Cannabis has been a part of our world for many thousands of years. In fact, there is some evidence of people using cannabis medicinally as early as 2800 BCE¹. There have been some hot debates about the use of this substance, especially in recent decades.

Generally, there are two major ways in which we discuss cannabis: in terms of advocacy, and in terms of scientific/medicinal uses.

• Advocacy – There is a contingent of people who advocate for the use of both medical cannabis and recreational cannabis. These individuals fight hard for the right to use cannabis however they wish.
• Scientific/medicinal uses – We’ll mostly cover this side in this article, and discuss the scientific use of medical cannabis for the treatment of cough and lung disorders. 

The goal of this piece is not to take a position on whether or not cannabis should be legal or illegal. Legality is an extremely important consideration with regard to cannabis use. In terms of legal implications, you should always thoroughly research the relevant laws and rules governing this drug in your country or region. Further, you should never smoke or consume any drugs with the goal of treating a condition before discussing the matter thoroughly with your doctor.

Advocacy for Cannabis Use

Cannabis is an extremely complex drug. Not only does it present us with conundrums related to health and medicine, but it also presents social issues as well. 

Advocates for the use of cannabis will often point to the fact that the substance is fairly mild, especially when compared to drugs such as heroin and cocaine. For this reason, many advocates of legalizing cannabis point out that long jail sentences for the use and possession of cannabis are excessive. This is of particular concern when cannabis-related offenses have gained some prisoners life sentences.

Furthermore, advocates stress that medical cannabis has been used to treat a variety of conditions over the years. Therefore, the drug may have a functional utility, rather than strictly a recreational benefit.

This brings us to the main focus of the article: can cannabis be used for the treatment of cough and lung issues? Let’s take a look!

What the Science Says: Medical Cannabis and the Lungs

In this section, we’ll provide an overview of the current understanding of how cannabis affects cough and lung issues.

Properties of Medical Cannabis

When cannabis is used to treat health issues, it is referred to as medical cannabis, to differentiate it from recreational use. Countries may legalize cannabis for medical use but not for recreational use. There is a lot of research on its effects on the human body. Some of its properties include:

• Short-term bronchodilation (expansion of the airways)²
• Anti-inflammatory³
• Anti-convulsant⁴
• Anxiety reduction (anxiolytic)⁵
• Pain reduction (analgesia)⁶
• Epileptic seizure reduction (antispasmodic)⁷

Methods of Delivery for Medical Cannabis

The most common method for medical cannabis delivery is smoking or inhalation. This includes vaporizers, traditional smoking, or other, similar methods.

Many of the benefits of cannabis, although not all, come from a chemical in cannabis called cannabidiol. You may have heard of this as CBD or CBD oil. There are many different sprays, mists, balms, and other topical solutions that deliver isolated CBD.

CBD can be somewhat separated at home through the production of cannabis butter or oil. This can then be used in cooking food with cannabis in. 

Ingestion has been increasing in popularity as a delivery method. Cookies, gummies, and other foods are now being supplemented with cannabis. This makes it much easier and more tolerable for some individuals to access the positive effects of cannabis.

Effects On Lung Health

When it comes to any therapeutic option, there are always risks and benefits. This is even true with regard to something as benign as exercise or dietary changes. 

Cannabis offers a host of potential benefits; many of its beneficial properties have been listed above. Additionally, cannabis may help with symptoms of asthma, COVID-19, COPD, and other disorders, which are discussed in more detail below. 

However, there are some documented risks, including higher risk of psychosis in susceptible individuals⁸ as well as increased coughing frequency.⁹ Here, we will focus on the effects on lung health. 

Many of these are to do with the delivery method – smoking is a very common method, and has been associated with a higher risk of certain cancers,¹⁰ including lung, neck and head. 

Vaping is a similar method that is becoming more common, and comes with its own set of risks,¹¹ including e-cigarette or vaping-associated lung injuries (EVALI: cough, chest pain, and shortness of breath), stomach pain, nausea, vomiting, diarrhea, fever, chills, and weight loss.

Minimizing the risks associated with cannabis use and potentially maximizing the benefits of the drug can involve changing methods of use. Namely, ingesting cannabis orally seems to reduce many of the risks that come with smoking cannabis.

Medical Cannabis and Cough, Asthma, and COPD

Perhaps surprisingly, there is some evidence¹² that indicates that cannabis can be an effective treatment for chronic cough. 

Unfortunately, it’s not exactly clear why cannabis assists with cough and other lung disorders. One theory is that the use of cannabis leads to a temporary widening of the airways¹³ and that this may reduce inflammation. These two effects may decrease the intensity and frequency of coughs.

Because of its anti-inflammatory properties,¹⁴ CBD specifically may improve asthma symptoms. In fact, airway hyperresponsiveness was found to be mitigated with CBD, no matter how much or how little of the substance was used in treatment.

Many thousands of people around the world suffer from COPD (chronic obstructive pulmonary disorder), one cause of difficult-to-treat chronic coughs. Therefore, effective therapeutics for this condition are essential. There is tentative molecular evidence¹⁵ that CBD oil could treat this frustrating condition; while we are still waiting on full studies in humans, this bodes well for future COPD treatment.

Negative Effects of Cannabis on Cough

Similarly to smoking tobacco, smoking cannabis can also worsen or cause a chronic cough. Additionally, smoking cannabis can cause wheezing and coughing through tar and other particle inhalation or through inflammation of the lungs.¹⁶ 

Finally, while cannabis’ ability to widen the airways can reduce an existing cough, it can also cause bronchitis,¹⁷ whether it is smoked or ingested. A symptom of bronchitis is a mucusy, wet cough. 

Medical Cannabis and COVID-19

Because this disease has ravaged our world and is likely to be a part of our lives for many years to come, it’s critical that we find as many viable treatments as possible. 

CBD, an active component within cannabis, has been found as a potential treatment for COVID-19.¹⁸ CBD seems to inhibit the infection of the SARS-COV2 virus in the body. It restricts the virus’s ability to express its genes and therefore reduces its impact.

However, further clinical research is needed¹⁹ to assess its true effect when ingested and not directly applied to the cells.

Medical Cannabis Interactions With Other Medication

Whether a drug is available over the counter, with a prescription, or only illegally, there are potential interaction risks when it is taken alongside other drugs, chemicals and herbs. This applies to cannabis as much as it does any other chemical. 

In general, interactions may manifest as:

• Additional side effects
• Reduction in the effectiveness of one or both of the drugs
• Toxicity

When it comes to drug interactions and cannabis, there is still much that we do not know. There are likely some interactions or adverse reactions that can occur when one pairs cannabis with other drugs, although the details of many of these need further research. 

The interactions currently known about with medical cannabis include:²⁰

• CBD taken alongside various anticonvulsants lead to higher levels of the anticonvulsants in people’s blood (topiramate, rufinamide, clobazam, eslicarbazepine, and zonisamide)
• Liver function was affected when CBD was taken alongside an anticonvulsant/bipolar medication (valproate)
• An antifungal medication (ketoconazole) increases the concentration of CBD and other chemicals responsible for cannabis’ effects, potentially strengthening the effect of the cannabis
• An antibiotic (rifampin), in contrast, reduces the concentration of CBD and other cannabis chemicals, potentially reducing the effect of the cannabis
• Vaping cannabis seems to make opioid-based painkillers more effective
• Alcohol increases blood levels of the psychoactive cannabis chemical THC

Gabapentin may increase the therapeutic, pain-reducing benefits of THC

Conclusion

Like it or not, cannabis use (both medically and recreationally) is becoming more common as time goes by. More and more countries around the world are passing laws allowing for the use of this drug.

Because of this, the medical and research community needs to quickly and effectively compile data regarding the safety and effectiveness of cannabis. In the future, look out for more data and guidance related to the use of cannabis for respiratory and other conditions. Keeping up with effective cough treatments and remedies may help you manage your cough.

1. Deiana, S. (2012). Medical use of cannabis. Cannabidiol: A new light for schizophrenia? Drug Testing and Analysis, 5(1), 46–51. https://doi.org/10.1002/dta.1425[↩]
2. Lee, M. H., & Hancox, R. J. (2011). Effects of smoking cannabis on lung function. Expert Review of Respiratory Medicine, 5(4), 537–547. https://doi.org/10.1586/ers.11.40[/efn_note]
3. Muscle relaxation((Russo, E., & Guy, G. W. (2006). A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses, 66(2), 234–246. https://doi.org/10.1016/j.mehy.2005.08.026[↩]
4. Russo, E., & Guy, G. W. (2006). A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses, 66(2), 234–246. https://doi.org/10.1016/j.mehy.2005.08.026[↩]
5. Russo, E., & Guy, G. W. (2006). A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses, 66(2), 234–246. https://doi.org/10.1016/j.mehy.2005.08.026[↩]
6. Russo, E., & Guy, G. W. (2006). A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses, 66(2), 234–246. https://doi.org/10.1016/j.mehy.2005.08.026[↩]
7. Russo, E., & Guy, G. W. (2006). A tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Medical Hypotheses, 66(2), 234–246. https://doi.org/10.1016/j.mehy.2005.08.026[↩]
8. Rosenberg, E. C., Tsien, R. W., Whalley, B. J., & Devinsky, O. (2015). Cannabinoids and Epilepsy. Neurotherapeutics 12(4), 747–768. https://doi.org/10.1007/s13311-015-0375-5[↩]
9. Volkow, N. D., et al. (2016). Effects of Cannabis Use on Human Behavior, Including Cognition, Motivation, and Psychosis: A Review. JAMA Psychiatry 73(3), 292. https://doi.org/10.1001/jamapsychiatry.2015.3278[↩]
10. Tashkin, D. P., & Roth, M. D. (2019). Pulmonary effects of inhaled cannabis smoke. The American Journal of Drug and Alcohol Abuse, 45(6), 596–609. https://doi.org/10.1080/00952990.2019.1627366[↩]
11. Kaplan A. G. (2021). Cannabis and Lung Health: Does the Bad Outweigh the Good?. Pulmonary therapy, 7(2), 395–408. https://doi.org/10.1007/s41030-021-00171-8[↩]
12. Chadi, N., et al. (2020). Cannabis vaping: Understanding the health risks of a rapidly emerging trend. Paediatrics & Child Health, 25(Supplement_1), S16–S20. https://doi.org/10.1093/pch/pxaa016[↩]
13. Neef, C., & Fullerton, S. (2020). Cannabis for Treatment of Intractable Malignant Cough- A Case Report. Journal of Cancer Science and Clinical Therapeutics, 4, 457-461. https://www.fortunejournals.com/articles/cannabis-for-treatment-of-intractable-malignant-cough-a-case-report.html [↩]
14. Ribeiro, L. I., & Ind, P. W. (2016). Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review. NPJ primary care respiratory medicine, 26, 16071. https://doi.org/10.1038/npjpcrm.2016.71[↩]
15. Vuolo, F., et al. (2019). Cannabidiol reduces airway inflammation and fibrosis in experimental allergic asthma. European Journal of Pharmacology, Volume 843, Pages 251–-259., ISSN 0014-2999,  https://doi.org/10.1016/j.ejphar.2018.11.029[↩]
16. Mamber, S. et al. (2020). Effects of cannabis oil extract on immune response gene expression in human small airway epithelial cells (HSAEpC): implications for chronic obstructive pulmonary disease (COPD). Journal of Cannabis Research, 2(5). https://doi.org/10.1186/s42238-019-0014-9[↩]
17. Tashkin, D. P., & Roth, M. D. (2019). Pulmonary effects of inhaled cannabis smoke. The American Journal of Drug and Alcohol Abuse, 45(6), 596–609. https://doi.org/10.1080/00952990.2019.1627366[↩]
18. Lee, M. H., & Hancox, R. J. (2011). Effects of smoking cannabis on lung function. Expert review of respiratory medicine, 5(4), 537-547. https://doi.org/10.1586/ers.11.40[↩]
19. Holst, Nowak, & Hoch. (2022). Cannabidiol As a Treatment for COVID-19 Symptoms? A Critical Review [Manuscript submitted for publication in Cannabis and Cannabinoid Research]. Mary Ann Liebert, Inc. https://doi.org/10.1089/can.2021.0135[↩]
20. Nguyen, L. C., et al. (2022). Cannabidiol inhibits SARS-CoV-2 replication through induction of the host ER stress and innate immune responses. Science Advances, 8(8) https://www.science.org/doi/full/10.1126/sciadv.abi6110[↩]
21. Alsherbiny, M. A., & Li, C. G. (2018). Medicinal Cannabis—-Potential Drug Interactions. Medicines (Basel, Switzerland), 6(1), 3. https://doi.org/10.3390/medicines6010003[↩]

Bennett Richardson

Bennett Richardson is a physical therapist and writer out of Pittsburgh, PA. He treats a variety of conditions and writes about a number of topics in the health field. In his free time, Bennett enjoys exercising, reading, and philosophizing with anyone he can trick into having a conversation with him.