How to Use This Guide
Medical Patient Guide
Medical cannabis helps some people with some conditions, and the strength of the science varies a lot from one condition to the next. This guide tells you honestly what the research shows for each condition, so you and your practitioner can decide together whether cannabis is worth trying.
Qualifying Conditions
Conditions Table of Contents
Each entry lists the evidence for each symptom, what kind of product was studied, and how cannabis compares with standard treatment.
- ALS
- Alzheimer’s
- Anxiety
- Appetite
- Arthritis: osteoarthritis
- Arthritis: rheumatoid
- Autism
- Cancer
- Chronic pain
- Crohn’s and colitis
- Depression
- Endometriosis
- Epilepsy
- Fibromyalgia
- Glaucoma
- HIV/AIDS
- Huntington’s
- IBS
- Migraine
- Multiple sclerosis
- Muscular dystrophy
- Neuropathy
- Opioids
- Palliative care
- Parkinson’s
- PTSD
- Sleep
- Spinal cord injury
- Substance use
- Tourette syndrome
What the Evidence Ratings Mean
Medical cannabis is a treatment option, not a cure. It usually works best alongside your regular care, not in place of it. Never stop or change a prescribed medicine without talking to the clinician who prescribed it.
| Rating | What it means for you | |
| Strong |
Several good-quality studies agree, and in most cases there is an FDA-approved cannabinoid medicine for this use. |
|
| Moderate |
Good studies show a real but usually modest benefit for many patients. Results vary from person to person. |
|
|
Limited |
Some studies and patient reports are encouraging, but the research is small, mixed, or short-term. Worth discussing; not guaranteed |
|
| Not Established |
Research has not shown a benefit, or results so far have been negative. Cannabis may still ease related symptoms (such as sleep or appetite), but not the condition itself . |
These ratings were checked against the medical literature as of October 2026. Research in this field moves quickly , and we will update this guide as new studies are published.
This guide is for education only. It is not medical advice and does not replace a visit with a qualified health care practitioner
Conditions at a Glance
Cannabis rarely works the same way for every symptom of a condition. A product can help one symptom and do nothing for another , and the type of product and how you take it matter. This table breaks each condition down by symptom.
People differ, too, and genes are part of the reason. In one study , people with two copies of a common variant of the liver enzyme CYP2C9 had about three times more THC in their blood after the same oral dose, with a trend toward more sedation (Sachse-Seeboth 2009). A variant of the AKT1 gene has been linked to a higher risk of psychosis among cannabis users, especially with daily use (Di Forti 2012).
Personalized testing with EndoDNA. That is why NYSOM works with EndoDNA, a genetic testing company , to give patients who want it a more personalized starting point. From a cheek swab, or from results you already have from a service like 23andMe or Ancestry, EndoDNA ‘s accredited lab looks at hundreds of thousands of genetic markers tied to the endocannabinoid system and to how your body processes medicines. Your report covers about 60 traits, including:
- how quickly you are likely to break down THC and CBD
- medications you take that may interact with THC or CBD
- whether you may be more prone to side effects such as anxiety , a racing heart, or ,
- rarely , psychosis-like reactions
- traits related to sleep, mood, pain, and inflammation
We combine your EndoDNA results with your history , your medications, and how you actually respond, and a pharmacist reviews every recommendation. Genetic testing for cannabis is still being validated: the gene links come from published studies, but no trial has yet shown that choosing products by genetic results improves outcomes. Testing requires your written consent. NYSOM has a business partnership with EndoDNA.
What was Studied
| Condition | Symptom or goal | What was studied | Evidence | Bottom Line | |
| ALS | Muscle stiffness | THC/CBD mouth spray | Limited | One small trial showed less stiffness. | |
| ALS | Slowing the disease | — | Not established | No human evidence. | |
| Alzheimer’s | Agitation | Prescription THC capsules | Limited | Two trials, one published in 2026, showed calmer behavior. | |
| Alzheimer’s | Memory and progression | — | Not established | No evidence it protects memory. | |
| Anxiety | Social or performance anxiety | Oral CBD | Limited | Small trials show some benefit. | |
| Anxiety | Daily anxiety | THC | Limited | THC can make anxiety worse. | |
| Appetite | Weight loss with HIV/AIDS | Prescription THC (dronabinol) | Moderate | FDA-approved for this use. | |
| Appetite | Weight loss with cancer |
THC, cannabis | Not established | No reliable weight gain shown. | |
| Arthritis: osteoarthritis | Joint pain | Oral CBD | Not established | Three trials found no benefit over placebo. | |
| Arthritis: osteoarthritis | Joint pain in a small joint | Topical CBD cream | Limited | One small thumb trial was positive. More trials under way. | |
| Arthritis: rheumatoid | Joint pain | THC/CBD | Limited | Very small, short trials. | |
| Arthritis: rheumatoid | Joint damage | — | Not established | Keep your rheumatology medicines. | |
| Autism | Disruptive behavior | CBD-rich extract (20:1) | Limited | Mixed trial results. | |
| Autism | Core autism traits |
— | Not established | No evidence. | |
| Cancer | Treating the tumor | — | Not established | Experts advise against. | |
| Cancer | Chemotherapy nausea | Prescription THC; THC/CBD capsules | Strong | Helps when standard anti- nausea drugs are not enough. | |
| Cancer | Cancer pain | THC/CBD spray,THC | Not established | Not better than placebo in trials. | |
| Chronic pain | Nerve-related pain | THC or THC/CBD products | Moderate | Small to modest relief for some. | |
| Chronic pain | Chronic low back pain | Standardized THC extract (oral) | Moderate | Large 2025 trial showed modest but meaningful relief. | |
| Chronic pain | Any pain | CBD alone, swallowed | Not established | Trials mostly negative. | |
| Crohn’s and colitis | Pain, appetite, well-being | Inhaled cannabis, oils | Limited | Some patients feel better. | |
| Crohn’s and colitis | Healing the gut | — | Not established | No effect on inflammation shown. | |
| Depression | Low mood | — | Not established | No trials; heavy use linked to worse mood. | |
| Endometriosis | Pelvic pain | Inhaled THC, oral CBD | Not established | Trials could not enroll enough patients. | |
| Epilepsy | Lennox-Gastaut, Dravet, TSC | Prescription CBD (Epidiolex) | Strong | Many patients have seizures cut by half or more. | |
| Epilepsy | Other seizure types | Dispensary CBD or THC | Not established | Not studied the same way. | |
| Fibromyalgia | Pain and sleep | Nabilone, THC products | Limited | Mixed results. | |
| Glaucoma | Eye pressure | THC | Not established | Effect lasts only 3 to 4 hours. | |
| HIV/AIDS | Nerve pain | Inhaled cannabis | Moderate | About half got meaningful relief . | |
| Huntington’s | Involuntary movements | Nabilone; THC/CBD mouth spray | Limited | Mixed: one trial helped, one did not. | |
| IBS | Gut symptoms | — | Not established | No good trials. | |
| Migraine | Stopping an attack | Inhaled THC + CBD | Limited | One good trial was positive. | |
| Migraine | Stopping an attack | CBD alone | Not established | Did not help in that trial. | |
| Multiple sclerosis | Muscle stiffness (spasticity) | THC/CBD mouth spray | Strong | Approved in Canada and Europe. | |
| Multiple sclerosis | Nerve pain | Oral THC products | Moderate | Modest relief. | |
| Multiple sclerosis | Bladder, sleep | THC/CBD mouth spray | Limited | Early signals only. | |
| Muscular dystrophy | Stiffness (myotonia), pain | Oral THC/CBD oil | Limited | Six-patient case series only. | |
| Muscular dystrophy | Slowing muscle loss | — | Not established | Animal studies only. | |
| Neuropathy | Burning, tingling pain | THC-containing products | Moderate | Modest relief for some. | |
| Neuropathy | Foot and leg nerve pain | Topical CBD oil | Limited | One small positive trial. | |
| Opioids | Pain control compared with opioids | Standardized THC extract (back pain) | Limited | One trial: similar pain relief , much less constipation. | |
| Opioids | Lowering opioid dose | Various cannabis products | Limited | Patients report it; trials have not confirmed it. | |
| Opioids | Craving in opioid use disorder | Oral CBD | Limited | One small trial reduced craving and anxiety . | |
| Palliative care | Appetite and weight in cancer | THC, cannabis extract | Not established | Megestrol worked better in one trial. | |
| Parkinson’s | Tremor, movement, mood | CBD , THC | Not established |
Ten trials found no benefit. | |
| PTSD | Overall symptoms | Smoked cannabis, CBD | Not established | Trials negative. | |
| PTSD | Nightmares | Prescription THC (dronabinol, nabilone) | Moderate | A large 2026 trial found fewer, milder nightmares. | |
| Sleep | Insomnia on its own | THC, CBD | Limited | Mixed results. | |
| Sleep | Sleep broken by pain | THC-containing pain products | Moderate | Sleep improved in pain trials. | |
| Spinal cord injury | Muscle stiffness | Prescription THC, nabilone | Limited | Small trials showed less stiffness. | |
| Substance use | Cannabis use disorder | THC/CBD spray with counseling | Limited | Fewer days of use. | |
| Substance use | Opioid use disorder | Cannabis, CBD | Not established | Not a substitute for buprenorphine or methadone. | |
| Tourette syndrome |
Tics | Oral THC/CBD oil | Limited | One small trial showed fewer tics. |
Read the THC:CBD Ratio First
The ratio of THC to CBD matters more than anything else on the label. Most of the benefit and most of the side effects in trials track with the amount of THC.
| Product Type | Typical Ratio | Best supported for | Feels like |
| THC-dominant | THC much higher than CBD | Nausea, appetite, nerve pain, back pain, PTSD nightmares | Most likely to cause a high, dizziness, or anxiety |
| Balanced | About 1:1 | MS stiffness, nerve pain, migraine attacks, Tourette, rheumatoid arthritis pain | The high depends mainly on the THC dose |
| CBD-dominant | 10:1 to 20:1 CBD to THC, or more | Anxiety , prescription CBD for specific epilepsies | Little or no high |
| CBD only | No meaningful THC |
Topical use on a painful joint or nerve area | No high |
Swallowed CBD on its own has not relieved pain in controlled trials. If pain is the goal, products with some THC have the better evidence.
Minor Cannabinoids and Terpenes
Terpenes are the aroma compounds in cannabis. Products are often marketed by terpene or by “indica” and “sativa.” Large lab studies have shown the indica and sativa labels do not reliably predict what is in the product. Here is what human research shows so far:
| Compound | Common claim | What human studies show | Evidence |
| CBN | Sleep | In a 2024 placebo-controlled trial, 20 mg of CBN nightly for a week reduced nighttime awakenings and overall sleep disturbance. It did not help people fall asleep faster. Adding CBD did not improve results. |
Limited |
| CBG | Calm, focus | In a 2024 trial of 34 healthy adults, 20 mg of CBG reduced anxiety and stress and slightly improved memory, without impairment. | Limited |
| THCV | Blood sugar, appetite | In a 2016 trial of 62 people with type 2 diabetes, THCV lowered fasting blood sugar. Appetite and weight effects are unproven. | Limited |
| Limonene (citrus) | Mood, calm | In a 2024 Johns Hopkins study of 20 adults, inhaling limonene with THC reduced THC-caused anxiety and paranoia without blunting other THC effects. | Limited |
| Linalool (lavender) | Calm, sleep | Lavender oil capsules rich in linalool reduced anxiety in 5 trials. Cannabis contains far less linalool, and it has not been tested in cannabis. | Not established in cannabis |
| Eucalyptol (eucalyptus) | Breathing, inflammation | Capsules of eucalyptol, 200 mg three times a day, reduced COPD flare-ups and improved asthma control in trials. Cannabis contains only traces. | Not established in cannabis |
| Menthol (mint) | Topical pain relief | FDA recognizes menthol at 1.25% to 16% as an over-the-counter topical pain reliever . Many cannabis creams and balms add it. | Proven as a topical (non-cannabis) |
| Camphor | Topical pain relief | FDA recognizes camphor at 3% to 11% as an over- the-counter topical pain reliever . Often combined with menthol. | Proven as a topical (non-cannabis) |
| Myrcene (earthy) | Sedation, “couch lock” | No human trials. | Not established |
| Beta- caryophyllene (pepper) |
Inflammation, pain | Acts on CB2 receptors in the lab. No human pain trials. | Not established |
| CBDV, CBC, THCA | Seizures, inflammation, nausea | Lab and animal data only. CBDV failed in a large seizure trial. | Not established |
If a cannabis cream or balm contains menthol or camphor , part of the relief you feel may come from those ingredients. Check the label.
The Physician Reference has a full condition-by-compound table with sources. Full list: all 125 cannabinoids and about 55 terpenes, with what is proven and what is not, are in the Cannabinoids & Terpenes tab.
A 2024 review concluded that terpenes boosting the effects of cannabinoids, the “entourage effect,” remains unproven in people. Terpene profiles are a reasonable tiebreaker between two products with the same THC:CBD ratio. They should not be the main reason to choose a product.
Choosing a Form
- Fast relief for symptoms that come and go (migraine attack, breakthrough pain, nausea): inhaled flower , vaporized, or an under-the-tongue spray.
- Steady all-day or overnight control (chronic pain, spasticity , sleep): capsules or oils taken on a schedule.
- One or two painful joints or a small area of nerve pain: a topical, which puts very little into the bloodstream.
Using Cannabis Safely
Medical cannabis is generally well tolerated, but it is not risk-free. Knowing the risks helps you use it safely.
- Drowsiness, dizziness, or feeling unsteady
- Dry mouth and red eyes
- Faster heartbeat
- Trouble with short-term memory or concentration
- Anxiety or paranoia, mostly with higher THC doses
- Nausea, especially with edibles taken in large amounts
Most side effects ease as your body adjusts or when the dose is lowered.
- Stay in a safe, quiet place and sit or lie down.
- Drink water , and wait. The feeling passes as the THC wears off , usually within a few hours.
- Do not take more cannabis, and do not drive.
- Next time, use a lower THC dose or a product with less THC.
Call 911 or go to an emergency room for chest pain, trouble breathing, f ainting, seeing or hearing things that are not there, severe panic or paranoia that does not ease, or vomiting that will not stop.
Avoid cannabis in every form, not just smoking or vaping, while pregnant or breastfeeding. THC passes to the baby through the placenta and breast milk. Talk with your practitioner about other options.
- Are trying to become pregnant (if you are pregnant or breastfeeding, avoid cannabis in every form)
- Are under 25, because the brain is still developing
- Have had psychosis, schizophrenia, or bipolar disorder , or have a close relative who has
- Have heart disease, irregular heartbeat, or have had a stroke
- Are over 65 or prone to falls
- Have had a problem with alcohol or drug use
THC and CBD are processed by the same liver enzymes as many common medicines. They can raise or lower the levels of other drugs in your blood. Ask your practitioner or pharmacist before using cannabis if you take:
- Blood thinners such as warfarin
- Seizure medicines such as clobazam or valproate
- Transplant medicines such as tacrolimus
- Sleep aids, anxiety medicines, opioids, or other sedating drugs
Avoid mixing cannabis with alcohol. The combination increases impairment.
Large studies have linked frequent cannabis use with higher rates of heart attack and stroke, even in people who never smoked tobacco. The risk rises with daily use. If you have heart disease or risk factors, discuss this with your doctor.
Cannabis can be habit-forming. Studies estimate that about 1 in 4 people who use medical cannabis develop some degree of cannabis use disorder . Warning signs include needing more to get the same effect, trouble cutting back, and cravings.
Stopping after heavy use. People who use cannabis daily and stop suddenly can have irritability , trouble sleeping, low mood, and an upset stomach for a week or two. Tapering down gradually makes this easier .
Some long-term, frequent users develop repeated bouts of severe nausea and vomiting. People with this condition often find relief in hot showers. It usually goes away only after stopping cannabis.
- Do not drive or operate machinery while impaired. Impairment from edibles can last 6 hours or more.
- Keep all cannabis in its original child-resistant packaging, locked and out of reach. Edibles can look like ordinary candy .
- If a child or pet swallows cannabis, call Poison Control at 1-800-222-1222. Call 911 for trouble breathing, seizures, or unresponsiveness.
Smoking any plant material irritates the lungs, and heavy use can cause cough and bronchitis-like symptoms. If you inhale cannabis, vaporized flower or a regulated vape at a lower temperature is gentler . Very hot “dabbing” of concentrates breaks terpenes down into irritating chemicals.
A 2019 outbreak of serious lung injuries was linked mostly to unregulated THC vape cartridges, with vitamin E acetate strongly implicated. Buy vape products only from a licensed dispensary . Stop and seek care if you develop cough, shortness of breath, or chest pain after vaping.
- Store all cannabis locked, out of sight, and out of reach of children and pets.
- Report a side effect or product problem to the dispensary pharmacist and to the Office of Cannabis Management through its Report an Incident page. New York requires adverse events to be reported.
- Check the OCM website for product recalls.
How the program developed
New York Program Basics
- 2014: the Compassionate Care Act created New York’s medical program. Sales began in 2016 through a small number of Registered Organizations (ROs), companies licensed to grow, make, and dispense medical cannabis.
- 2017 onward: chronic pain and PTSD were added, along with more product forms such as topicals, chewables, and lozenges.
- 2021: the Marihuana Regulation and Taxation Act (MRTA) legalized adult use and created the Office of Cannabis Management (OCM), which now runs the medical program. Practitioners can now certify for any condition they believe cannabis may help.
As of October 1, 2026, the program had 69,031 registered patients and 4,820 certifying practitioners (OCM).
Medical, Adult-Use, Unregulated, and Hemp Products
| Type | Tested and labeled? | Who you deal with | Notes |
| Medical | Yes, by a state-approved lab | A pharmacist at a medical dispensary | Requires a certification; no adult-use excise tax |
| Adult-use | Yes | Retail staff; no pharmacist required | Age 21 and older; no clinician involved |
| Unregulated | No | Unknown | Potency and contaminants unknown; linked to the 2019 vaping lung injuries |
| Hemp-derived CBD | Varies | General retail | Studies often find labels inaccurate; some products contain THC |
How to Get Certified
Any New York practitioner who can prescribe controlled substances, is qualified to treat your condition, and has completed a state-approved course can certify you. Visits can be in person or by telehealth. OCM publishes a searchable list of practitioners.
You need a government-issued photo ID , an email address, and your current address.
It is paper or digital and is valid for up to two years. Your practitioner can either leave product and dose to the pharmacist or write specific instructions, which the pharmacist must follow.
Bring your certification and photo ID. Every medical dispensary has a pharmacist on site; ask to speak with them about product and dose. There is no state registration fee.
Caregivers
Certified patients can designate up to five registered caregivers to buy and help give medical cannabis on their behalf .
Cost and coverage
Health insurance does not cover medical cannabis, and purchases are cash or debit. Prices vary by product and dose, so ask the dispensary before you buy . Workers’ compensation is the exception: in New York, medical cannabis can be covered for a work- related injury . Ask your practitioner or the dispensary about the process.
Visiting New York
Patients enrolled in another state’s medical program can buy at New York medical dispensaries with their home-state documentation and photo ID . New York patients traveling elsewhere should check that state’s rules; many do not accept out-of-state cards. Never carry cannabis across state lines.
Home cultivation
Certified patients 18 and older , and their caregivers, may grow cannabis at home under OCM rules. Check OCM’s Home Grow guidance for plant limits and where to buy seeds.
Lab testing and labels
Every medical product is tested by a New York State–approved lab for cannabinoid content and contaminants. Labels show THC and CBD content and required warnings, and many list other cannabinoids such as CBG and CBN. Every manufacturer must offer balanced (1:1) and CBD-dominant (for example, 1:20 THC:CBD) products. THC-dominant products are sold at every dispensary and are the most commonly used.
Legal protections
New York law protects certified patients, caregivers, and practitioners who follow program rules. Federally , state-licensed medical cannabis moved to Schedule III in April 2026, but federal rules still apply on federal property and in federal workplaces. See OCM’s Patient Rights and Protections guide.
Product Forms and How Fast They Work
| Form | Starts working | Lasts | Good for | Watch out for |
| Vaporized flower or oil | Within minutes; peaks at about 9 minutes | Up to about 2 hours | Fast relief; easy to adjust the dose | Throat and lung irritation; the state guideline advises against vaping, smoking, and dabbing |
| Smoked flower and pre-rolls | Within minutes | Similar to vaping | Fast relief | Smoke carries the most lung risk of any form; harder to measure the dose |
| Concentrates (wax, shatter, hash) | Almost immediately | 2 to 3 hours | Experienced patients only | Often above 60% THC; strong intoxication and risk of psychosis; very hot use creates irritants |
| Under the tongue (tinctures, sprays, lozenges) | As early as 10 minutes | Up to about 10 hours | Small, adjustable doses; no inhaling; trouble swallowing | Becomes a slower oral dose if swallowed |
| Swallowed (capsules, tablets, chewables, edibles, beverages) | Peaks 1 to 5 hours after a dose | Many hours, sometimes up to a day | Steady overnight or all-day relief | Easiest form to take too much of (see dose stacking); hardest to adjust |
| Topical and transdermal (creams, lotions, gels, patches) | About 2 hours for transdermal products | Up to 48 hours, depending on the product | One painful area; people who cannot use other forms | Absorption varies widely; products designed to reach the bloodstream can cause a high if they contain THC |
| Suppository | 1 to 2 hours | Up to about 8 hours | When swallowing is not possible | Very little research |
Times come from the New York State Department of Health clinical guideline (October 2025) and vary from person to person and by product.
Start Low, Go Slow
- New patients usually start with 2.5 mg of THC or less, often in the evening at home, as the state clinical guideline suggests.
- Increase in small steps (about 1 to 2.5 mg) every few days, only if needed.
- Avoid dose stacking: with edibles and capsules, wait at least 2 hours before taking more. Taking another dose before the first has worked is the most common cause of feeling too high.
- Products with CBD and little THC are less likely to cause a high; many patients start there.
- Check in with your practitioner or pharmacist 1 to 2 weeks after starting.
- Keep a simple log of product, dose, time, and how you felt. Bring it to follow-up visits.
- If you already use cannabis, the state guideline suggests starting medical cannabis at about half the THC you use now; ask the pharmacist which products match.
Questions to ask your practitioner:
- What symptom are we trying to improve, and how will we know it is working?
- Should I start with CBD , THC, or a mix?
- Which form makes sense for my symptoms and schedule?
- Do any of my current medicines interact with cannabis?
- When should we check in, and when should I stop if it is not helping?
Glossary
| Term | Meaning |
| Bioavailability | The share of a dose that reaches the bloodstream |
| Cannabinoid | A compound that acts on the body’s cannabinoid receptors; THC and CBD are the best known |
| Cannabis use disorder | Problem use: needing more, trouble cutting back, or use that interferes with daily life |
| Cannabinoid hyperemesis syndrome | Repeated severe vomiting in some long-term heavy users; ends after stopping |
| CB1 and CB2 receptors | The body’s two main cannabinoid receptors. CB1 is concentrated in the brain and nerves and drives the high; CB2 is found mainly on immune cells |
| Certification | A practitioner’s documented recommendation that a patient may use medical cannabis |
| Certificate of analysis (COA) | The lab report showing what a product contains |
| Designated caregiver | A registered person who may buy and give medical cannabis for a patient |
| Dose stacking | Taking another dose before the first has taken full effect |
| Endocannabinoid system | The body’s own network of cannabinoid receptors and natural cannabinoid-like molecules |
| Morphine milligram equivalents (MME) | A standard way to compare doses of different opioids |
| OCM | The New York State Office of Cannabis Management |
| Reciprocity | One state honoring another state’s medical cannabis enrollment |
| Registered Organization (RO) | A company licensed in New York to grow, make, and dispense medical cannabis |
| Terpene | An aroma compound in cannabis, such as limonene or myrcene |
| THC:CBD ratio | The proportion of THC to CBD in a product |
| Titration | Adjusting the dose gradually to find the lowest dose that works |