"A couple of products were supposed to contain 100 milligrams of THC but had only two to three [milligrams]," says lead author Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University. "That was striking -- these were not cheap products and were being sold as medicine."
Currently, 23 states and Washington, D.C., have laws legalizing marijuana for medical purposes. Four states and D.C. allow legal recreational use of cannabis. Some laws are broader than others, and qualifications for medical marijuana vary as well.
The rush to legalize medical marijuana tends to obscure the fact that it's not clear if medical marijuana has any therapeutic benefits at all. A review of studies on the topic, also published in Tuesday's JAMA, found "moderate" evidence that cannabinoids help with chronic pain and spasticity. But the researchers found little evidence that they help with nausea and vomiting due to chemotherapy, weight gain in people with HIV, sleep disorders and Tourette syndrome. About one third of people in the studies reported side effects ranging from probably OK (euphoria) to distressing (vomiting, dizziness, hallucinations.)
Does this mean all the cannabis-infused tea that you've been drinking doesn't help your anxiety disorder at all? It's really impossible to say. There's just not enough scientific evidence to prove that it does work, or to tell us how much THC is needed to treat a certain condition.
For the people who are using medical marijuana to treat illnesses, the population affected by mislabeling is not small: An estimated 16 to 23 percent of medical cannabis patients consume edible products, according to the Vandrey study. Losing out on potential benefits is one thing, but potential overdosing poses a much bigger threat, especially when it comes to edibles. Undesirable side effects such as decreased short-term memory, panic, paranoia and even acute psychosis are possible, and the risk increases with higher dosages.
In the natural cannabis plant there is a ceiling amount of THC, but edibles can contain much more. A pot-infused brownie with over 1,200 milligrams of THC can look the same as the brownie with only 50 milligrams of THC.
Marijuana product testing, as Shots has previously reported, is a fairly new phenomenon. Oversight and regulations for testing medicinal cannabis vary from state to state.
Colorado mandated potency testing for marijuana edibles last May, but the rule applies only to edibles for recreational purposes.
As a result, labels for recreational marijuana are getting better at accurately stating THC content, according to Ian Barringer, owner of RM3 Labs in Denver, Colo. Products for both medicinal and recreational uses came in much weaker than labeled in earlier years, Barringer says, but most of the products the lab tests now fall within the acceptable range of 20 percent plus or minus the labeled THC content displayed on the label.
And starting in July 2016, Colorado will require independent testing and certification for medical marijuana and infused products containing medical marijuana, according to a bill approved and signed by Gov. John Hickenlooper on May 29. The state of Washington followed suit, requiring testing for THC and CBD levels, accurate labels and child-resistant packaging specifically for medical marijuana.
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