When it comes to medical cannabis, it can be difficult to sift through a century of misinformation and find the truths about what this drug is, how it works, and what it's role should be in an evidence-based health care system. As always, finding good answers is all about asking the right questions.

Is it safe?

With any medication, the question of safety should be central. Many drugs, like opioids, which have long histories of prescription in Canada come with serious safety concerns that the medical system must mitigate. Compared to other medications as a whole, cannabis is an extremely safe drug. “It's far safer than the other options,” says pain and addiction specialist Dr. Lionel Marks de Chabris. “No one has ever found a lethal dose of cannabis. And the risk of addiction is high in youths, low in middle age and negligible in seniors. Another way of saying it? The risk of addiction is about the same as caffeine…”

Is it legal?

Cannabis is legal for medical use across Canada if you have a prescription and purchase it from a licensed provider (or grow it yourself with a license). Much broader legalization of cannabis for non-medical use also appears to be on the horizon, but you should always consult with your health care provider if you are considering it for therapeutic purposes.

How does it work?

Cannabis is a complex plant made up of over 600 compounds, but the two compounds medical experts are most interested in are THC and CBD, both cannabinoids. These compounds work on the body's endocannabinoid system, a recently discovered and widely researched part of our nervous system that reacts to cannabinoids the body produces itself for purposes related to stress response, pain management, appetite control, and memory.

Does it need to be smoked?

Medical cannabis can be smoked, but doctors advise vaporizing it or taking it orally as an oil, delivery methods that negate health concerns related to smoking any substance. “When you vaporize cannabis, you release the THC and CBD without combustion, which means that it has no effect on the respiratory system and you don't get the carcinogens that you do from smoking,” explains pharmacist Michael Kani. “Taking oils orally is also good because it's the best way to really dose yourself accurately. The main benefit of inhalation through vaporization is that it kicks in within seconds to minutes, which can be important for pain. When taken orally, cannabis can take an hour to an hour and a half to kick in, but then it lasts a lot longer.”

Is it effective?

As Dr. Marks de Chabris succinctly puts it: “Every therapy for every patient is a trial.” Medical cannabis, like any medication, isn't guaranteed to work for everyone. But many patients have found it to be a very effective therapy, and the scientific evidence is continuing to accumulate every day. For some patients, medical cannabis early in their treatment regimen provides an effective alternative to more dangerous medications like opioids. For others, cannabis gives them their lives back when all other treatment options have been exhausted. While research continues to investigate the optimal use of cannabis and the full spectrum of conditions for which it can be beneficial, the medical consensus is very much agreed on one thing: cannabis is a valuable tool in the therapeutic toolbox.