Medical marijuana is no longer a novelty: In fact, physical therapists (PTs) in half the United States may be treating patients who use the drug, says Charles D. Ciccone, PT, PhD, FAPTA, in a recent "Perspective" column published in Physical Therapy (PTJ), APTA's science journal.

The growing prevalence of medical marijuana means that PTs should be aware of the marijuana options available to their patients, potential benefits for certain conditions, and possible adverse effects on “cognition, coordination, balance, and cardiovascular and pulmonary function,” Ciccone writes.

The "Perspectives" article outlines methods of consumption (each has "benefits and drawbacks," Ciccone writes), the differences between THC and cannabidiol, the drug's positive effects on certain conditions, and links to possible negative effects, such as increased risk of stroke, myocardial infarction, and falls. Ciccone writes that it would be “unwise” for a PT to advise a patient on the use of marijuana; patients should always be referred to their physician for a consultation. But, he notes, “Patients and their caregivers may approach physical therapists with questions about medical marijuana,” so PTs should educate themselves about its potential effects on patient function.

Ciccone also writes about current barriers to research that could make a stronger case for or against the use of medical marijuana for particular conditions, not the least of which are federal regulations that aren't always sympatico with state laws. While some states may allow access to it, marijuana’s legal classification (in plant form) as a class I controlled substance (highest abuse potential) clouds the issue, making it difficult to conduct well-designed randomized controlled trials on its potential benefits, Ciccone observes. And despite pleas from the medical community, the FDA refuses to reclassify it—even though synthetic compounds are classified at a lower risk.

While still controversial, “medical marijuana continues to gain acceptance” for treating a variety of disorders, Ciccone concludes. While more research clearly needs to conducted, “clinicians must be aware of the potential side effects of medical marijuana” and “should be able to educate their patients about the current status of medical marijuana” and refer them to their physicians for more information.

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