By Jeff G. Konin

In my travels around the world and meeting with others who engage in a conversation about all things cannabis, I have found it difficult to meet individuals who portray a truly objective view about the benefits and risks of cannabis.  Simply put, there are those who are what I refer to as “Kool Aid Drinkers” whereby everything about every cannabinoid is good and is the next miracle potion to cure everything.  Then there are those who dig their heels in the ground and insist everything about cannabis – THC, CBD or any other derivative – is bad, very bad and so dangerous. I have been on this earth long enough to know that the truth to every two stories lies somewhere in between. And so, the real question surrounding the future of cannabinoid use is what cannabinoids, in isolate or in combination, in what dosage, produce what benefits and risks to what populations of people? A loaded question, nonetheless, to move forward in this space we can no longer group it as an all or none answer.

I recognize that most if not all of you reading this completely understand this approach and are likely shaking your head saying, “no kidding.” Yet there are many stakeholders and decision-makers who have not yet educated themselves to this concept whereby no different than any other pharmaceutical drug there are benefits and risks, indications and contraindications, and standard guidelines for application.

What will it take to experience a time in life where cannabis is understood by more people at a higher level of comprehension? Education? Scientific studies? Legislative changes? Patient-reported outcomes? Adverse events that clarify and/or validate the concerns of some? Successful disease management to support the claims of many?

It isn’t so easy to look at this with an objective lens when you compare cannabis to alcohol or tobacco.  We have tens of thousands of studies published on both alcohol and tobacco.  Can you point to any that have shown positive therapeutic benefits for either? You can certainly cite numerous studies that point toward adverse short and long-term effects on not only one’s own body but the potential public health harm to others for example with drunk driving.  Not to judge either, but both remain legal with little to no additional efforts being made to curtail such concerns from legislative or scientific action.  Could one argue that cannabis used in the form of medical marijuana, or other cannabinoids such as CBD, CBDA, CBN, etc., have shown to demonstrate promise for therapeutic effects?  And while the side effects may remain to be seen long-term in well-controlled studies, we could say that we are aware of short-term risks and concerns.  Are these any worse than what we know exists for alcohol and cigarettes?  You can be the judge as to where any differences may lie.

The first step is to understand and educate regarding the differences between THC-based products used for medicinal purposes with supervised physician management and dosage control and that of other cannabinoid products that interact beneficially with the endocannabinoid system in a way that alleviate one’s symptoms and bring a balance back to their functioning quality of life. Grouping “cannabis” as one is not a winning solution toward educating others and making progress.

Yes, THC used in super dosages with high frequency especially at a younger age and with no medical supervision poses great risks on many levels.  I have not met a person who disputes this in all my travels. Herein lies the argument for reclassifying all cannabinoids and supporting for controlled research and medicinal oversight with patient care that is not regulated solely from a political perspective but that carries more weight scientifically and clinically.

Individuals in the cannabis industry are made up of all types from those in agriculture, to botanists, to bankers and investors and entrepreneurs, to clinicians, and many more.  Believing in something is a passion of most but having the ability to demonstrate the efficacy beyond anecdotal “Ns of 1” that are found in our walks through life speaking to product users is something we all want.  In fact, with studies of all cannabis components we can better learn what works and what doesn’t, what poses risk and what doesn’t, what are ideal dosages, and how are recommendations (maybe someday prescriptions) determined.

Cannabis has taken a different pathway than most pharmaceutical interventions.  It has perhaps experienced more scrutiny than any other and has encountered the most debate and disagreement ranging from its effectiveness to one’s beliefs on the societal and social justice of where it stands.  It is long past due time to now factually address the important questions that may or may not change the quality of life for individuals regardless of what country or state border separates us.

To each person reading this, ask yourself what you can do to achieve step one of separating the conversation between medical cannabis and non-euphoric cannabinoids that contribute to therapeutic benefits. Where do you fall on adult-use of THC and any of the delta derivatives and is this helping or hurting the cause for healthcare advances in the cannabis space?

I propose the following steps in an effort to advance the conversation:

  • Create a classification nomenclature that separates euphoric versus non-euphoric cannabinoids
  • Assure the nomenclature differentiates between medicinal cannabis, over-the-counter cannabinoids, and adult-use cannabis
  • Standardize language throughout all research proposals to assure consistent knowledge of known risks, side effects, and concerns with any study being reviewed for approval
  • Establish a centralized agency within the deferral government that is responsible for all things cannabis and speaks with an objective, evidence-based voice absent political influence

This is just a start and many of you may have more ideas and suggestions, of which all are welcomed, and all will likely lead to changes in the near future.


Jeff G. Konin is a Clinical Professor in the Department of Athletic Training in the Nicole Wertheim College of Nursing and Health Sciences at Florida International University (FIU) where he directs the Global Initiative for Cannabinoid Research and Education. To learn more about FIU’s cannabinoid research and education initiative you can visit their website at Views represented in this column do not reflect that of Florida International University and are solely attributed to Dr. Jeff G. Konin.