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This is How Oncologists Feel About Prescribing Cannabis



Alexander Beadle Science Writer @alexbeadlesci

In just a few short decades, there has been a seismic shift in attitude among the general American public when it comes to cannabis legalization.

Between the year 2000 and 2018, public support for legalization has more than doubled from 31 percent to 66 percent, and up from 12 percent in 1969. 

Thanks to extensive polling like this, we have a good idea of how the general public feels about the drug. There are even polls that exist which shed light on incredibly specific opinions, such as whether Americans would feel comfortable having a President who has admitted to having used the drug.

But how do medical professionals feel? 

It’s a subject that, until recently, the industry has known relatively little about. General public opinion can support cannabis use, but unless there are physicians and caregivers who are knowledgeable and willing to prescribe the drug, prospective medical cannabis patients could face a tough time getting treatment, even in states where medical use has been long been legal. 

Cancer care providers like cannabis, but aren’t comfortable prescribing

Researchers from the University of Colorado Cancer Center recently released the results of a survey which asked oncology providers about their attitudes towards medical cannabis. The researchers’ findings were presented at the annual meeting of the American Society for Clinical Oncology (ASCO) in June. 

The survey was answered by 172 oncology providers in the state of Colorado, the majority of which were registered nurses, advanced practice providers, and physicians. 

Of those providers:

73.3 percent believed cannabis provides a medical benefit to cancer patients.84.3 percent rated their knowledge of the endocannabinoid system a 4 or below, on a scale of 1 (no knowledge) to 7 (very knowledgeable). And 54.7 percent didn’t feel comfortable recommending medical cannabis 

“What we found was that the majority of providers do feel like there is a benefit [to medical cannabis], but they lack the comfort and the knowledge around it,” Ashley E Glode, an assistant professor at the University of Colorado and the study’s lead author, told Analytical Cannabis. “A lot of their desires are to get more information from more legitimate sources.”

A whopping 98.2 percent of all respondents felt that medical cannabis should have been included more within healthcare education, and a giant 98.8 percent would like to see the topic featured within continuing medical education courses. 

The oncology providers also admitted that cannabis-related information usually came to them via their patients (68.4 percent), shortly followed by the news media (55 percent), and other providers (53.2 percent). 

“We know that different dispensaries have different strains, different doses, that they recommend, but the providers don't really have that information or know what to recommend to patients,” said Glode. “There's really not a lot of dosing guidelines like there are for the traditional drugs that we're used to seeing and prescribing.”

“As a pharmacist myself, we're always worried about potential drug interactions, and that information is lacking,” she added. “This plays into a lot of the hesitation we feel recommending that patients use [cannabis].”

The researchers are hoping to see similar studies be undertaken in other US states to help in fully assessing the concerns of cancer care providers throughout the nation. On the flipside, such studies might also help identify regions with good systems already in place. 

“If you are interested in using medical cannabis, talk to your oncologist providers,” says Glode. “We might not be the most knowledgeable, but we do want to support patients in managing symptoms and giving them the best options.”

Nearly all dermatologists support medical cannabis research

Oncologists aren’t the only medical professionals to be surveyed in this way. Last December, a group of researchers from the George Washington University School of Medicine and Health Sciences released the results of their own survey, which reached out to over 500 dermatology providers to gauge their knowledge, attitudes, and perceptions of cannabinoids as relates to dermatology. 

In that survey, nearly all (94 percent) of the 531 dermatologists believed that it would be worthwhile to research cannabinoids for dermatologic use, and a majority (84 percent) also thought that cannabinoids should be legal to use in medical treatments. 

Interestingly, most dermatologists (86 percent) said they would be willing to prescribe an FDA-approved cannabinoid topical treatment, but nearly half (48 percent) of the total respondents said they are concerned about negative stigmas associated with proposing cannabinoid therapies to their patients. 

Overall, dermatology providers appear to be interested in prescribing cannabinoid treatments. But, like the survey of oncologists, education was singled out as an area where further work needs to be done. 

Almost two-thirds (64 percent) of the dermatologists surveyed didn’t know that cannabidiol (CBD) is not psychoactive, and almost one-third (29 percent) didn’t know that tetrahydrocannabinol (THC) is psychoactive. 

But beware the “cannabis cure-all”, say medical professionals

But as the profile of medical cannabis treatment has grown, so too has the number of “miracle cure” claims, and many oncologists are now concerned that patients could be overestimating marijuana’s medical potential and shunning effective treatments. 

“As an oncologist in San Francisco for the past forty years, I have to say, if cannabis cured cancer, I would certainly have a lot more survivors,” Donald Abrams MD, a professor of clinical medicine at the University of California, San Francisco, told Analytical Cannabis in July

One such “miracle cannabis cure” is Rick Simpson oil, a homemade cannabis extract named for the man who reportedly used the oil to cure his own skin cancer. Despite not holding a single prescription to its name, online cancer discussion forums frequently mention the product as a viable and worthwhile treatment. 

Now medical professionals like Abrams are concerned that products like this could be leading patients to snub other clinically proven treatments in favor of these products, while cannabis industry professionals fear these false claims could be discrediting the still-emerging field of cannabis science. 

“I'm a very strong proponent of [medical cannabis], because a day doesn't go by that I don't see a cancer patient with nausea, loss of appetite, pain, insomnia, depression, and I can recommend one medicine to those patients,” Abrams told Analytical Cannabis.

“What pains me is people forgoing conventional therapy that may benefit them greatly and even cure them, in favor of using these products that have absolutely no evidence to support their use,” he explained. “And in San Francisco, patients pay up to $7,000 a month for these products. I just find it criminal and tragic.”

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