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MEDICAL YEAR
IN REVIEW

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of medical marijuana with different propor-
tions of various naturally occurring cannabi-
noids (primarily THC and cannabidiol
[CBD]) can be chosen to minimize its psy-
choactive effects.
Medical marijuana laws appear to have
contributed to increased prevalence of il-
licit cannabis use and cannabis use disor-
ders; state-specific policy changes may also
have played a role. While medical mari-
juana may help, some cannabis-related
health consequences associated with
changes in state marijuana laws should re-
ceive consideration by health care profes-
sionals and the public. (ref 5-8)

Summary
In summary, this is an area where doc-
tors as lifelong learners will continue to
see new information but are awaiting evi-
dence-based recommendations. We will
likely take a back seat to dispensary “baris-
tas” and our patients’ experiences but
should keep eyes on the literature to man-
age abuse, treat overdosage and use of
adulterated products, and recommend
new therapies when available.

J.J. Seidenfeld, MD is board certified in Pul-
monary Disease and Internal Medicine and is a
member of the Bexar County Medical Society.

References
1. J Basic Clin Physiol Pharmacol 2016: Therapeutic Target. Kaur R , Ambwani US Adult Illicit Cannabis Use, Cannabis
27(3): 181-7. Cannabis- the Israeli Per- SR, Singh S. Department of Pharmacol- Use Disorder, and Medical Marijuana
spective. Mechoulam, R ogy, AIIMS, Jodhpur, Rajasthan, India. Laws 1991-1992 to 2012-2013 Deborah
2. CMAJ. 2019 August 19:191:E907-8 doi sidhurimple@yahoo.com. Abstract S. Hasin, PhD; Aaron L. Sarvet, MPH;
10.1503. Medical Cannabis: strengthen- 5. Epilepsia. 2014; 55(6):791-802. Doi:10- Magdalena Cerdá, DrPH; Katherine M.
ing evidence in the face of hype and 1111. Cannabidiol. Pharmacology and Keyes, PhD; Malka Stohl, MS; Sandro
public pressure. Fitzcharles, MA, Shir, potential role in epilepsy. Devinsky, O, Galea, MD, DrPH; Melanie M.Wall, PhD
Yoram, Hauser, Winfried Cilio MR, Cross, H et al Published online April 26, 2017.
3. Ann Med. 2016;48(3):128-41. doi: 6. Current Medical Diagnosis and Treat- 8. Cannabis | The Substance Abuse Hand-
10.3109/07853890.2016.1145794. Epub ment 2020. Maxine A. Papdakis and book, 2e | Pedro Ruiz and Eric C. Strain.
2016 Feb 25. Cannabinoids: Medical im- Stephen J. McPhee 15-02: Nausea & Chapter One
plications. Schrot RJ1,2, Hubbard JR3,4 Vomiting Kenneth R. McQuaid
4. Curr Clin Pharmacol. 2016;11(2):110-7. 7. JAMA Psychiatry. 2017;74(6):579-588.
Endocannabinoid System: A Multi-Facet doi:10.1001/jamapsychiatry.2017.0724

28 San Antonio Medicine • December 2019