Cannabis is often discussed as if it were a single drug with a single effect, but a new JAMA Patient Page emphasizes that the plant and its chemical components can influence the body in complex and sometimes contradictory ways. The patient-focused article explains the conditions for which cannabis and cannabinoids are used, the uncertainty surrounding many therapeutic claims, the risk of cannabis use disorder, and practical strategies intended to reduce harm. JAMA Network senior editors selected the article as a highlight, underscoring the continuing public health importance of cannabis as its medical and recreational use expands.
Cannabis contains dozens of biologically active compounds, including cannabinoids that interact with the body’s endocannabinoid system. This system helps regulate processes such as pain perception, mood, appetite, memory, sleep, and immune activity. The best-known plant cannabinoids are tetrahydrocannabinol, or THC, and cannabidiol, or CBD. THC can activate cannabinoid receptors in the brain and produce intoxication, altered perception, impaired coordination, and changes in memory. CBD does not produce the same intoxicating effect, but it can still influence biological pathways and may interact with prescription medicines.
The article distinguishes between cannabis products used under medical supervision and products consumed independently for symptoms such as pain, anxiety, insomnia, or nausea. Evidence for benefit varies substantially by condition, formulation, dose, and route of administration. A standardized pharmaceutical preparation is not equivalent to a commercially available edible, vape cartridge, tincture, or dried cannabis product. Differences in cannabinoid concentration, manufacturing quality, absorption, and labeling can lead to markedly different effects, making it difficult for consumers to predict how much THC or other compounds they are taking.
How cannabis enters the body is a major determinant of risk. Inhaled cannabis reaches the bloodstream rapidly, so effects can appear within minutes, but the intensity may be difficult to control. Edible products are absorbed more slowly and undergo metabolism in the liver, where THC is converted into compounds that can remain active for longer periods. The delayed onset can encourage people to consume additional amounts before the first dose has taken effect. This pattern increases the risk of severe intoxication, panic, confusion, vomiting, falls, and other adverse events.
Repeated cannabis use can also develop into cannabis use disorder, a condition characterized by impaired control over consumption despite harmful consequences. Warning signs may include using more cannabis than intended, unsuccessful attempts to cut down, spending substantial time obtaining or recovering from use, craving, and continuing to use despite problems at work, school, home, or in relationships. Some people experience withdrawal symptoms after reducing or stopping cannabis, including irritability, sleep disturbance, reduced appetite, restlessness, depressed mood, and strong urges to use again.
The likelihood of harm is not identical for everyone. Adolescents and young adults may be particularly vulnerable because the brain continues developing through early adulthood, especially in networks involved in decision-making, attention, learning, and impulse control. Frequent use, products with high THC concentrations, and a personal or family history of psychosis or substance use disorder may increase concern. Cannabis can also impair reaction time and judgment, making driving or operating machinery dangerous. Combining cannabis with alcohol or sedating medicines may intensify impairment.
Pregnancy and breastfeeding represent additional situations in which health professionals generally urge caution or avoidance. Cannabinoids can cross biological barriers, and exposure during development may carry risks that are not fully understood. Cannabis may also affect cardiovascular function, including heart rate and blood pressure, which could be important for people with cardiovascular disease. The article’s emphasis is not that every person who uses cannabis will experience serious harm, but that risk depends on dose, potency, frequency, age, health status, and the circumstances of use.
Harm reduction strategies focus on lowering exposure and preventing predictable injuries, even when a person is not ready or able to stop using cannabis. These strategies may include choosing products with lower THC concentrations, avoiding concentrates, taking small amounts, waiting sufficiently long before using more, and avoiding inhalation of smoke. People should not drive after using cannabis and should store products securely away from children and pets. Clear communication with clinicians is also important because cannabis may affect the action or metabolism of other medicines and can influence treatment decisions.
The JAMA Patient Page presents cannabis as a topic requiring informed, individualized discussion rather than simple approval or condemnation. Patients considering cannabis or cannabinoid products can benefit from reviewing the intended purpose, evidence of effectiveness, possible alternatives, interactions, and warning signs of problematic use with a qualified health professional. The article appears alongside a 2025 JAMA Review on the therapeutic use of cannabis and cannabinoids, reflecting the broader scientific effort to separate established medical applications from claims that remain uncertain. As access to cannabis products continues to grow, understanding both cannabinoid biology and real-world patterns of use will be essential to making safer decisions.
Subject of Research: Cannabis, cannabinoids, cannabis use disorder, risks of cannabis use, and harm reduction strategies.
News Publication Date: Not provided.
Web References: https://doi.org/10.1001/jama.2026.12754; JAMA Review, “Therapeutic Use of Cannabis and Cannabinoids”: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2025.19433
References: JAMA Patient Page, DOI: 10.1001/jama.2026.12754; JAMA Review, “Therapeutic Use of Cannabis and Cannabinoids” (2025).
Keywords: Cannabis, cannabinoids, medical treatments, risk factors, substance abuse, drug abuse.
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