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Perception of Benefits and Harms of Medical Cannabis among Seriously Ill Patients in an Outpatient Palliative Care Practice.

Authors
  • Zarrabi, Ali John1
  • Welsh, Justine W2
  • Sniecinski, Roman3
  • Curseen, Kimberly1
  • Gillespie, Theresa4
  • Baer, Wendy2
  • McKenzie-Brown, Anne Marie3
  • Singh, Vinita3
  • 1 Department of Family and Preventive Medicine, Emory University, Atlanta, Georgia. , (Georgia)
  • 2 Department of Psychiatry and Behaviorial Sciences, Emory University, Atlanta, Georgia. , (Georgia)
  • 3 Department of Anesthesiology, Emory University, Atlanta, Georgia. , (Georgia)
  • 4 Department of Surgery, Emory University, Atlanta, Georgia. , (Georgia)
Type
Published Article
Journal
Journal of palliative medicine
Publication Date
Sep 20, 2019
Identifiers
DOI: 10.1089/jpm.2019.0211
PMID: 31539298
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Introduction: Patients with serious illness often have pain, uncontrolled symptoms, and poor quality of life. Evidence continues to evolve regarding the role of cannabis to treat chronic pain, nausea, and anorexia. Little is known about how patients with serious illness perceive its benefits and harms. Given that an increasing number of clinicians across the United States are treating patients with medical cannabis, it is important for providers to understand patient beliefs about this modality. We assessed patient perceptions of benefits and harms of cannabis who obtained a medical cannabis card within an ambulatory palliative care (APC) practice. Methods: We recruited patients with a medical cannabis card, allowing for legal possession of cannabis oil, from an APC practice in Georgia. All participants reported using cannabis products. Patients completed an online survey that included questions about their cannabis use, concurrent opiate or controlled medication use, and perceptions of benefits and harms of cannabis. Results: All 101 patients invited to participate completed the survey. A majority had cancer (76%) and were married (61%), disabled or retired (75%), older than 50 years of age (64%), and men (56%). Most patients ingested (61%) or vaporized (49%) cannabis products. A majority of respondents perceived cannabis to be important for their pain (96%) management. They reported that side effects were minimally bothersome, and drowsiness was the most commonly reported bothersome harm (28%). A minority of patients reported cannabis withdrawal symptoms (19%) and concerns for dependency (14%). The majority of patients were using concurrent prescription opioids (65%). Furthermore, a majority of cancer patients reported cannabis as being important for cancer cure (59%). Conclusion: Patients living with serious illnesses who use cannabis in the context of a multidisciplinary APC practice use cannabis for curative intent and for pain and symptom control. Patients reported improved pain, other symptoms, and a sense of well-being with few reported harms.

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