Help Patients Make Wise Decisions About Cannabis Use

June 27th, 2023
Medical cannabis

Although data are still limited for its efficacy, cannabis is used by many patients to control pain, and pharmacists can discuss the evidence from recent clinical trials, according to a presentation at the APhA2023 Annual Meeting and Exposition.

A lot of patients, as I begin to talk to them about their cannabis use, see me as the policeman. And that’s not what I’m trying to do,” said Kari L. Franson, PharmD, PhD, BCPP, a professor and the associate dean at the USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, in Los Angeles. “I’m trying to help them make wise decisions about their cannabis use.”

During the talk, Franson discussed clinical studies investigating the efficacy of cannabis for treating pain and the risks of acute and chronic exposure. It’s important, she said, to “identify techniques to support patient counseling, consultation and advocacy in the complex legal environment we’re in when it comes to cannabis.”

Pharmacists should also ascertain the nature of the product the patient is using, which may have different effects depending on whether it contains relatively more THC (tetrahydrocannabinol, the compound responsible for the cannabis “high”) or CBD (cannabidiol), or is a hybrid of both, or “maybe is just hemp that doesn’t have cannabinoids in it at all,” Franson said.

A number of studies have found little benefit for cannabis on acute pain (Reg Anesth Pain Med 2021;46[2]:137-144; Br J Clin Pharmacol 2022;88[7]:3114-3131; Med J Aust 2021;214[8]:370-375). On the other hand, the Living Systematic Review on Cannabis and Other Plant-Based Treatments for Chronic Pain undertaken by the Department of Health and Human Services’ Agency for Healthcare Research and Quality indicates that THC-type cannabis may decrease chronic pain.

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