What are the main cannabinoids?

The main cannabinoids are THC and cannabidiol (CBD).

How many cannabinoids are there?

Besides THC and CBD, more than 100 other cannabinoids have been identified.

 

Has the U.S. Food and Drug Administration (FDA) approved cannabis or cannabinoids for medical use?

The FDA has not approved the cannabis plant for any medical use. However, the FDA has approved several drugs that contain individual cannabinoids.

• Epidiolex, which contains a purified form of CBD derived from cannabis, was approved for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome, two rare and severe forms of epilepsy.
• Marinol and Syndros, which contain dronabinol (synthetic THC), and Cesamet, which contains nabilone (a synthetic substance similar to THC), are approved by the FDA. Dronabinol and nabilone are used to treat nausea and vomiting caused by cancer chemotherapy. Dronabinol is also used to treat loss of appetite and weight loss in people with HIV/AIDS.

Is it legal for dietary supplements or foods to contain THC or CBD?

The FDA has determined that products containing THC or CBD cannot be sold legally as dietary supplements. Foods to which THC or CBD has been added cannot be sold legally in interstate commerce. Whether they can be sold legally within a state depends on that state’s laws and regulations.

Are cannabis or cannabinoids helpful in treating health conditions?

Drugs containing cannabinoids may be helpful in treating certain rare forms of epilepsy, nausea and vomiting associated with cancer chemotherapy, and loss of appetite and weight loss associated with HIV/AIDS. In addition, some evidence suggests modest benefits of cannabis or cannabinoids for chronic pain and multiple sclerosis symptoms. Cannabis isn’t helpful for glaucoma. Research on cannabis or cannabinoids for other conditions is in its early stages.

The following sections summarize the research on cannabis or cannabinoids for specific health conditions.

Are cannabis and cannabinoids safe?

Several concerns have been raised about the safety of cannabis and cannabinoids:

• The use of cannabis has been linked to an increased risk of motor vehicle crashes.
• Smoking cannabis during pregnancy has been linked to lower birth weight.
• Some people who use cannabis develop cannabis use disorder, which has symptoms such as craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities.
• Adolescents using cannabis are four to seven times more likely than adults to develop cannabis use disorder.
• Cannabis use is associated with an increased risk of injury among older adults.
• The use of cannabis, especially frequent use, has been linked to a higher risk of developing schizophrenia or other psychoses (severe mental illnesses) in people who are predisposed to these illnesses.
• Marijuana may cause orthostatic hypotension (head rush or dizziness on standing up), possibly raising danger from fainting and falls.
• The FDA has warned the public not to use vaping products that contain THC. Products of this type have been implicated in many of the reported cases of serious lung injuries linked to vaping.
• There have been many reports of unintentional consumption of cannabis or its products by children, leading to illnesses severe enough to require emergency room treatment or admission to a hospital. Among a group of people who became ill after accidental exposure to candies containing THC, the children generally had more severe symptoms than the adults and needed to stay in the hospital longer.
• Some long-term users of high doses of cannabis have developed a condition involving recurrent severe vomiting.
• There have been reports of contamination of cannabis/cannabinoid products with microorganisms, pesticides, or other substances.
• Some cannabis/cannabinoid products contain amounts of cannabinoids that differ substantially from what’s stated on their labels.

Can CBD be harmful?

Unlike Epidiolex (the purified CBD product sold as an FDA-approved prescription drug), over-the-counter CBD products may contain more or less CBD than stated on their labels, and because of less rigorous regulatory oversight than prescription drugs, they may also contain contaminants, such as THC.

CBD may have side effects, including decreases in alertness, changes in mood, decreased appetite, and gastrointestinal symptoms such as diarrhea. CBD may also produce psychotic effects or cognitive impairment in people who also regularly use THC.

In addition, CBD use has been associated with liver injury, male reproductive harm, and interactions with other drugs. Some side effects, such as diarrhea, sleepiness, abnormalities on tests of liver function, and drug interactions, appear to be due to CBD itself rather than contaminants in CBD products; these effects were observed in some of the people who participated in studies of Epidiolex before its approval as a drug.

Research Funded by the National Center for Complementary and Integrative Health (NCCIH)

Several NCCIH-funded studies are investigating the potential pain-relieving properties and mechanisms of action of substances in cannabis, including minor cannabinoids (those other than THC) and terpenes (substances in cannabis that give the plant its strain-specific properties such as aroma and taste). The goal of these studies is to strengthen the evidence regarding cannabis components and whether they have potential roles in pain management.

NCCIH is also supporting other studies on cannabis and cannabinoids, including:

• An observational study of the effects of edible cannabis and its constituents on pain, inflammation, and thinking in people with chronic low-back pain.
• Studies to develop techniques to synthesize cannabinoids in yeast (which would cost less than obtaining them from the cannabis plant).
• Research to evaluate the relationship between cannabis smoking and type 2 diabetes.

More To Consider

• Don’t use cannabis or cannabinoids to postpone seeing a health care provider about a medical problem.
• Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions.