“Is medical cannabis safe for my patients?” A practical review of cannabis safety considerations

Summary & key facts

The authors looked at research and used expert opinion to answer two safety questions for doctors: can medical cannabis be used safely for a particular patient, and how can harms be reduced. They found that clear safety advice is scarce, so they made a practical, safety-focused framework. The framework lists who should take extra care or avoid cannabis, warns about drug interactions, and gives guidance on choosing the right cannabis type, how people take it, how much to use, and how doctors should monitor patients over time.

Key facts:

• The authors reviewed existing studies and added expert clinical opinion to focus on safety, not to prove effectiveness.
• They found that there is not much clear, practical safety guidance for medical cannabis in the current research.
• As a result, they created a safety-focused framework to help clinicians decide whether medical cannabis can be used in a specific patient.
• The framework includes precautions and contraindications, meaning it points out who might need to avoid cannabis or be closely watched.
• It also covers drug interactions, so doctors are warned about other medicines that could cause problems with cannabis.
• The review gives advice on risk-reduction steps such as choosing the right chemovar (the strain or chemical make-up of the product), picking a route of administration (for example inhaled versus oral), and starting with careful dosing.
• The authors recommend structured assessment and ongoing monitoring so clinicians can spot and manage problems while a patient is using medical cannabis.
• Because the guidance combines limited research and expert opinion, the authors note that uncertainty remains and that monitoring and cautious use are important.

Abstract

Medical cannabis use is increasing worldwide. Clinicians are commonly asked by patients to provide guidance on its safety and efficacy. Although there has been an increase in research on the role of medical cannabis for a number of different conditions, we found that there was a paucity of clear safety guidance on its use. We aim to address this issue by answering two pertinent clinician safety questions: 1 Can medical cannabis be safely used in this patient? 2. What strategies can be used to ensure that any harms from medical cannabis are mitigated? To address these questions, we reviewed available evidence and provided expert clinical opinion to summarize the fundamental components for evaluating medical cannabis safety and strategies to reduce risk from its use. Our review resulted in a safety-focused framework for medical cannabis initiation and utilization. We provide clear recommendations for patients being considered for cannabis (e.g. precautions, contraindications and drug interactions). Risk mitigation strategies such as appropriate chemovar (strain) selection, routes of administration, and dosing are reviewed. As with any other pharmacotherapy, we review the key components of monitoring and address potential issues that may arise while using medical cannabis. We propose a structured assessment and monitoring strategy that can be used by clinicians recommending cannabis (CRC) to guide patients through each step of their cannabis journey. This framework can be used to ensure that medical cannabis utilization is associated with the lowest possible risk to the patient.

Topics

Cannabis and Cannabinoid Research Homelessness and Social Issues Prenatal Substance Exposure Effects

Categories

Health Sciences Medicine Pharmacology

Tags

Cannabidiol Cannabis Computer science Computer security Dosing Economic growth Economics Effects of cannabis Health care Intensive care medicine Law Medical cannabis Medical emergency Medicine MEDLINE Patient safety Pharmacology Political science Psychiatry Risk assessment

Substances

Cannabis medical cannabis

Conditions & symptoms

Addiction Anxiety Chronic Pain Addiction or harmful habbits Anxiety or worry Chronic pain Poor sleep