Using Medical Marijuana Effectively in Clinical Practice

As regulatory approval of medical marijuana spreads in the US, practicing clinicians need to be apprised of cannabis-related indications, efficacy, and adverse effects.

In an effort to develop viable standards for patient counseling and education, Jayesh Parmar, PhD, and colleagues from the school of pharmacy and health professions at the University of Maryland Eastern Shore in Princess Anne, Maryland, and colleagues reviewed 68 abstracts, summarizing common medical uses of cannabis-based medications and their safety in various disease states and populations. The study was published online September 16 in Research in Social and Administrative Pharmacy.

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“The overall purpose of this article was to provide clinicians with evidence-based counseling guidelines that can be strengthened as new clinical information becomes available,” lead author Dr. Parmar told Clinical Pain Advisor. “This is a starting point on developing counseling guidelines for the clinicians, subject to their review and modification.”

The study found that all 3 FDA-approved products (dronabinol, nabilone, and nabiximols), as well as inhaled and ingested marijuana products, are often used to treat neuropathic pain.

Other common uses for dronabinol included weight gain and chemotherapy-induced nausea and vomiting (CINV); nabilone is also used for CINV, while nabiximols is favored for spasticity in multiple sclerosis (MS). Smoked marijuana is also commonly used to treat glaucoma, and orally ingested marijuana is often used to improve sleep and seizure control in MS.

According to Barth Wilsey, MD, from the department of physical medicine and rehabilitation at the University of California Davis Medical Center in Sacramento, California, the key findings mirror those of a recent rigorous review involving 79 randomized trials with almost 6,500 participants.²