Medical Cannabis Project

When we speak about Medical Marijuana or Medical Cannabis, it is often difficult to find the right information. It often becomes a guessing game as to what will work best for your patient for the symptom you are treating. Keep in mind, there are many different formulations, and it is often frustrating to find the right formulation that will work best. Recently, I was involved in a Capstone project for the purpose of educating our patients more fully to be able to treat them safely and successfully. This project worked to create an easy packet for patient distribution which is currently being worked on.

I thought it’s important to share some of the information. It is always my recommendation to start slow and titrate up to tolerance and effectiveness. Often, finding the right combination takes time and patience. However, medical marijuana can be an excellent and effective adjunct for many of the symptoms we treat.

Cannabis works with the same system in our bodies responsible for maintaining balance, which is why medical cannabis can help patients with different chronic conditions.

There are different formulations, as mentioned above, including High THC/Low CBD, equal parts THC and CBD, and High CBD/Low THC formulations. CBD can limit the unwanted effects of THC when used with THC or as a treatment for its adverse effects by reducing your heart rate and any feelings of panic or paranoia. CBD is nontoxic and has no potential for addiction or hallucinations.

Not to say there are no risks. Like everything we prescribe, there can be adverse effects, including lightheadedness, lethargy, confusion, anxiety, hallucinations, dry mouth or eyes, decreased motor skills and delayed reaction time, impaired shortterm memory, and increased blood pressure if in a reclined position. There are contraindications and, like anything else, potential drug-drug interactions. 

There are also many ways to consume medical cannabis, including oral, sublingual, inhalation, and topical routes. Each of these formulations has a different mechanism of action. For example, oral formulations may take 30- 90 minutes to take effect and may last 4-12 hours, whereas inhalation effect can be felt within minutes and lasts only 2- 3 hours. Vaping has similar effects to smoking but may be safer for patients with mild respiratory issues. Sublingual products are placed under the tongue, held for about a minute for absorption, and usually take effect within 15 minutes. Topical cannabinoids are absorbed through the skin and cause no changes to your patient.

If you feel your patients may benefit from the use of Medical Marijuana for symptom relief, our palliative team can alleviate fears, provide education, and come up with a plan of treatment that will work best for the ailment we seek to treat. Another important element of medical marijuana consultations is that it opens the gateway for the palliative care team to offer advanced symptom management and begins to build the rapport for a long-standing relationship.