Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

Abstract

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

Framing the use of cannabis as a medicine in New Zealand: Regulatory, Clinician and Patient contexts

“…264 Within the state of Georgia, Singh reported that 32% of patients accessed their cannabis products from a private supplier and 57% shipped it from out of state, whilst 10% reported using a medical cannabis dispensary. 262 As with my study, cost and access regarding cannabis-related products rated highly as a concern in multiple studies, regardless of diagnosis. [97][98][99][100]262 Whilst a recent study of NZ medicinal cannabis users, regardless of diagnosis, indicated that smoking was the primary mode of administration, 99 this study indicated that oncology patients were just as likely to use oils and edibles.…”

“…262 As with my study, cost and access regarding cannabis-related products rated highly as a concern in multiple studies, regardless of diagnosis. [97][98][99][100]262 Whilst a recent study of NZ medicinal cannabis users, regardless of diagnosis, indicated that smoking was the primary mode of administration, 99 this study indicated that oncology patients were just as likely to use oils and edibles. This is in keeping with an Australian study by Luckett et al, where in oncology patients who were surveyed about cannabis and possible participation in a clinical trial for anorexia and appetite loss indicated a preference for oral administration of medicinal cannabis products (71%).…”

“…This finding is similar to overseas of their most common reasons for using cannabis. 243,[261][262][263] Whilst pain management seems to be of most interest to the patients in our survey, it is of interest that 17% of participants indicated they believed that cannabis may be able to cure their condition.…”

“…282 Singh et al reported that more than 50% of participants were using oil of some type, compared with 20% indicating 'other use'. 262 Pergam et al reported equal numbers of active users who smoked and used edible/oral administration. 243 This may be taken into consideration when reviewing the types of medicinal cannabis products offered through medicinal cannabis schemes.…”

“…261 Singh et al, 2019, surveyed patients in a state (Georgia) with restrictive cannabis laws, with 95% of patients indicating that 'cannabis-related' products, whether illicit or licit, were important or extremely important in reducing pain. 262 In Italy, Cortellini et al, 2019, surveyed oncology patients about their beliefs surrounding medicinal cannabis use, of which 55% had considered use for pain. 263 Pergam et al, 2017, reported that active users reporting cannabis use were using it most frequently for pain.…”