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HIGH HOPES
Hematology patients are turning to cannabis for symptom relief , but should they ?
As of October 2017 , 28 states and the District of Columbia had legalized medical or recreational marijuana . However , the plant is still considered a “ schedule I substance ” under the Controlled Substance Act , which means it has a high potential for abuse ; no accepted medical use ; and falls into the same category as heroin , LSD , and ecstasy – at least according to the federal government . 1 In 2016 , responding to petitions asking for marijuana to be “ rescheduled ” for the benefit of scientific research , the Drug Enforcement Agency ( DEA ) doubled down on its insistence that cannabis and its compounds are recreational drugs , not medicine . 2 At the same time , another federal agency , the U . S . Food and Drug Administration ( FDA ), approved two cannabis-derived products for a variety of indications . 3 , 4 Despite the conflict between state and national laws and the confusion among federal agencies , many patients with cancer have embraced marijuana to help manage their cancer and cancer-related symptoms .
“ Patients with hematologic malignancies often seek aggressive treatment , including transplants , nearly up until the end of life ,” David Casarett , MD , chief of palliative care at Duke University in Durham , North Carolina , told ASH Clinical News . This can mean weeks and months of active treatment when they do not have access to hospice care , he explained . “ For those patients , there is a particularly strong need for palliative care delivered alongside aggressive treatment ; medical cannabis represents one option for palliative care .”
If patients are using marijuana medicinally , the onus is on their physicians to address their use . “ As physicians , we need to have conversations about the use of medical marijuana with our patients ,” noted Steven Pergam , MD , MPH , medical director of infection prevention at the Seattle Cancer Care Alliance in Washington , a state where medicinal and recreational marijuana use is legal . “ Many physicians are skeptical about its benefits , and it ’ s true that there are few data on its risks and benefits , but if we don ’ t talk to our patients about it , they will talk with other people [ who ] may not be the best sources of information .”
As evidenced by the patchwork of marijuana legalization laws in the U . S ., the acceptance of medical marijuana is still hazy . ASH Clinical News spoke with Drs . Casarett and Pergam and
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