Marijuana (cannabis): Good or bad?

According to the National Institutes of Health, people have used marijuana, or cannabis, to treat their ailments for at least 3,000 years. However, the Food and Drug Administration have not deemed cannabis safe or effective in the treatment of any medical condition, although cannabidiol, a substance that is present in cannabis, received approval in June 2018 as a treatment for some types of epilepsy.

 

This tension, between a widespread belief that cannabis is an effective treatment for a wide assortment of ailments and a lack of scientific knowledge on its effects, has been somewhat exacerbated in recent times by a drive toward legalisation.

 

Twenty-nine states in the USA plus the District of Columbia have now made cannabis available for medical — and, in some states, recreational — purposes.

 

A recent study published in the journal Addiction also found that use of cannabis is increasing sharply across the United States, although this rise may not be linked to the legalisation of cannabis in participating states. Nevertheless, this rise in use is prompting major public health concerns.

 

In this article, we look at the scientific evidence weighing the medical benefits of cannabis against its associated health risks in an attempt to answer this simple question: is cannabis good or bad?

 

What are the medical benefits of cannabis?

Over the years, research has yielded results to suggest that cannabis may be of benefit in the treatment of some conditions. These are listed below:

 

1.    Chronic pain

Last year, a large review from the National Academies of Sciences, Engineering, and Medicine assessed more than 10,000 scientific studies on the medical benefits and adverse effects of cannabis.

 

One area that the report looked closely at was the use of medical cannabis to treat chronic pain. Chronic pain is a leading cause of disability, affecting millions of people worldwide.

 

The review found that cannabis, or products containing cannabinoids — which are the active ingredients in cannabis, or other compounds that act on the same receptors in the brain as cannabis— are effective at relieving chronic pain.

 

2.    Alcoholism and drug addiction

Another comprehensive review of evidence, published last year in the journal Clinical Psychology Review, revealed that using cannabis may help people with alcohol or opioid dependencies to fight their addictions.

But this finding may be contentious; the National Academies of Sciences review suggests that cannabis use actually drives increased risk for abusing, and becoming dependent on, other substances.

Also, the more that someone uses cannabis, the more likely they are to develop a problem with using cannabis. Individuals who began using the drug at a young age are also known to be at increased risk of developing a problem with cannabis use.

 

3.    Depression, post-traumatic stress disorder, and social anxiety

The review published in Clinical Psychology Review assessed all published scientific literature that investigated the use of cannabis to treat symptoms of mental illness.

 

Its authors found some evidence supporting the use of cannabis to relieve depression and post-traumatic stress disorder symptoms.

That being said, they caution that cannabis is not an appropriate treatment for some other mental health conditions, such as bipolar disorder and psychosis.

The review indicates that there is some evidence to suggest that cannabis might alleviate symptoms of social anxiety, but again, this is contradicted by the National Academies of Sciences, Engineering, and Medicine review, which instead found that regular users of cannabis may actually be at increased risk of social anxiety.

 4.    Cancer

Evidence suggests that oral cannabinoids are effective against nausea and vomiting caused by chemotherapy, and some small studies have found that smoked cannabis may also help to alleviate these symptoms.

Some studies on cancer cells suggest that cannabinoids may either slow down the growth of or kill some types of cancer. However, early studies show that tested this hypothesis in humans revealed that although cannabinoids are a safe treatment, they are not effective at controlling or curing cancer.

 

5.    Multiple sclerosis

The short-term use of oral cannabinoids may improve symptoms of spasticity among people with multiple sclerosis, but the positive effects have been found to be modest.

 

6.    Epilepsy

In June 2018, the Food and Drug Administration (FDA) approved the use of a medication containing cannabidiol (CBD) to treat two rare, severe, and specific types of epilepsy — called Lennox-Gastaut syndrome and Dravet syndrome — that are difficult to control with other types of medication. This CBD-based drug is known as Epidiolex.

CBD is one of many substances that occurs in cannabis. It is not psychoactive. The drug for treating these conditions involves a purified form of CBD. The approval was based on the findings of research and clinical trials.

A study published in 2017 found that the use of CBD resulted in far fewer seizures among children with Dravet syndrome, compared with a placebo.

Dravet syndrome seizures are prolonged, repetitive, and potentially lethal. In fact, 1 in 5 children with Dravet syndrome do not reach the age of 20 years.

In the study, 120 children and teenagers with Dravet syndrome, all of whom were aged between 2 and 18, were randomly assigned to receive an oral CBD solution or a placebo for 14 weeks, along with their usual medication.

The researchers found that the children who received the CBD solution went from having around 12 seizures per month to an average of six seizures per month. Three children receiving CBD did not experience any seizures at all.

Children who received the placebo also saw a reduction in seizures, but this was slight — their average number of seizures went down from 15 each month before the study to 14 seizures per month during the study.

The researchers say that this 39 percent reduction in seizure occurrence provides strong evidence that the compound can help people living with Dravet syndrome, and that their paper has the first rigorous scientific data to demonstrate this.

However, the study also found a high rate of side effects linked to CBD. More than 9 in 10 of the children treated with CBD experienced side effects — most commonly vomiting, fatigue and fever.

The patient information leaflet for Epidiolex warns of side effects such as liver damage, sedation, and thoughts of suicide.

 

What are the health risks of cannabis?

At the other end of the spectrum is the plethora of studies that have found negative associations between cannabis use and health. They are listed below.

 

1.    Mental health problems

Daily cannabis use is believed to exacerbate existing symptoms of bipolar disorder among people who have this mental health problem. However, the National Academies of Sciences, Engineering, and Medicine report suggests that among people with no history of the condition, there is only limited evidence of a link between cannabis use and developing bipolar disorder.

Moderate evidence suggests that regular cannabis users are more likely to experience suicidal thoughts, and there is a small increased risk of depression among cannabis users.

Cannabis use is likely to increase risk of psychosis, including schizophrenia. But a curious finding among people with schizophrenia and other psychoses is that a history of cannabis use is linked with improved performance on tests assessing learning and memory.

2.    Testicular cancer

Although there is no evidence to suggest any link between using cannabis and an increased risk for most cancers, the National Academies of Sciences did find some evidence to suggest an increased risk for the slow-growing seminoma subtype of testicular cancer.

 3.    Respiratory disease

Regular cannabis smoking is linked to increased risk of chronic cough, but “it’s unclear” whether smoking cannabis worsens lung function or increases the risk of chronic obstructive pulmonary disease or asthma.

A 2014 study that explored the relationship between cannabis use and lung disease suggested that it was plausible that smoking cannabis could contribute to lung cancer, though it has been difficult to conclusively link the two.

The authors of that study — published in the journal Current Opinion in Pulmonary Medicine — conclude:

“There is unequivocal evidence that habitual or regular cannabis smoking is not harmless. A caution against regular heavy cannabis usage is prudent.”

“The medicinal use of cannabis is likely not harmful to lungs in low cumulative doses,” they add, “but the dose limit needs to be defined. Recreational use is not the same as medicinal use and should be discouraged.”

So, is cannabis good or bad for your health?

There is evidence that demonstrates both the harms and health benefits of cannabis. Yet despite the emergence over the past couple of years of very comprehensive, up-to-date reviews of the scientific studies evaluating the benefits and harms of the drug, it’s clear that more research is needed to fully determine the public health implications of rising cannabis use.

 

More research is needed to confirm the harms and benefits of cannabis use.

Many scientists and health bodies — including the American Cancer Society (ACS) — support the need for further scientific research on the use of cannabis and cannabinoids to treat medical conditions.

However, there is an obstacle to this: cannabis is classed as a Schedule I controlled substance by the Drug Enforcement Administration, which deters the study of cannabis and cannabinoids through its imposition of strict conditions on the researchers working in this area.

If you happen to live in a state where medical use of cannabis is legal, you and your doctor will need to carefully consider these factors and how they relate to your illness and health history before using this drug.

For instance, while there is some evidence to support the use for cannabis for pain relief, you should certainly avoid cannabis if you have a history of mental health problems.

Remember to always speak to your doctor before taking a new medicine.

 

Why You Should Stop Labelling Food Good and Bad

In mainstream discourse about food and nutrition, food is often put into binary categories of good and bad, healthy and unhealthy. This blog post discusses why you should stop labelling food good and bad and the harms of binary thinking around food.  

For many people who are first learning about intuitive eating, one of the stuck points is understanding how there can be no good or bad foods. It goes against everything they’ve been told about nutrition. They’ve heard so many scary messages about added sugars and carbs and processed foods and dairy, they believe surely there must be foods that are just flat out bad for you, right?

Categorising food as good and bad is incredibly normalised in how we talk about food in our culture. Foods are labelled as healthy and clean. There’s dairy free ice cream, guilt free mac and cheese and Future Life protein bars. Conversely, other foods get labelled as junk food, unhealthy or are just referred to as “crap.” It’s hard to have a discussion about nutrition where food isn’t being put into a hierarchy.

As normal as it is to label food as good or bad, putting food into these hierarchies is not only scientifically and nutritionally incorrect, it’s also harmful to our relationship with food too. Here’s why:

Why We should Stop Labeling Food Good and Bad

It confuses nutrition and health.

When we look at food in a more neutral way, one of the things we should discuss is how nutrition is different from health. When food gets labelled as good and bad or healthy and unhealthy, it’s based on the idea that “bad” foods have low or no nutrition and “good” foods are high in nutrients. While it is true that some foods contain very low amounts of vitamins, minerals, fiber and antioxidants, and that other foods are more nutrient-dense, that doesn’t mean these foods are healthy or unhealthy.

Health is much more complex than nutrition. It encompasses social, psychological and financial factors. For example, if someone was trying to eat only the most nutritious foods, but it meant that they were socially isolated, had to spend all of their time and money on food, and were stressing out about eating the “right” foods all the time, that wouldn’t be a very healthy way of eating. In this example, it might be healthier to choose food with less nutrients, but are more satisfying, budget-friendly, and allow flexibility when socializing.

The healthy choice isn’t always the most nutritious choice. Making healthy choices with food means considering other factors outside of nutrition, like mental/emotional, financial, and/or social needs.

Some “bad” foods are helpful in certain situations.

Different foods serve different purposes, and that includes foods that are often thought of as “bad.” For example, a runner might decide to use a gel packet during a race. These gel packets are simply sugar. They are not exactly nutritious, and yet they’re a really healthy choice for someone who needs a quick source of easily available energy to fuel a workout. Similarly, when someone is experiencing a low blood sugar, the rapidly available glucose in a soda or candy is a healthy choice for that situation.

Another example: for anyone reading this who has had a bad stomach bug or struggled with morning sickness during pregnancy, what were the foods that were most easily tolerated? Simple, starchy carbs – think ramen noodles, white toast, and saltines. While not necessarily nutrient-dense (although most of these are fortified so you are getting a nice dose of B vitamins and iron), these foods are perfect for giving your body the energy it needs for fighting off illness or nourishing a growing fetus when you’re not able to hold many things down.

Labeling Foods Good and Bad Ignores Individual Nutrition Needs

Mainstream nutrition discourse makes it seem like there is one “right” way to eat. One thing we need to stress with gentle nutrition is that nutrition needs are different from person to person based on many factors including (but not limited to) health history, genetics, and nutrition status. For example, almonds are a quintessential health food (hello “almond moms!”). They are packed with vitamin E, heart healthy monounsaturated fats, fiber, and phytonutrients. Almonds are a healthy food for most people to eat – but definitely not for someone who has a tree nut allergy!

OK, so that example might be a little too obvious for you, so let’s look at a less clear example. For many people with IBS, high fiber foods, especially raw fruits and vegetables, can trigger IBS symptoms. One might think of a snack with raw crudites and hummus as a healthy snack, and while it’s certainly nutritious, it’s not a healthy choice for someone if it causes intense abdominal pain and cramping.

Less nutritious doesn’t mean harmful.

There are certainly examples of foods that can cause harm when consumed. There’s some pretty horrifying stories about adulterated foods in the past. While today we have a much more tightly regulated and relatively safe food supply, there are still outbreaks of food-borne illnesses, sometimes because of shotty business and food safety practices, and sometimes because of plain old bad luck. There are also examples of foods that can cause harm for certain people when consumed in excess, like foods containing trans-fats. But the vast, vast majority of foods that get labeled “bad” aren’t actually harmful, they are simply less nutritious.

Labelling a food as “bad” sends the message that a food is categorically harmful to consume. While moderation with certain foods (a loaded term for sure, especially in non-diet spaces) might be useful in some circumstances, that doesn’t mean including it as part of an overall nutritious eating pattern is harmful or that a food is bad for everyone. Yes, even for sweets. Yes, even for soda. And yes, even for processed foods.

This might sound like semantics, but it’s actually pretty important. When a food is categorically labelled as “bad,” it sends the message that a food should be avoided completely. If avoidance is the goal, that doesn’t leave any space for talking about a food with nuance, or for figuring out how to engage with a food in a physically and mentally healthy way.

What if I Really and Truly Believe That a Food is Bad.

So, we're not debunking, reframing and adding context and nuance to every nutrition belief out there. Right now you are possibly thinking of at least one food that you are absolutely positive is flat out bad.

Let’s go with it and say you’re right. The food you’re thinking of is categorically, certifiably, trademarked BAD. Does labelling it as such actually help you engage with it in a healthy way? If it’s a food you like or are exposed to regularly, probably not. More likely, you’re still eating that food but in a chaotic, restrict-binge kind of way. And if you are one of the few that’s “successfully” avoiding the food, it’s likely creating quite a bit of stress and fear.

Remember, good nutrition is about the big picture of what you’re consuming over time, not micromanaging every meal and snack. You don’t need to consume a multivitamins worth of nutrition every time you eat. There’s space to include foods solely for pleasure, enjoyment, social connection and convenience.

Health benefits of fermented food

From improved gut health to boosted energy, nutrition editor Eve Kalinik takes a look at some of the key health benefits of fermented food...

Looking to spruce up your diet? Why not try adding some fermented foods to your diet? Not only will they spice up (or should we say, umami up) your pallet, they are also jam-packed full of endless health benefits. Some might say the health benefits of fermented foods are anecdotal, but humans have eaten them for millennia for their health-giving properties.

What are fermented foods?

Fermentation is where the ‘good bacteria’ in foods are encouraged to thrive. This leads to a change in both the flavour and shelf-life of the food in question – not to mention, the added health benefits.

Let’s look specifically at vegetables. All vegetables are covered in a good bacteria called lactobacillus. When you cut up and combine the veggies with salt, it forms a brine. This causes the lactoballilus to multiply, before breaking down the natural sugars and turning them into lactic acid.

This process creates the distinct, tangy flavour of fermented foods, alongside the necessary conditions required to keep bad bacteria at bay and preserve the food.

Some of the most popular fermented foods include sauerkraut, kimchi, kefir and kombucha. However, while these have only recently become trendy, people have used them globally for thousands of years, mainly for their numerous health benefits.

Our relationship with the microbial world

You could look at the health benefits of fermented foods as a demonstration of a long-standing give-and-take relationship with our microbial world. We feed microbes their preferred food, depending on the ferment, and they reciprocate by producing positive substances, which provide us with a range of health benefits.

7 health benefits of fermented foods

Below are some of the key health benefits of eating fermented foods…

 

1. Boost your energy levels and aid detoxification

When we feed our bodies with fermented foods, our microbes produce beneficial substances, including compounds such as organic acids that can help us by supporting energy, detoxification and the production of neurotransmitter chemicals that benefit both gut and brain.

2. Top up your vitamin levels

Fermented foods are higher in both concentration and absorption of certain vitamins and minerals, including vitamin B12, biotin, folic acid, calcium, magnesium, potassium and zinc. This means, not only will you be ingesting higher levels of these vitamins and minerals, but your body will also be able to more readily absorb and use them.

3. Fermentation makes proteins easier to digest

The fermentation process means that proteins are, to varying degrees, ‘pre-digested’. This includes casein in milk and gluten in bread, which can make them easier to digest and absorb.

This is why fermented dairy in cheese and yoghurt can often be better tolerated if someone has issues with straight-up milk, and why sourdough can be easier on the gut than non-fermented bread.

4. Feed your good bacteria with prebiotics

Fermented foods contain prebiotics. These have a positive feeding effect on our existing gut microbiota. Think of prebiotics as food or fertiliser for the trillions of good bacteria living in your gut. By feeding them, you’re giving your gut the best possible chance to thrive.

5. Fermented foods are essentially probiotics in food form

Unlike PREbiotics, which are food or fertiliser for live bacteria, PRObiotics refers to the live bacteria itself. By ingesting probiotics, you can diversify or restore your gut microbiome.

Did you know, fermented foods are essentially probiotics in food form? This means, when you eat or drink fermented foods, you’re ingesting a high source of gut-boosting microbes. Your gut will certainly thank you!

6. Our gut microbiota thrive in the acidic conditions from fermentation

In addition, fermentation increases lactic acid production, which makes it tricky for many other microbes to survive. Luckily the beneficial acid-loving bugs in our gut thrive in these acidic conditions, meaning they win out. This is a huge plus for our resident gut microbiota!

7. Eating fermented foods expands your tastes

Last, but by no means least, there is a depth of flavour in fermented foods, derived from their natural umami. Once you foray into fermentation, you’ll wonder why you didn’t start sooner. You’ll be amazed at how the simple addition of a spoonful of sauerkraut or kimchi can elevate the simplest of sarnies!

Have a superb week further, and remember... happy gut, happy mind! 

 

Dealing with conflict: how to assert yourself with confidence

Discover how to deal with conflict and assert yourself with confidence with these top tips from award-winning coach, Kim Morgan.

Award-winning coach, Kim Morgan, mentors a woman who wants to please her friend and her husband, avoids conflict and finds it difficult to assert herself. Discover her top tips on dealing with conflict healthily and how to assert yourself with confidence. These are her words...

Learning to spot manipulative behaviour

I first saw Caz* prior to the pandemic. I had a diary mix-up and arrived an hour late which I was mortified about and apologised profusely. Caz was not only understanding, but began taking the blame for my mistake. I wondered if this was a pattern in her life. 

Caz’s husband had urged her to have coaching because he believed she was being manipulated by a friend. ‘What do you think?’ I asked. She said she didn’t really know but I pressed her: ‘Why do you think your husband thinks you are being manipulated?’

‘He says I am easily influenced and my friend is pushy and powerful. He thinks she has persuaded me to do things I wouldn’t usually do. She just got divorced and wants to have a good time. I want to support her, so I have been going to parties and drinking with her. We’re going to Ibiza this year.’ ‘Did you want to do all those things?’ I asked. I expected Caz’s reply: ‘I don’t mind – she’s my friend. ’

It was clear Caz did not have a strong sense of her rights or needs. I remarked that her husband seemed to feel strongly about the situation. Caz suddenly became animated: ‘I don’t know which one of them is pushing me around. I feel torn. I try to keep everyone happy but they both want me to be a certain way. Maybe they are both pushing me around?’

The session came to an end at this point. In coaching, we sometimes call this the ‘door handle moment’ – when something significant is said in the last minute. I gave Caz some material to read about spotting the signs of manipulative behaviour before our next session.

Recognising a lack of assertiveness and difficulty dealing with conflict

Caz was visibly shaken. ‘I read the list you gave me and I recognised every sign of manipulative behaviour: being hurried and hassled; not having my boundaries respected; not considering my needs – only theirs; taking advantage of my good nature, my time, my money and my possessions; preying on my inability to say no; rewarding me if I do what they want and making me suffer if I don’t,’ she said woefully.

‘Who are you talking about?’ I asked gently. ‘Both of them – my friend and my husband. And there is a long list of others. I think I must walk around with a sign on my head reading “push me around – I won’t complain”.’ We talked about Caz’s lack of assertiveness and low self-confidence and how she always put her needs below the needs of others. It became clear that she hoped that if she kept being nice, people would eventually reciprocate.

She diffused herself with other people – she became what they wanted her to be and had no clear boundaries or sense of self. ‘Manipulative and controlling people spot me as an easy target. I am really unhappy, actually,’ said Caz. It was another ‘door handle moment’ and a sign of progress. For the first time, Caz expressed how she felt.

Learning how to assert yourself and deal with conflict

We had many sessions because Caz had to unlearn a lifetime of people pleasing, fear of conflict and putting other people’s happiness before her own. She started to see that it was not only OK to get angry, but that anger serves a purpose – it signals to us that we are not being treated fairly and enables us to respond accordingly.

Caz had never been allowed to express negative emotions in childhood, which resulted in her having extreme anxiety about confrontation of any kind. In the safety of our sessions, we rehearsed showing anger and dealing with conflict.

I asked Caz what she had really wanted to say to me in our first session when I was late. It took a while but, eventually, Caz let me have it: ‘I couldn’t believe it! You kept me waiting for an hour. I was disappointed and you made me feel unimportant.’ We both laughed in celebration of this breakthrough. Caz was starting to take control of her choices and her life, dealing with conflict and learning that it’s okay to assert yourself.

How to assert yourself: 2 simple exercises

Get in touch with your authentic self

If you are easily influenced, pushed around or manipulated by others, consider this question: ‘When am I most true to myself?’ Take a pen and paper and think about the question in the following ways:

• Which people in my life allow me to just be me and do not pressurise me to change?
• When I am being true to myself, how do I choose to spend my time?
• What do I like to eat and drink? How do I like to dress?
• What causes or issues really matter to me?
• What are my opinions about films, books and politics?
• How would I choose to spend my time if I was a castaway on a desert island?

Consider how many of these things you currently do, and what you agree to do that you don’t want to do. What or who is stopping you from asserting your own needs, wants and rights? It’s time to learn how to assert yourself with confidence and be your true, authentic self.

Write your own fairy story

People who are easily manipulated tend to take the blame for being manipulated. They wonder how they can change to make things better and struggle to feel angry about how someone is treating them. By stepping outside your situation and acting as an observer, you may be able to see more clearly the parts that everyone is playing in your story. You may also be able find your anger and sense of injustice about how someone is manipulating you.

Here is a simple exercise to help you learn how to assert yourself and deal with conflict…

• If someone is ever treating you badly, try turning your situation into a fairy story. Include villains, victims, heroes, a happy ending and just deserts for the characters.
• Take time to write about what you are going through as if you were writing a classic tale with all the usual elements: villains and victims, knights on chargers, fairy godmothers, castles, dragons, battles and, of course, a conclusion with good triumphing over evil.
• Don’t stop to edit your story. Keep writing whatever pops into your head. Don’t feel bad about killing off villains – it’s only a story! After you have reread your story a couple of times, ask yourself:

1. How close is my story to the truth?
2. What did I learn from my character in the story?
3. How similar are the characters to the real people?
4. What have I learned from this story?
5. What do I need to do now?