Indications for Cannabis

(Patients may have more than one diagnosis)

Precautions

• Bronchitis- No COPD, Emphysema, or Lung/Airway Cancers
• Metabolism by cytochrome p450 2C and 3A families

Cannabis-Induced Euphoria

• Often described as a “side effect” of Rx
• Is it really an “adverse experience”, particularly in the terminal patient?
• Is a single treatment that increases appetite, decreases nausea and vomiting, relieves pain and improves mood and sleep for overall Quality of Life.
• A potentially useful tool in palliative medicine.

What can (will) you do?

• Call it CANNABIS
• Learn more
• Ask patients about their use
• Assess and monitor
• Don’t include in drug testing if not necessary
• Talk to your legislators
• Talk to your colleagues
• Advocate for federally legal cannabis and regulations for medical use

Bad Medical Practice

• Refuse to learn about the science
• Refuse to treat the patient
• Refuse opioids for pain management
• Encourage drug addiction treatment
• Use more powerful medications with untoward side effects
• Take off transplant lists (“substance abuser”)

Department of Veteran Affairs

“If a Veteran obtains and uses medical cannabis in a manner consistent with state law, testing positive for cannabis would not preclude the Veteran from receiving opioids for pain management in a Department of Veteran Affairs (VA) Facility.”

Robert A. Petzel, MD
July 2010

“The provider will take the use of medical cannabis into account in all prescribing decisions just as the provider would for any other medication.”

Robert A Petzel, MD
July 2010