4 Things Pharmacists Should Know About Medical Marijuana

DECEMBER 06, 2015
Meghan Ross, Senior Associate Editor
What are the potential risks and benefits of medical marijuana? Should hospitals open their own dispensaries? Can medical marijuana decrease opioid mortality?

These were some of the questions discussed at the 2015 American Society of Health-System Pharmacists Midyear meeting on December 6, 2015.

Lee Kral, PharmD, BCPS, Jennifer Strickland, PharmD, BCPS, and Ernest J. Dole, PharmD, BCPS, provided many perspectives on medical marijuana, including the drug’s risks and benefits.
On the one hand, medical marijuana has been shown to have utility in treating pain.

Research provides evidence that it can help prevent paclitaxel-induced neuropathy and reduce pain among patients with cancer, osteoporosis, and brachial plexus avulsion. The drug has also been shown to have a calming effect on patients with fibromyalgia.

Some other benefits include its use as an appetite stimulant, antiemetic, antispasmodic, analgesic, and anticonvulsant. The drug can also lower intraocular pressure.

Plus, no fatal overdose of cannabis alone has been reported, and acute medical risks of THC are low, Dr. Dole pointed out. Marijuana is also less lethal than alcohol, opiates, barbiturates, and some common medications.

On the other hand, aside from the fact that marijuana is not approved by the FDA, some people suggest it is a gateway drug.

Dr. Kral discussed one survey of patients with a long history of substance abuse. The researchers asked how they got started using drugs, and the majority of the patients said alcohol or marijuana was their first substance. In addition, many said they strongly believed these were gateway drugs.

In addition, Dr. Kral noted that patients who combine THC and opioids are putting themselves at risk.

Patients who use cannabis have a higher prevalence of nonmedical opioid use in the past year than those who do not use THC, Dr. Kral noted.

Cannabis use is also associated with faster relapse to alcohol, cocaine, and heroin use. In addition, it may pose cardiovascular risks, as well as a risk for COPD and dependence. Another concern is its effects on adolescent development, memory, and psychiatric illness.

In Dr. Dole’s opinion, marijuana has benefits, but more research is needed to support this claim.

“It’s incredibly muddy waters,” Dr. Dole said.

Regardless of one’s opinion on medical marijuana, here are 4 facts health-system pharmacists should know: