But the use of marijuana to treat some medical conditions is legal under state laws in many states. This means that marijuana can have different effects based on the compounds that have been approved in the US for medical use. that can overcome the often debilitating side effects of cancer and its. Currently, 28 states and the District of Columbia allow medical marijuana but the to marijuana, but it can also be beneficial for many side effects of cancer and. Many people diagnosed with cancer feel that CBD is better at than half of the states, as well as the District of Columbia, have passed laws People use marijuana to ease the side effects of treatment and pain caused by the cancer. “People have to be as diligent about researching medical marijuana as.
Side Have States Medical Effects Approved That Cannabis Chemotherapy for
Studies have shown cannabinoids can make the adverse effects more manageable. Chemotherapy is a category of cancer treatment that uses strong drugs, administered orally or intravenously. There are more than chemotherapy drugs that are used in the treatment of cancer.
The drugs prevent cancer from spreading to other parts of the body, slow the growth of tumors, and kill cancer cells.
While chemotherapy can be effective against cancer, it does cause sometimes-serious side effects. The side effects from chemotherapy develop because the chemotherapy drugs that attack cancerous cells also damage normal, healthy cells. Common side effects associated with chemotherapy are fever and chills, fatigue, nausea and vomiting, sore mouth, diarrhea, constipation, loss of appetite that can lead to anorexia, pain or difficulty with swallowing, swelling in the hands or feet, itching, shortness of breath, cough, and muscle or joint pain.
Most side effects will gradually go away after completion of the treatment. Cannabinoids have shown to effectively reduce the nausea and vomiting that often occurs during and after chemotherapy treatments.
Studies have found that one of the major cannabinoids found in cannabis, cannabidiol CBD , is effective at treating the more difficult to control symptoms of nausea, as well as preventing anticipatory nausea in chemotherapy patients 11, Another study found that tetrahydrocannabinol THC , another major cannabinoid found in cannabis, is also effective at reducing conditioned rejection and chemotherapy-induced nausea Cannabis has also demonstrated that it can significantly reduce neuropathic pain; even pain that traditional treatment had been unsuccessful at managing In one study, cancer patients with intractable pain , and who had previously and unsuccessfully tried to manage their discomfort with opioids, saw significant reductions in pain levels after being treated with cannabis containing both THC and CBD for two weeks 9.
Cannabis can also help prevent weight loss and a loss of appetite in chemotherapy patients. THC has shown to significantly stimulate appetite in patients that have cachexia related to cancer 8,12, Research also suggests that cannabis may help reduce the swelling in the hands and feet that can occur alongside chemotherapy. A survey of cancer patients participating in cannabis treatments for six to eight weeks reported significant improvements in all of the measured symptoms, including nausea , vomiting, mood disorders, fatigue, weight loss, anorexia, constipation, sexual function, sleep disorders, itching, and pain 1.
Patients treated with THC have also been shown to experience a higher quality of sleep and relaxation 2. The National Cancer Institute, an organization run by the U.
Department of Health and Human Services, recognizes cannabis as an effective treatment for providing relief of a number of symptoms associated with cancer and chemotherapy treatments, including pain, nausea and vomiting, anxiety and loss of appetite 4. Marijuana is currently recognized by the U. Cannabis is the most commonly cultivated, trafficked, and abused illicit drug worldwide; according to the World Health Organization WHO , marijuana consumption has an annual prevalence rate of approximately million individuals or nearly 2.
The use and acceptance of medicinal cannabis continues to evolve, as shown by the growing number of states now permitting use for specific medical indications. The Food and Drug Administration FDA has considered how it might support the scientific rigor of medicinal cannabis claims, and the review of public data regarding safety and abuse potential is ongoing.
Cannabis is a plant-based, or botanical, product with origins tracing back to the ancient world. Evidence suggesting its use more than 5, years ago in what is now Romania has been described extensively. Federal restriction of cannabis use and cannabis sale first occurred in with the passage of the Marihuana Tax Act. In , California became the first state to permit legal access to and use of botanical cannabis for medicinal purposes under physician supervision with the enactment of the Compassionate Use Act.
As previously stated, as of January 1, , 28 states as well as Washington, D. As a Schedule I controlled substance with no accepted medicinal use, high abuse potential, concerns for dependence, and lack of accepted safety for use under medical supervision—along with a national stigma surrounding the potential harms and implication of cannabis use as a gateway drug to other substances—transitioning from a vilified substance to one with therapeutic merits has been controversial.
The United States Pharmacopoeia and the FDA have considered the complexities of regulating this plant-based therapy, including the numerous compounds and complex interactions between substances in this product, and how it might fit into the current regulatory framework of drugs in United States.
The emergence of interest in botanical medicinal cannabis is thought by many to be a collateral effect of the opioid abuse epidemic; public perception surrounding the use of medicinal cannabis suggests that this plant-based therapy is viewed as not much different than a botanical drug product or supplement used for health or relief of symptoms if disease persists.
Like some herbal preparations or supplements, however, medicinal cannabis may similarly pose health risks associated with its use, including psychoactive, intoxicating, and impairing effects, which have not been completely elucidated through clinical trials. Proponents argue that there is evidence to support botanical medicinal cannabis in the treatment of a variety of conditions, particularly when symptoms are refractory to other therapies; that beneficial cannabinoids exist, as evidenced by single-entity agents derived from cannabis containing the compounds THC and cannabidiol CBD ; that cannabis is relatively safe, with few deaths reported from use; that therapy is self-titratable by the patient; and that therapy is relatively inexpensive compared with pharmaceutical agents.
Regardless of personal views and perceptions, to deny or disregard the implications of use of this substance on patient health and the infrastructure of the health care system is irresponsible; clinicians must be aware of these implications and informed about how this therapy may influence practice in a variety of health care settings, including acute care.
Endocannabinoids eCBs and their receptors are found throughout the human body: Deficiencies in eCB signaling could be also involved in the pathogenesis of depression.
The eCB system consists of receptors, endogenous ligands, and ligand metabolic enzymes. A variety of physiological processes occur when cannabinoid receptors are stimulated. Cannabinoid receptor type 1 CB 1 is the most abundant G-protein—coupled receptor. It is expressed in the central nervous system, with particularly dense expression in ranked in order: CB 1 is also expressed in non-neuronal cells, such as adipocytes and hepatocytes, connective and musculoskeletal tissues, and the gonads.
CB 2 is principally associated with cells governing immune function, although it may also be expressed in the central nervous system. AEA and 2-AG are released upon demand from cell membrane phospholipid precursors.
Entourage compounds include N-palmitylethanolamide PEA , N-oleoylethanolamide SEA , and cisoctadecenoamide OEA or oleamide and may represent a novel route for molecular regulation of endogenous cannabinoid activity.
Additional noncannabinoid targets are also linked to cannabis. G-protein—coupled receptors provide noncompetitive inhibition at mu and delta opioid receptors as well as norepinephrine, dopamine, and serotonin. Ligand-gated ion channels create allosteric antagonism at serotonin and nicotinic receptors, and enhance activation of glycine receptors. THC is known to be the major psychoactive component of cannabis mediated by activation of the CB 1 receptors in the central nervous system; however, this very mechanism limits its use due to untoward adverse effects.
It is now accepted that other phytocannabinoids with weak or no psychoactivity have promise as therapeutic agents in humans. The cannabinoid that has sparked the most interest as a nonpsychoactive component is CBD.
Several activities give CBD a high potential for therapeutic use, including antiepileptic, anxiolytic, antipsychotic, anti-inflammatory, and neuroprotective effects.
And, some states have passed legislation to allow for the use of majority CBD preparations of cannabis for certain pathological conditions, despite lack of standardization of CBD content and optimal route of administration for effect. Finally, preliminary clinical trials suggest that high-dose oral CBD — mg per day may exert a therapeutic effect for epilepsy, insomnia, and social anxiety disorder. Nonetheless, such doses of CBD have also been shown to cause sedation.
The three most common methods of administration are inhalation via smoking, inhalation via vaporization, and ingestion of edible products. The method of administration can impact the onset, intensity, and duration of psychoactive effects; effects on organ systems; and the addictive potential and negative consequences associated with use.
Cannabinoid pharmacokinetic research has been challenging; low analyte concentrations, rapid and extensive metabolism, and physicochemical characteristics hinder the separation of compounds of interest from biological matrices and from each other.
The net effect is lower drug recovery due to adsorption of compounds of interest to multiple surfaces. In a randomized controlled trial conducted by Huestis and colleagues, THC was detected in plasma immediately after the first inhalation of marijuana smoke, attesting to the efficient absorption of THC from the lungs. THC levels rose rapidly and peaked prior to the end of smoking. Vaporization provides effects similar to smoking while reducing exposure to the byproducts of combustion and possible carcinogens and decreasing adverse respiratory syndromes.
THC is highly lipophilic, distributing rapidly to highly perfused tissues and later to fat. After oral THC, the onset of clinical effects was slower and lasted longer, but effects occurred at much lower plasma concentrations than they did after the other two methods of administration. Cannabinoids are usually inhaled or taken orally; the rectal route, sublingual administration, transdermal delivery, eye drops, and aerosols have been used in only a few studies and are of little relevance in practice today.
The pharmacokinetics of THC vary as a function of its route of administration. Inhalation of THC causes a maximum plasma concentration within minutes and psychotropic effects within seconds to a few minutes. These effects reach their maximum after 15 to 30 minutes and taper off within two to three hours. Following oral ingestion, psychotropic effects manifest within 30 to 90 minutes, reach their maximum effect after two to three hours, and last for about four to 12 hours, depending on the dose.
Within the shifting legal landscape of medical cannabis, different methods of cannabis administration have important public health implications. A survey using data from Qualtrics and Facebook showed that individuals in states with medical cannabis laws had a significantly higher likelihood of ever having used the substance with a history of vaporizing marijuana odds ratio [OR], 2. Longer duration of medical cannabis status and higher dispensary density were also significantly associated with use of vaporized and edible forms of marijuana.
Medical cannabis laws are related to state-level patterns of utilization of alternative methods of cannabis administration.
Metabolic and pharmacodynamic interactions may exist between medical cannabis and other pharmaceuticals. Much of what is known about the adverse effects of medicinal cannabis comes from studies of recreational users of marijuana. A systematic review of published trials on the use of medical cannabinoids over a year period was conducted to quantify adverse effects of this therapy.
In the randomized trials, the median duration of cannabinoid exposure was two weeks, with a range between eight hours and 12 months. Of patients assigned to active treatment in these trials, a total of 4, adverse effects were reported; The most common serious adverse effects included relapsing MS 9.
No significant differences in the rates of serious adverse events between individuals receiving medical cannabis and controls were identified relative risk, 1. The most commonly reported non-serious adverse event was dizziness, with an occurrence rate of Other negative adverse effects reported with acute cannabis use include hyperemesis syndrome, impaired coordination and performance, anxiety, suicidal ideations or tendencies, and psychotic symptoms, whereas chronic effects may include mood disturbances, exacerbation of psychotic disorders, cannabis use disorders, withdrawal syndrome, and neurocognitive impairments, as well as cardiovascular and respiratory conditions.
Cannabis and cannabinoid agents are widely used to alleviate symptoms or treat disease, but their efficacy for specific indications is not well established. For chronic pain, the analgesic effect remains unclear. A systematic review of randomized controlled trials was conducted examining cannabinoids in the treatment of chronic noncancer pain, including smoked cannabis, oromucosal extracts of cannabis-based medicine, nabilone, dronabinol, and a novel THC analogue.
Fifteen of the 18 included trials demonstrated a significant analgesic effect of cannabinoids compared with placebo. Cannabinoid use was generally well tolerated; adverse effects most commonly reported were mild to moderate in severity. Overall, evidence suggests that cannabinoids are safe and moderately effective in neuropathic pain with preliminary evidence of efficacy in fibromyalgia and rheumatoid arthritis.
While there is not enough evidence to suggest routine use of medicinal cannabis for alleviating chemotherapy-related nausea and vomiting by national or international cancer societies, therapeutic agents based on THC e. Only recently has the efficacy and safety of cannabis-based medicines in managing nausea and vomiting due to chemotherapy been evaluated. The effects can also differ based on how deeply and for how long the user inhales.
Likewise, the effects of ingesting marijuana orally can vary between people. Also, some chronic users can develop an unhealthy dependence on marijuana. There are 2 chemically pure drugs based on marijuana compounds that have been approved in the US for medical use. Nabiximols is a cannabinoid drug still under study in the US. Based on a number of studies, dronabinol can be helpful for reducing nausea and vomiting linked to chemotherapy.
Dronabinol has also been found to help improve food intake and prevent weight loss in patients with HIV. Research is still being done on this drug. Like many other drugs, the prescription cannabinoids, dronabinol and nabilone, can cause side effects and complications. Some people have trouble with increased heart rate, decreased blood pressure especially when standing up , dizziness or lightheadedness, and fainting.
They can also worsen depression, mania, or other mental illness. Some patients taking nabilone in studies reported hallucinations. The drugs may increase some effects of sedatives, sleeping pills, or alcohol, such as sleepiness and poor coordination. Patients have also reported problems with dry mouth and trouble with recent memory. People who have had emotional illnesses, paranoia, or hallucinations may find their symptoms are worse when taking cannabinoid drugs.
Talk to your doctor about what you should expect when taking one of these drugs. The American Cancer Society supports the need for more scientific research on cannabinoids for cancer patients, and recognizes the need for better and more effective therapies that can overcome the often debilitating side effects of cancer and its treatment.
The Society also believes that the classification of marijuana as a Schedule I controlled substance by the US Drug Enforcement Administration imposes numerous conditions on researchers and deters scientific study of cannabinoids.
Federal officials should examine options consistent with federal law for enabling more scientific study on marijuana. The American Cancer Society medical and editorial content team. Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. Cannabis in painful HIV-associated sensory neuropathy: Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy.
American College of Physicians. Supporting research into the therapeutic role of marijuana. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.
J Pain Symptom Manage. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. Comparison of orally administered cannabis extract and deltatetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: Smoked medicinal cannabis for neuropathic pain in HIV: A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme.
Dronabinol and marijuana in HIV-positive marijuana smokers. Caloric intake, mood,and sleep.
Marijuana and Cancer
Side effects that have been reported include: Slideshow: Medical Marijuana The FDA has approved three drugs that include The National Institute on Drug Abuse says marijuana can be addictive and is Medical Marijuana and Cancer . Studies have shown cannabinoids can make the adverse side effects of States That Have Approved Medical Cannabis for Chemotherapy Side Effects. In the United States, cannabis is approved for medicinal use in 28 states, the District is absent; that adverse health effects relate not only to smoking cannabis but to .. that allow medicinal cannabis relate to relief of the symptoms of cancer.