Rates of Cannabis Use in Patients with Cancer

Martell, Kevin; Fairchild, Alysa; LeGerrier, B.; Sinha, Richie; Baker, Sarah; Liu, H.; Ghose, A.M.; Olivotto, Ivo A.; Kerba, Marc

doi:10.3747/co.25.3983

Cited by 114 publications

(104 citation statements)

References 11 publications

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“…Current users tended to primarily use cannabis oil extracts to alleviate multiple symptoms simultaneously, suggesting potential for measurable doses of cannabinoids to substitute for other drugs such as analgesics, anti-emetics, hypnotics, and anxiolytics [5]. These results are consistent with those of other similar studies in Canada which reported on cannabis use in the medical setting prior to legalization [10,11].…”

supporting

confidence: 84%

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

Hawley

Gobbo

Afghari

2020

Preprint

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BackgroundCanada legalized cannabis use for medical purposes in 1999. Legalization of cannabis for recreational purposes in October 2018 offered the opportunity to assess the impact of recreational legalization on cancer patients' patterns of use to identify learning points that would be of use to other countries considering similar legislation. MethodTwo identical anonymous cross-sectional surveys were administered to cancer patients in British Columbia, 5 months apart (2 months before and 3 months following legalization), with the same eligibility criteria. The prevalence of medical cannabis use, the distribution of symptoms leading to use, the most common types of cannabis products and sources, reasons for stopping using cannabis, and barriers to access were assessed. ResultsThe overall response rate was 27% with 821 and 852 individuals returning the first and second surveys respectively. Both cohorts were similar regarding participants' characteristics, including age (median= 66yrs), gender (53% of participants were female), and education (one-third of participants had an education level of high school or less). Comparison of the two cohorts showed that legalization increased the prevalence of current cannabis use by 21% (23·1% to 29·1%, p-value 0·01). However, after legalization, Current Users reported more issues in getting cannabis (18% compared to 8%, pvalue: <0·01). The most common barrier cited was lack of available preferred products, from closure of illegal dispensaries. ConclusionsResults showed that legalization of access to cannabis for recreational purposes will have an unintended negative impact on those who use cannabis products for medical purposes. These should be anticipated and mitigated in the design and implementation of new legislation.

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supporting

confidence: 84%

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

Hawley

Gobbo

Afghari

2020

Preprint

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“…Comparing our two surveys, we found that legalization was associated with a 26% increase in the prevalence of current cannabis use, from 23•1% to 29•1% (p=0•01). One explanation for this increase might be that in the run-up to legalization news and media outlets were lled with articles about dispensaries opening and closing, [18,26,27] products available, [28,29], and new research [30-33], which may have emboldened more patients to try cannabis. Despite both surveys being anonymous, they may also have felt more comfortable disclosing recreational motivation for use.…”

Section: Comparison Between Before and After Legalization Surveysmentioning

confidence: 99%

“…Under the new legislation, only licensed dispensaries were allowed to sell legal recreational cannabis products, and many unlicensed dispensaries were forced to close while their license applications were being processed [15,17]. At the time of this study, 3 months after legalization, there was only one licensed dispensary open in BC [18]. Widespread publicity of the planned date of legalization created a unique opportunity to observe the use of cannabis in the medical setting both before and after recreational legalization.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

Hawley

Gobbo

Afghari

2020

Preprint

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Background Canada legalized cannabis use for medical purposes in 1999. Legalization of cannabis for recreational purposes in October 2018 offered the opportunity to assess the impact of recreational legalization on cancer patients’ patterns of use to identify learning points that could be helpful to other countries considering similar legislation.Method Two identical anonymous cross-sectional surveys were administered to cancer patients in British Columbia (2 months before and 3 months following legalization), with the same eligibility criteria. The prevalence of medical cannabis use, the distribution of symptoms leading to use, the most common types of cannabis products and sources, reasons for stopping using cannabis, and barriers to access were assessed.Results The overall response rate was 27%. Both cohorts were similar regarding age (median= 66yrs), gender (53% female), and education (approximately 85% of participants had an education level of high school graduation and higher). Respondents had multiple motives for taking cannabis, including to manage multiple symptoms, to treat cancer, and for recreational reasons. The majority of patients in both surveys did not use the legal medical access system. Comparison of the two cohorts showed that after legalization the prevalence of current cannabis use increased by 26% (23·1% to 29·1%, p-value 0·01), including an increased disclosure of recreational motive for use, from 32% to 40%. However, in the post-legalization cohort more Current Users reported problems getting cannabis (18%) than the pre-legalization cohort (8%), (p-value <0·01). The most common barrier cited was lack of available preferred products, including edibles, as these were only available from illegal dispensaries.Conclusions Results showed that legalization of cannabis for recreational purposes may have an impact on those who use medical cannabis. Impacts include an increase in prevalence of use; problems accessing preferred products legally; higher cost, and difficulties using a legal access system. The desired goal of regulation in reducing harms from use of illegal cannabis products are unlikely to be achieved if the legal process is less attractive to patients than use of illegal sources.

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“…Approximately 75% of individuals with cancer use cannabis for symptom management, most commonly pain, nausea, and sleep disruption; however, to the best of our knowledge, the evidence base supporting this has been limited. It is important to note at the outset that the majority of the cannabis research conducted in oncology patients lacks the rigor that would be required of most other oncology treatments in practice.…”

Section: Cannabis: Indications Use Versus Evidence Basementioning

confidence: 99%

Medical cannabis use among individuals with cancer: An unresolved and timely issue

Nugent

Meghani

Rogal

et al. 2020

Cancer

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The role of cannabis in cancer care is a complex and challenging issue. Cancer and its treatments currently are designated as qualifying conditions in the majority of the 33 states that now have legalized medical cannabis. 1 Consequently, cannabis use in patients with cancer is common: nearly one-quarter of individuals with cancer report current cannabis use 2,3 and >90% of cancer survivors view cannabis as potentially beneficial for symptom management and support its legalization. 4 Recent studies have suggested that physicians may be more likely to recommend cannabis to patients with cancer compared with patients with other serious illnesses, 5 and that oncologists are becoming increasingly accepting of patients using cannabis, despite their continued concerns regarding its safety and efficacy. 6,7 For example, approximately 46% of oncologists reported recommending medical cannabis clinically and approximately 80% discussed it with their patients, despite the fact that approximately 70% acknowledged that they were insufficiently educated regarding medical cannabis. 8 Thus, there appears to be a disconnect between medical cannabis's legal status and high acceptance by patients, recommendations from clinicians, and a poor evidence base concerning its safety and efficacy.A more complete and nuanced understanding of the relevant issues is imperative in this current climate of growing cannabis availability and acceptance. In this commentary, we have discussed key clinical issues related to the efficacy and safety of cannabis in patients with cancer and noted important lingering questions for clinical practice and research in this area. Cannabis: Indications, Use Versus Evidence BaseApproximately 75% of individuals with cancer use cannabis for symptom management, most commonly pain, nausea, and sleep disruption 9,10 ; however, to the best of our knowledge, the evidence base supporting this has been limited. It is important to note at the outset that the majority of the cannabis research conducted in oncology patients lacks the rigor that would be required of most other oncology treatments in practice. Even the limited number of randomized controlled trials that exist for comparing the efficacy of cannabis with that of placebo or other drugs in oncologic patients are homogeneously low or very low in quality. 11 A recent systematic review characterized the available evidence regarding cannabis for cancer symptom management as low quality and found no benefit for its common indications of pain, sleep, or a reduction of opioid dose. 12 In addition, to our knowledge, evidence for the antiemetic properties of plantbased preparations is seriously lacking. In effect, the best evidence exists for oral, pharmaceutically prepared, synthetic tetrahydrocannabinols (THCs) such as nabilone and dronabinol, which have been found to be superior to placebo and equivalent to other antiemetic medications. [13][14][15] For example, one observational prospective study found at least a 30% reduction in symptoms such as vomiting and fatigue ...

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Rates of Cannabis Use in Patients with Cancer

Abstract: Background A comprehensive assessment of cannabis use by patients with cancer has not previously been reported.

Cited by 114 publications

References 11 publications

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

The Impact of Legalization of Access to Recreational Cannabis on Canadian Medical Users with Cancer.

Medical cannabis use among individuals with cancer: An unresolved and timely issue

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