8+ Ways Weed Impacts Blood Test Results


8+ Ways Weed Impacts Blood Test Results

Cannabis use can influence laboratory test outcomes in several ways, impacting values related to liver function, blood sugar, and hormone levels. For example, chronic use might elevate liver enzymes, potentially mimicking liver damage, while acute intoxication can lead to temporary fluctuations in blood glucose. Understanding the interaction between cannabis and physiological markers is crucial for accurate medical interpretation.

Recognizing the potential impact of cannabis on laboratory results is essential for both patients and healthcare professionals. Accurate diagnoses and treatment plans hinge on understanding how this substance can alter physiological indicators. This awareness becomes increasingly important as cannabis use becomes more widespread, legally and medically. Historically, research into these interactions has been limited, but the growing acceptance of cannabis has underscored the need for more thorough investigation.

This article will further examine the specific effects of cannabis on various blood components, exploring the clinical implications and offering guidance for patients and practitioners. It will delve into the mechanisms behind these interactions, discussing the duration of these effects and highlighting areas requiring further research.

1. Liver Enzyme Levels

Cannabis use, particularly chronic use, can influence liver enzyme levels, potentially complicating the interpretation of blood work results. While cannabis does not typically cause direct liver damage in the same way as alcohol abuse, it can induce metabolic changes that lead to elevated levels of enzymes like gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT). This elevation can sometimes mimic patterns seen in liver disease, potentially leading to misdiagnosis or unnecessary further investigation. For instance, a patient with elevated liver enzymes due to heavy cannabis use might undergo expensive and invasive procedures to rule out liver conditions, even when the underlying cause is cannabis-related. This highlights the importance of open communication between patients and healthcare providers regarding cannabis use to ensure accurate interpretation of bloodwork.

The mechanism behind these enzyme elevations is not fully understood but is thought to be related to the way the liver processes cannabinoids. The liver plays a central role in metabolizing these compounds, and chronic exposure can stress the liver’s metabolic pathways, potentially leading to enzyme release. Furthermore, co-existing factors like alcohol consumption or pre-existing liver conditions can exacerbate the effect of cannabis on liver enzymes. For example, an individual who uses cannabis and also consumes alcohol regularly might experience a more significant elevation in liver enzymes than someone who only uses cannabis. This interplay of factors makes it crucial to consider a patient’s complete health profile when evaluating liver enzyme levels.

Understanding the link between cannabis use and liver enzyme levels is crucial for accurate medical diagnosis and treatment planning. It underscores the need for comprehensive patient histories, including cannabis use patterns, to avoid misinterpreting blood work results. Further research is needed to fully elucidate the mechanisms involved and determine the long-term effects of cannabis exposure on liver health. This knowledge will empower healthcare professionals to make informed decisions and provide appropriate care for patients who use cannabis.

2. Blood Glucose Fluctuations

Cannabis use, particularly acute intoxication, can influence blood glucose levels, presenting a relevant factor in interpreting blood work results, especially for individuals with diabetes or those undergoing glucose monitoring. Understanding this interaction is crucial for accurate assessment and management of blood sugar control. The relationship between cannabis and blood glucose is complex and warrants careful consideration.

  • Hypoglycemic Effects

    Some studies suggest that cannabis, particularly high-THC strains, can induce temporary hypoglycemia (low blood sugar). This effect may be attributed to the stimulation of appetite and subsequent increased carbohydrate intake, followed by an insulin response. For example, a person consuming cannabis might experience increased hunger, leading to a large meal and a subsequent drop in blood sugar as insulin is released. This poses a potential risk for individuals with diabetes managing their insulin intake. The hypoglycemic effect can confound blood glucose measurements and complicate diabetes management.

  • Hyperglycemic Effects

    Conversely, other research indicates that cannabis can also lead to hyperglycemia (high blood sugar), particularly in chronic users. This may be due to the impact of cannabinoids on insulin resistance or pancreatic function. For instance, long-term cannabis use could potentially decrease insulin sensitivity, leading to elevated blood sugar levels even in the absence of increased carbohydrate intake. This effect requires further investigation to fully understand the underlying mechanisms and its implications for long-term metabolic health.

  • Variability and Individual Factors

    The influence of cannabis on blood glucose is highly variable and depends on factors such as the individual’s metabolism, cannabis strain (THC/CBD content), consumption method, and frequency of use. For example, a person consuming a high-CBD strain might experience different effects on blood glucose compared to someone consuming a high-THC strain. Additionally, individual factors like diet and exercise habits can influence the interplay between cannabis and blood glucose control. This variability makes it challenging to predict the precise effect of cannabis on an individual’s blood glucose levels.

  • Implications for Medical Interpretation

    Given the potential for both hypo- and hyperglycemic effects, cannabis use needs to be considered when interpreting blood glucose results. A patient who uses cannabis might have fluctuating blood glucose levels that do not accurately reflect their underlying metabolic health. Open communication between patients and healthcare providers about cannabis use is essential for accurate interpretation of blood work and appropriate diabetes management. Failure to account for cannabis use can lead to misdiagnosis or inappropriate treatment adjustments.

The complex and sometimes paradoxical influence of cannabis on blood glucose homeostasis underscores the need for further research. Understanding the specific mechanisms involved and the interplay of various factors is crucial for accurate interpretation of blood glucose results and effective diabetes management in individuals who use cannabis. It emphasizes the importance of including cannabis use as part of a comprehensive patient history to ensure appropriate medical care.

3. Hormone Level Changes

Cannabis use can influence various hormone levels, impacting blood work results and potentially affecting reproductive health, stress responses, and thyroid function. The endocannabinoid system (ECS), a complex network of receptors and neurotransmitters, interacts with the endocrine system, which regulates hormone production. Cannabinoids, particularly THC, can disrupt the delicate balance of this interaction, leading to measurable changes in hormone concentrations.

One key area of impact is reproductive hormones. Studies suggest that cannabis use can alter levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), essential for ovulation and sperm production. In females, disruptions in these hormones can lead to irregular menstrual cycles and potentially affect fertility. In males, reduced testosterone levels and impaired sperm motility have been observed with chronic cannabis use. For instance, a male patient undergoing fertility testing might exhibit lower-than-expected testosterone levels on blood work if he is a regular cannabis user. This highlights the importance of considering cannabis use when evaluating reproductive hormone panels. Similarly, changes in prolactin levels have been associated with cannabis use, which can have implications for lactation and other physiological processes.

Beyond reproductive hormones, cannabis can also influence cortisol levels, the primary stress hormone. While acute cannabis use can initially increase cortisol, chronic use may lead to a blunted cortisol response, potentially affecting the body’s ability to manage stress effectively. Furthermore, some research indicates that cannabis use might affect thyroid hormone levels, although the clinical significance of these changes remains an area of ongoing research. Understanding the multifaceted influence of cannabis on hormonal balance is crucial for interpreting blood work results accurately and addressing potential health concerns. It underscores the need for comprehensive patient histories and further research to fully elucidate the long-term consequences of cannabis-induced hormonal changes.

4. Immune System Markers

Cannabis use can influence immune system markers, impacting blood work results and potentially affecting the body’s ability to fight infections and regulate inflammation. The immunomodulatory effects of cannabis are complex and not fully understood, with both immunosuppressive and immunostimulatory properties reported depending on various factors, including the specific cannabinoids involved, dosage, frequency of use, and individual characteristics. Analyzing changes in immune cell populations and cytokine levels in blood work can provide insights into the impact of cannabis on immune function.

Studies have shown that chronic cannabis use can decrease the number of circulating lymphocytes, a type of white blood cell crucial for adaptive immunity. This reduction can potentially impair the body’s ability to mount an effective immune response against pathogens. For instance, a chronic cannabis user might exhibit lower lymphocyte counts on a complete blood count (CBC), potentially indicating a weakened immune system. Furthermore, cannabis can alter cytokine profiles, impacting inflammatory responses. Certain cannabinoids, like THC, have been shown to suppress the production of pro-inflammatory cytokines, which could have implications for managing inflammatory conditions. However, this immunosuppressive effect could also increase susceptibility to infections. Conversely, other cannabinoids, like CBD, have shown potential anti-inflammatory and immunomodulatory properties, which warrants further investigation for therapeutic applications.

Understanding the complex interplay between cannabis and the immune system is crucial for interpreting blood work results accurately and assessing potential health risks and benefits. The impact of cannabis on immune markers can confound diagnostic evaluations and influence treatment strategies. For example, suppressed immune markers in a patient undergoing immunosuppressive therapy might be mistakenly attributed to the medication, when cannabis use could be a contributing factor. Therefore, considering cannabis use during medical evaluations is essential for accurate diagnosis and treatment planning. Further research is necessary to fully elucidate the mechanisms by which cannabis affects immune function and to determine the long-term consequences of these interactions on overall health outcomes.

5. Blood Cell Counts

Cannabis use can influence blood cell counts, a key component of complete blood count (CBC) analysis, impacting interpretations of blood work results and potentially indicating underlying health conditions. While not always clinically significant, these changes warrant consideration when evaluating a patient’s overall health status, particularly in the context of other laboratory findings and clinical symptoms. Understanding how cannabis can affect various blood cell populations provides a more comprehensive picture of its physiological impact.

  • White Blood Cell Count (WBC)

    Cannabis use, particularly chronic use, has been associated with changes in white blood cell counts. While some studies suggest a potential decrease in certain white blood cell populations, like lymphocytes, other research indicates minimal impact. Variations in findings might be attributed to differences in study methodologies, cannabis potency, and individual factors. Interpreting WBC changes in cannabis users requires careful consideration of other factors that might contribute to altered counts, such as infections or other underlying health conditions. For instance, a slightly lowered lymphocyte count in a regular cannabis user might not be clinically significant in isolation but warrants further investigation if accompanied by other symptoms.

  • Red Blood Cell Count (RBC) and Hemoglobin

    The impact of cannabis use on red blood cell parameters, like RBC count and hemoglobin levels, is less clear. Some studies have reported slight elevations in RBC counts in chronic users, potentially related to the stimulating effects of cannabis on erythropoiesis (red blood cell production). However, these changes are often within the normal physiological range and rarely cause clinical concern. For example, a slightly elevated RBC count in a cannabis user might not necessitate intervention unless accompanied by other hematological abnormalities. Further research is needed to clarify the long-term effects of cannabis use on red blood cell parameters.

  • Platelet Count

    Platelets play a critical role in blood clotting, and alterations in platelet counts can have implications for bleeding risk. Limited research suggests that cannabis use might not significantly affect platelet counts in most individuals. However, some case reports have documented instances of thrombocytopenia (low platelet count) associated with heavy cannabis use. Therefore, monitoring platelet counts in individuals with pre-existing bleeding disorders or those undergoing procedures requiring adequate clotting is essential. A comprehensive assessment of an individual’s health status and medication history is necessary to determine the clinical significance of any observed platelet changes.

  • Clinical Significance and Interpretation

    Changes in blood cell counts related to cannabis use are often subtle and might not be clinically significant in isolation. Interpreting these changes requires a nuanced approach, considering the individual’s overall health, concurrent medication use, and other lifestyle factors. For example, a minor fluctuation in white blood cell count in an otherwise healthy individual who uses cannabis might not warrant intervention. However, similar changes in a patient with a compromised immune system could be more concerning. Therefore, open communication between patients and healthcare providers about cannabis use is crucial for accurate interpretation of blood work results and appropriate medical management.

Integrating information about blood cell counts with other blood work findings and clinical observations is crucial for accurate assessment of a patient’s health status. Cannabis-induced changes in blood cell counts, when considered in the broader context of a patient’s medical history, can contribute to a more comprehensive understanding of the potential impact of cannabis on overall health. Further research is needed to fully elucidate the mechanisms involved and to determine the long-term consequences of cannabis use on hematological parameters.

6. Kidney Function Tests

Kidney function tests, essential for assessing renal health, play a role in evaluating the broader impact of cannabis use on blood work results. While cannabis is not typically associated with direct kidney damage in the same way as certain medications or chronic diseases, its impact on other physiological systems can indirectly influence kidney function markers. Evaluating kidney health through these tests helps provide a more comprehensive understanding of the potential systemic effects of cannabis use. Understanding this connection requires examining the relationship between cannabis use and factors that can influence kidney function, such as hydration status, blood pressure, and metabolic changes.

For instance, cannabis use can sometimes lead to dehydration due to its diuretic effects or increased fluid intake related to dry mouth. Dehydration can impact kidney function by reducing blood flow to the kidneys and affecting glomerular filtration rate (GFR), a key measure of kidney function. Furthermore, cannabis can influence blood pressure, and chronic hypertension is a known risk factor for kidney disease. Changes in blood pressure related to cannabis use can potentially contribute to long-term kidney health implications. Metabolic alterations induced by cannabis, such as changes in electrolyte balance or glucose metabolism, can also indirectly affect kidney function. For example, fluctuations in blood glucose levels, sometimes observed with cannabis use, can impact the kidneys’ ability to filter and reabsorb glucose effectively. Analyzing kidney function tests, alongside other blood work parameters and clinical observations, provides a more complete picture of the potential systemic consequences of cannabis use.

In summary, while cannabis is not a primary cause of kidney disease, its indirect effects on hydration, blood pressure, and metabolism can influence kidney function test results. Incorporating kidney function tests into the broader evaluation of cannabis-related blood work changes helps provide a more comprehensive understanding of the potential systemic impact. This understanding highlights the importance of considering cannabis use when interpreting blood work and emphasizes the need for comprehensive patient histories to ensure accurate medical assessment and personalized treatment strategies. Further research is needed to fully elucidate the complex interplay between cannabis use and kidney function, particularly in individuals with pre-existing renal conditions or other risk factors.

7. Electrolyte Imbalances

Electrolyte imbalances, detectable through blood work, represent a potential consequence of cannabis use, particularly heavy or frequent consumption. These imbalances can manifest as abnormal levels of essential minerals like sodium, potassium, calcium, and chloride, which play crucial roles in various physiological processes, including nerve and muscle function, hydration, and blood pressure regulation. Understanding the connection between cannabis use and electrolyte imbalances is important for accurate interpretation of blood work results and comprehensive patient care.

  • Sodium Imbalances

    Cannabis use can influence sodium levels, potentially leading to hyponatremia (low sodium) or hypernatremia (high sodium). These imbalances can be exacerbated by behaviors associated with cannabis use, such as increased fluid intake or dehydration. Hyponatremia can cause symptoms like nausea, confusion, and seizures, while hypernatremia can lead to lethargy, muscle weakness, and irritability. Monitoring sodium levels in regular cannabis users is essential, especially in individuals with pre-existing conditions that affect sodium balance.

  • Potassium Imbalances

    Potassium plays a vital role in muscle function and heart rhythm. Cannabis use, particularly in combination with other substances or medications, can disrupt potassium homeostasis, potentially leading to hypokalemia (low potassium) or hyperkalemia (high potassium). Hypokalemia can cause muscle weakness, fatigue, and cardiac arrhythmias, while hyperkalemia can lead to life-threatening heart rhythm disturbances. Careful monitoring of potassium levels is crucial for individuals who use cannabis, particularly those with underlying cardiac conditions or taking medications that affect potassium levels.

  • Calcium and Magnesium Imbalances

    While less common than sodium and potassium imbalances, alterations in calcium and magnesium levels have also been observed in association with cannabis use. These minerals are essential for bone health, nerve function, and muscle contraction. Disruptions in calcium or magnesium homeostasis can manifest as muscle cramps, tremors, or even seizures. Assessing calcium and magnesium levels in individuals who use cannabis, especially those with underlying metabolic disorders or nutritional deficiencies, is important for comprehensive health evaluation.

  • Clinical Significance and Interpretation

    The clinical significance of electrolyte imbalances related to cannabis use depends on the severity of the imbalance and the individual’s overall health status. Mild imbalances may be asymptomatic and require no specific intervention, while more pronounced imbalances can cause significant symptoms and require medical attention. Interpreting electrolyte levels in the context of cannabis use necessitates a comprehensive evaluation of the individual’s medical history, concurrent medication use, and other lifestyle factors that may contribute to electrolyte disturbances.

Electrolyte imbalances associated with cannabis use, when detected through blood work, can provide valuable insights into the broader physiological impact of cannabis on the body. These imbalances, though often subtle and transient, highlight the importance of considering cannabis use when interpreting laboratory results and developing personalized treatment plans. Further research is needed to fully characterize the extent and mechanisms by which cannabis affects electrolyte balance and to determine the long-term implications for overall health and well-being.

8. Drug Screening Detection

Drug screening detection forms a critical aspect of how cannabis use influences blood work results. While not directly indicative of physiological changes, the presence of cannabis metabolites in blood work serves as a crucial indicator of recent exposure. Understanding the nuances of drug screening detection in the context of blood work analysis is essential for accurate interpretation of results and informed decision-making, particularly in employment settings, legal contexts, and medical monitoring.

  • Detection Window and Frequency of Use

    The detection window for cannabis in blood work varies depending on the frequency and quantity of cannabis consumed. Occasional users might test positive for a shorter period, typically a few days, while chronic, heavy users can test positive for several weeks after ceasing use. This variability stems from the accumulation of cannabis metabolites, primarily THC-COOH, in fatty tissues. For example, a chronic user might test positive on a blood test weeks after last use, even if experiencing no intoxicating effects, whereas an infrequent user might test negative within days. This difference underscores the importance of considering usage patterns when interpreting drug screening results.

  • Testing Methodologies and Sensitivity

    Different testing methodologies employed in blood work analysis exhibit varying sensitivities for detecting cannabis metabolites. Enzyme-linked immunosorbent assays (ELISAs) are commonly used for initial screening due to their cost-effectiveness, but they may yield false positives. Confirmatory tests, such as gas chromatography-mass spectrometry (GC-MS), offer higher specificity and sensitivity, reducing the likelihood of false positives. For example, an initial positive ELISA result might be followed by a GC-MS test to confirm the presence and concentration of cannabis metabolites, ensuring accuracy and reliability in critical situations.

  • Impact on Medical Interpretation and Treatment

    Detecting cannabis metabolites in blood work can influence medical interpretation and treatment decisions. While not directly indicative of impairment or physiological dysfunction, a positive drug screen for cannabis can provide valuable context for interpreting other blood work abnormalities, such as elevated liver enzymes or fluctuating blood glucose levels. For example, a patient presenting with elevated liver enzymes who also tests positive for cannabis might warrant further investigation into potential cannabis-induced liver changes, whereas a patient with normal liver enzymes and a positive test might not require further investigation related to liver health. Open communication between patients and healthcare providers regarding cannabis use is crucial for accurate interpretation of blood work results and personalized treatment planning.

  • Legal and Employment Implications

    Drug screening results for cannabis in blood work have significant legal and employment implications. Positive test results can lead to consequences ranging from job loss to legal penalties, depending on the specific context and jurisdiction. Understanding the limitations and interpretations of these tests is crucial in legal and employment settings. For example, a positive cannabis test on a pre-employment blood screen might disqualify an applicant from a safety-sensitive position, even in jurisdictions where cannabis is legal for recreational use. Awareness of the potential consequences and legal frameworks surrounding drug testing is essential for both employers and employees.

Drug screening detection in blood work, while a distinct aspect from physiological changes induced by cannabis, offers a crucial piece of the puzzle when assessing the comprehensive impact of cannabis use. The presence of cannabis metabolites provides valuable context for interpreting other blood work findings and has significant legal and employment ramifications. Understanding the nuances of testing methodologies, detection windows, and potential implications allows for a more informed and responsible approach to evaluating blood work results in individuals who use cannabis.

Frequently Asked Questions

This section addresses common inquiries regarding the impact of cannabis use on blood work results. Clear, concise answers are provided to promote understanding and facilitate informed discussions between patients and healthcare providers.

Question 1: How long does cannabis remain detectable in blood work?

The detection window varies depending on factors like frequency of use, metabolism, and testing sensitivity. Occasional use might be detectable for a few days, while chronic use can be detected for several weeks after cessation.

Question 2: Can cannabis use lead to false positives on liver function tests?

While cannabis doesn’t typically cause direct liver damage, it can elevate liver enzymes, potentially mimicking patterns seen in liver disease. This highlights the importance of disclosing cannabis use to healthcare providers.

Question 3: Does cannabis affect blood sugar levels?

Cannabis can influence blood glucose levels, causing both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) in different individuals and usage patterns. This is a significant consideration for diabetic patients.

Question 4: How does cannabis impact hormone levels as reflected in blood work?

Cannabis can disrupt hormone balance, affecting reproductive hormones, stress hormones (cortisol), and potentially thyroid function. These hormonal fluctuations can have various health implications.

Question 5: Can cannabis use alter immune system markers in blood tests?

Cannabis has immunomodulatory properties, potentially affecting immune cell populations and cytokine levels. These changes can influence the body’s response to infections and inflammation.

Question 6: Does cannabis affect the results of standard blood cell counts?

Cannabis can subtly influence blood cell counts, particularly white blood cells. While often not clinically significant in isolation, these changes should be considered within the context of a patient’s overall health profile.

Open communication between patients and healthcare professionals regarding cannabis use is paramount for accurate interpretation of blood work results. These FAQs provide a starting point for discussion, and further consultation with a healthcare provider is encouraged for personalized guidance.

The following sections delve deeper into specific blood components and the mechanisms by which cannabis exerts its influence, offering more detailed insights into the complex interaction between cannabis use and laboratory test results.

Tips for Navigating Cannabis Use and Blood Work

Individuals who use cannabis should consider the following tips to ensure accurate blood work interpretations and informed healthcare decisions. Open communication with healthcare providers is crucial for navigating the complexities of cannabis use and its potential impact on laboratory results.

Tip 1: Disclose Cannabis Use to Healthcare Providers: Openly communicating cannabis use, including frequency, method of consumption, and product type (e.g., flower, edibles, concentrates), empowers healthcare professionals to accurately interpret blood work results. This transparency facilitates informed medical decision-making and personalized care.

Tip 2: Consider Temporary Abstinence Before Scheduled Blood Work: If feasible, temporarily abstaining from cannabis use before scheduled blood work can minimize potential interference with test results. The duration of abstinence needed varies depending on the specific tests and individual factors. Consulting with a healthcare provider can help determine an appropriate timeframe.

Tip 3: Maintain Accurate Records of Cannabis Consumption: Keeping a record of cannabis use, including dates, times, and product details, can provide valuable context for interpreting blood work results. This information can help identify potential correlations between cannabis use and specific laboratory findings.

Tip 4: Understand the Limitations of Drug Screening Tests: Recognizing that drug screening tests detect cannabis metabolites rather than active compounds is crucial. A positive test indicates exposure but not necessarily impairment or intoxication. Understanding the detection window and potential for false positives is essential.

Tip 5: Be Aware of Potential Drug Interactions: Cannabis can interact with certain medications, potentially impacting their efficacy or increasing the risk of adverse effects. Disclosing cannabis use allows healthcare providers to assess potential drug interactions and adjust treatment plans accordingly.

Tip 6: Prioritize Hydration and Balanced Nutrition: Maintaining adequate hydration and a balanced diet can help mitigate some potential effects of cannabis use on blood work parameters, such as electrolyte imbalances or fluctuations in blood glucose. These lifestyle factors play a vital role in overall health and well-being.

Tip 7: Seek Professional Guidance for Interpretation: Consulting with a healthcare provider or qualified laboratory professional is essential for accurate interpretation of blood work results, especially in the context of cannabis use. Professional guidance ensures personalized assessment and informed medical decision-making.

Following these tips empowers individuals who use cannabis to take an active role in their healthcare and facilitates informed discussions with their healthcare providers. Understanding the interplay between cannabis use and blood work results is crucial for accurate diagnosis, personalized treatment, and optimal health outcomes.

The concluding section of this article summarizes key takeaways and reinforces the importance of open communication and ongoing research in the field of cannabis and its effects on blood work results.

Does Weed Affect Blood Work Results? Conclusion

Cannabis use demonstrably influences various blood work parameters, impacting results related to liver function, blood glucose, hormone levels, immune markers, blood cell counts, and drug screening detection. While the clinical significance of these effects varies depending on individual factors such as frequency of use, underlying health conditions, and specific testing methodologies, the potential for cannabis to alter laboratory results is undeniable. Accurate interpretation of blood work necessitates considering cannabis use as a relevant factor, underscoring the importance of comprehensive patient histories and open communication between patients and healthcare providers.

Further research into the complex interplay between cannabis and physiological systems is crucial for refining our understanding of its impact on blood work results and overall health. Enhanced knowledge in this area will empower healthcare professionals to provide more accurate diagnoses, personalized treatment plans, and informed guidance to individuals who use cannabis. This continued exploration will also contribute to developing more sensitive and specific testing methodologies, ultimately improving patient care and promoting responsible cannabis use within a framework of informed medical practice.