Medical cannabis is neither a miracle nor a hoax. There is a short list of indications with genuine trial evidence, a longer list where the evidence is thin, and a very long list of claims made by people selling something. Here is that sorting, done honestly.
Educational summary only, not medical advice, and not a treatment recommendation. Cannabis interacts with common medicines and is not appropriate for everyone. Discuss any treatment with a qualified clinician.
A short list. These are indications where purified pharmaceutical cannabinoids have been tested in randomised controlled trials and approved by medicines regulators in at least one major jurisdiction.
Purified CBD reduced seizure frequency in multiple randomised trials, and is licensed for these rare childhood epilepsies in the US, UK and EU.
This is a specific pharmaceutical product at controlled doses, not a retail CBD oil.
Added to the same product's licensed indications on the strength of a further randomised trial.
Prescribed by specialists, with monitoring for liver effects and drug interactions.
Synthetic THC analogues have been licensed for decades where standard antiemetics fail.
Newer antiemetics outperform them for most patients, so this is a second or third line option.
A standardised THC and CBD oromucosal spray is approved in several countries for spasticity not controlled by other treatment.
Benefit is modest on average and clearest in a subgroup that responds within a short trial period.
Classical formulations containing cannabis leaf are manufactured and sold legally under AYUSH regulation, since the leaf sits outside the NDPS definition. They are the most accessible legal route, and the least characterised: cannabinoid content is generally not standardised or stated.
Government institutes and licensed partners have begun controlled cultivation and clinical work, notably in cancer pain and palliative care. This is the route through which anything reliable will eventually reach Indian patients.
Widely sold online with confident claims and no meaningful content regulation. Independent testing worldwide routinely finds products far off their labels in both directions. Treat the label as marketing until a certificate of analysis says otherwise.
Common, illegal, and unmeasured. Patients treating pain or nausea with illicit-market cannabis are dosing an unlabelled product, usually without telling their doctor, which is precisely where interactions and misdiagnoses happen.
For nearly every condition cannabis is marketed for, a better-evidenced option exists. Cannabinoids are usually a later line, not a first.
A product without a stated cannabinoid content cannot be dosed, and cannot be evaluated. Ask for a certificate of analysis and treat its absence as an answer.
CBD affects liver enzymes that process many common drugs, including some anti-epileptics and anticoagulants. This is a real interaction risk, not a technicality.
Adolescence, pregnancy, breastfeeding, and a personal or family history of psychosis or bipolar disorder are where the evidence for harm is strongest.
Illegality makes patients hide this, and hidden use is how avoidable harm happens. A clinician who knows can adjust around it, whatever the law says.