When Medical Cannabis May Not Be Right for You

Sometimes the most caring answer to "Should I try medical cannabis?" is "not right now" or "not for you." That can be hard to hear, especially after months or years of feeling unwell. This guide explains the situations where cannabis may carry more risk than benefit, so you know what to expect and why.

Why a Clinician May Say No

A medical cannabis evaluation is a full medical visit. Dr. Charlotte Ewals looks at your diagnosis, records, medicines and health history before she decides whether a written certification is appropriate. A no is not a verdict on you or on how much you hurt. It means that, for now, the risks look larger than the likely benefit, or that more information is needed.

Many of the concerns below are not absolute. Some mean "wait," some mean "be very careful," and some mean "this is probably not a safe choice for you." Being open about your history, even the parts that feel awkward, helps the clinician give you an honest answer.

If the answer is no, you should still leave with something useful. That may be a clear explanation, a suggestion to talk with your primary care provider or a specialist, ideas for other treatments to ask about, or an invitation to come back if your situation changes. You are always free to ask why, and to ask what would need to be different for the answer to change.

Pregnancy and Breastfeeding

The CDC says cannabis use during pregnancy may affect a baby's development and raise the risk of pregnancy complications, however it is used. That includes smoking, vaping, edibles and creams. The National Institute on Drug Abuse (NIDA) notes links to lower birth weight and preterm birth.

Breastfeeding matters too. The CDC explains that THC is stored in body fat and released slowly, so a baby may still be exposed after a parent stops using. If you are pregnant, trying to become pregnant or breastfeeding, tell the clinician. Expect a conversation about other ways to manage your symptoms.

Psychosis and Mental Health History

The CDC's page on cannabis and mental health says people who use cannabis are more likely to develop psychosis, which means losing touch with what is real, with hallucinations or paranoia. The link with schizophrenia is stronger in people who start young and use more often. NIDA adds that heavy use is associated with earlier onset of psychosis in people with genetic risk, and that high doses can cause short-term psychotic episodes.

That is why the clinician will ask about your own history and your family's. A parent, brother, sister or child with schizophrenia or another psychotic illness is important to mention. The CDC also lists links between cannabis and depression, social anxiety and suicidal thoughts, so share any history of these as well.

Young People, Heart Conditions and CHS

Young people. NIDA reports that regular heavy use in adolescence is linked to problems with memory, processing speed and school performance, and that starting early raises the chance of cannabis use disorder later. For teens and young adults, the clinician will weigh these risks carefully. State programs also have their own rules for minors.

Heart conditions. The CDC's page on cannabis and heart health says cannabis can make the heart beat faster and raise blood pressure right after use, and could increase the risk of stroke and heart disease. More research is needed. If you have had a heart attack, stroke, irregular heartbeat or high blood pressure, say so.

Cannabinoid hyperemesis syndrome (CHS). NIDA describes CHS as nausea, vomiting and belly pain after long-term, heavy cannabis use, which only resolves when a person stops using cannabis completely. If you already use cannabis and have had repeated bouts of vomiting, tell the clinician. Cannabis may be making things worse, not better.

Substance Use and Safety-Sensitive Work

The CDC says about 3 in 10 people who use cannabis have cannabis use disorder, meaning they struggle to stop even when it causes problems. Starting young and using often raise the risk. If you have had trouble with alcohol, cannabis or other drugs, or you are in recovery, it helps to say so. It does not automatically mean no, but it changes the conversation.

Your job matters too. Pilots, truck drivers, nurses, heavy equipment operators and others in safety-sensitive roles may face strict rules and drug testing. Read our guide to medical cannabis, driving, work and drug tests before your visit.

Before your evaluation, be ready to share:

• Whether you are pregnant, planning a pregnancy or breastfeeding.
• Any history of psychosis, hallucinations, schizophrenia or other serious mental illness.
• The same history in a parent, brother, sister or child.
• Heart problems, including heart attack, stroke, irregular heartbeat or high blood pressure.
• Past or current problems with alcohol, cannabis or other drugs.
• Any repeated vomiting while using cannabis.
• Your job, especially if it is safety-sensitive or involves drug testing.
• Your full medication list, including supplements.

Next Steps

Read about cannabis and medication interactions and what your first visit looks like. You can also learn more about our medical cannabis evaluations, or call (218) 274-4500 to talk through whether a visit makes sense before you book.