Scott Lentz As a cannabis epidemiologist with fifteen years of experience studying cannabis — and as a medical cannabis patient myself — I’ve spent a lot of time thinking about how science assesses and labels cannabis use. For medical patients, cannabis often replaces more harmful medications , reduces pain, and improves quality of life
It is also one of the few treatments shown to have a wide range of therapeutic effects , reducing the prescription cascade and polypharmacy often seen in individuals with comorbid conditions. Yet, when we use cannabis daily to manage symptoms, we’re at risk of being labeled with Cannabis Use Disorder (CUD ), a term that is deeply discriminatory when applied to legitimate medical use.
Why is it that patients who take prednisone, insulin, antidepressants, statins, glucagon-like peptide-1s and a myriad of other medications daily or regularly to manage chronic conditions don’t face the same scrutiny? They depend on those medications to function and live more normally and require continuous chronic use for their condition. And withdrawal, if possible, makes symptoms worse. Even after decades of experience, these "side effects" are rarely discussed as they are greatly outweighed by overall benefits.
Medical cannabis users like myself similarly depend on cannabis for improved quality of life. This double standard reflects a lingering stigma around cannabis that is overdue for change. Even when reviewing the literature on cannabis and examining NIH funding priorities for cannabis research, the overwhelming priority is on CUD. Daily Use Isn’t a Disorder
One of the criteria for Cannabis Use Disorder in the DSM-5 (the diagnostic manual for mental health conditions) is using cannabis in larger amounts or over a longer period than intended. But for medical patients, daily use is often prescribed or self-administered, just like any other medication. The goal isn’t recreational enjoyment but relief from debilitating symptoms. We need to rethink how the applicability of the symptoms of CUD as defined by the DSM-5 relate to medical cannabis users and the possibility that “ these criteria may not be the most suitable assessment of potential medical cannabis dependence ," according to […]
Rethinking Cannabis Use Disorder: A Harm Reduction Approach for Medical Patients
