Medical Marijuana: Clearing Away the Smoke

Igor Grant *, 1, J. Hampton Atkinson 1, 2, Ben Gouaux 1, Barth Wilsey 3
1 Center for Medicinal Cannabis Research; University of California, San Diego; San Diego, CA, USA
2 Psychiatry Service; VA San Diego Healthcare System; San Diego, CA, USA
3 Department of Physical Medicine and Rehabilitation; University of California, Davis; Sacramento, CA, USA

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© Igor Grant; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Psychiatry, School of Medicine; University of California San Diego, 9500 Gilman Drive; La Jolla, CA, 92093-0680; Tel: (858) 534-3652; Fax: (858) 534-7723; E-mail:


Recent advances in understanding of the mode of action of tetrahydrocannabinol and related cannabinoid in-gredients of marijuana, plus the accumulating anecdotal reports on potential medical benefits have spurred increasing re-search into possible medicinal uses of cannabis. Recent clinical trials with smoked and vaporized marijuana, as well as other botanical extracts indicate the likelihood that the cannabinoids can be useful in the management of neuropathic pain, spasticity due to multiple sclerosis, and possibly other indications. As with all medications, benefits and risks need to be weighed in recommending cannabis to patients. We present an algorithm that may be useful to physicians in determining whether cannabis might be recommended as a treatment in jurisdictions where such use is permitted.

Keywords: Cannabis, chronic pain, pain.