Maybe you’ve got chronic back pain. Or you’re too nauseated by chemotherapy or pregnancy to keep food down. Or you suffer from insomnia. Should you try marijuana?
For the past two and a half years, Missourians interested in sampling cannabis for medicinal purposes have been able to do so legally. They’ve just needed to report a qualifying condition to a doctor and obtain a state-issued patient card. In 2023, those bureaucratic steps will no longer be necessary: Thanks to the recent passage of Amendment 3, anyone over 21 can now walk into a dispensary and buy the drug in its various forms—flower, edibles, tinctures, etc.—almost as easily as you can walk into a Walgreens and buy Tylenol.
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Yet Dr. Becky Lynn, an adjunct associate professor in Saint Louis University’s certificate program in Cannabis Science and Operations, cautions that before attempting to self-medicate, folks should consult a doctor who’s familiar with the drug.
Lynn herself learned about it by listening to patients. She’s now the CEO of Evora Women’s Health, a concierge-medicine practice in Creve Coeur she founded in 2020. For about two decades before that, she was an OB/GYN, most recently at SLU, where patients with certain sexual problems told her that cannabis seemed to help. She looked for high-quality published research but found little. “When you read opinion pieces, it’s either 100 percent anti- or pro-cannabis, and I think both are extreme,” she says. “It’s a medicine like every other medicine: It has risks, benefits, and side effects.”
As for risks, Lynn points to one in her own field: She cautions against medicinal cannabis for women who are pregnant or breastfeeding. A failure to eat because of nausea can cause its own problems—and cannabis is popularly known to relieve nausea—but Lynn says there’s not enough data to conclude that cannabis is safe for a fetus or newborn.
Another risk, according to a series of reports issued in 2021 by a task force of the International Association for the Study of Pain (IASP), is that cannabis impairs driving and can cause car wrecks. The task force also mentioned a “particularly concerning” association between cannabis use and psychosis but noted that “the most common acute adverse effects are panic attacks and other forms of anxiety, mostly reported by naive users” who take too much then recover once the drug wears off.
But Lynn, who teaches a course in the SLU certificate program titled “Pharmacological Properties of Cannabis,” emphasizes the difference between heavy use and medical use. “The goal [of medical use] is not to get high,” she says. “The goal is to use the lowest dose necessary to treat the symptom.” Lynn never recommends smoking. Tinctures—drops left under the tongue—are quickly absorbed by the body, but Lynn warns folks to be patient with edibles, which can take a while to kick in.
Like other drugs, cannabis can also have unwelcome side effects. For example, Matthew Walker, a sleep expert at the University of California, Berkeley, has observed that while the plant’s psychoactive ingredient, THC, can help you fall asleep, it also interferes with quality REM sleep. So by solving one problem, you’ve triggered another.
Cannabis shows the most potential, Lynn believes, as a treatment for pain. The IASP found that existing research offers “substantial evidence” that cannabinoids “hold considerable promise for analgesic drug development,” but also that the journey ahead is “not to be underestimated.” Says Lynn: “We’re so at the tip of the iceberg of knowledge. We need more research.”
