Medical Marijuana

Chronic Pain

As of March 2015, 23 states and the District of Columbia had medical marijuana laws in place. Physicians should know both the scientific rationale and the practical implications for medical marijuana laws.

Objective of the Study
To review the pharmacology, indications, and laws related to medical marijuana use.

Evidence Review
The medical literature on medical marijuana was reviewed from 1948 to March 2015 via MEDLINE with an emphasis on 28 randomized clinical trials of cannabinoids as pharmacotherapy for indications other than those for which there are 2 US Food and Drug Administration-approved cannabinoids (dronabinol and nabilone), which include nausea and vomiting associated with chemotherapy and appetite stimulation in wasting illnesses.

Findings
Use of marijuana for chronic pain, neuropathic pain, and spasticity due to multiple sclerosis is supported by high-quality evidence. Six trials that included 325 patients examined chronic pain, 6 trials that included 396 patients investigated neuropathic pain, and 12 trials that included 1600 patients focused on multiple sclerosis. Several of these trials had positive results, suggesting that marijuana or cannabinoids may be efficacious for these indications.

Conclusion and Relevance
Medical marijuana is used to treat a host of indications, a few of which have evidence to support treatment with marijuana and many that do not. Physicians should educate patients about medical marijuana to ensure that it is used appropriately and that patients will benefit from its use

At Omega Health & Wellness here in Jacksonville, FL our physicians stay current on information that is important to the care our patients receive.

Irritable Bowel Disease

Prevalence and Patterns of Marijuana Use in Young Adults with Inflammatory Bowel Disease.
J Pediatr Gastroenterol Nutr. 2016 Nov 14.
Phatak UP1, Rojas-Velasquez D, Porto A, Pashankar DS.

Author information:
All authors are affiliated to Yale University, School of Medicine.

Objectives:
Recent studies in adults report symptom relief with marijuana use in patients with inflammatory bowel disease (IBD). We assessed the prevalence, pattern, effects and adverse effects of marijuana use in young adults with IBD.

Methods:
We conducted a prospective questionnaire survey study at a pediatric IBD clinic. All patients (18 to 21 years of age) answered anonymous questionnaires about demographics, IBD, medications and marijuana use.

Results:
Fifty-three patients (Mean age 18.7 years; 32 males) were enrolled. Thirty-seven patients (70%) reported using marijuana currently or in the past. There was no statistically significant difference between the users and non-users of marijuana regarding demographics, disease activity or medications. Despite prolonged use of marijuana, 70% of patients did not discuss it with their gastroenterologists. Twenty-four patients used marijuana medicinally for IBD symptoms in addition to medical therapy. While majority found marijuana to be moderately/very helpful, complete relief of symptoms such as abdominal pain, poor appetite, nausea and diarrhea was seen in 29%, 37%, 14% and 10% of patients respectively. Only half of patients reported knowledge of possible adverse effects of marijuana and 19% of patients reported mild neuropsychiatric adverse effects. Overall, 98% of patients supported legalization of marijuana and 85% were interested in using medical marijuana if it became legally available.

Conclusion:
We found a high rate of marijuana use in our cohort of young adults with IBD. Majority of users report symptom improvement but do not inform physicians. Future well controlled studies are necessary to assess role of marijuana in IBD therapy.

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