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Jury Still Out on Medical Marijuana and Otolaryngology

Comprehensive Otolaryngology Track

 

Medical marijuana may seem like a trend the United States is on its way to embracing, but whether it becomes a big player in otolaryngology remains to be seen.

The patchwork of state laws regarding the use of medical marijuana—as well as the fact that the drug itself is still illegal at the federal level—make it difficult to know exactly how many otolaryngologists are embracing the medical use of cannabis. But based on the available information, Brian J. McKinnon, MD, MBA, MPH, of the University of Texas Medical Branch at Galveston, Texas, said in his session on Monday, “A conservative estimate is that less than 2% of otolaryngologists are approved to recommend the medicinal use of cannabis.”

It’s not necessarily a surprising statistic. Despite a wealth of surveys that make claims about the effects of medical marijuana, research is still mixed.

The National Academies of Science, Engineering, and Medicine concluded definitively in 2017 that cannabis/cannabinoids are effective in three conditions:

  • Nausea and vomiting in chemotherapy patients
  • Chronic pain in adults
  • Improvement of patient-reported multiple sclerosis spasticity symptoms

Its effect on other conditions, such as its possible association with the incidence of head and neck cancer, still requires further research.

“In terms of the clinical side,” said Dr. McKinnon, “otolaryngology is still in its infancy of determining the efficacy and safety of cannabis among various otolaryngologic conditions.”

It’s important to note in discussions of medical marijuana that cannabis is not a single drug in the pharmacologic sense of the word. “Over one thousand distinct molecules have been described to be found in the plant species Cannabis sativa, including terpenes, phenolic compounds, and nearly one hundred distinct cannabinoids,” said Dr. McKinnon. Tetrahydrocannabinol (THC) and cannabidiol (CBD) are the most well-known cannabinoids.

States differ heavily on laws that determine if and when any form of cannabis can be used to treat patient conditions. Of the 33 states that allow medical marijuana, only Washington, DC and Oklahoma allow patients to use it for any medical diagnosis. The next most flexible state is Illinois, which has a list of 40 approved conditions for which medical marijuana can be prescribed.

So in terms of medical marijuana becoming widely embraced by otolaryngologists, the jury is still out.

“We have to be honest about the fact that it is still illegal at the federal level, and that from an otolaryngologist and patient point of view, there is a great deal of confusion about whether its role should be adopted or not in the provision of care based on this difference between the state and federal government,” said Dr. McKinnon. “Much research still needs to be done to overcome the paucity of evidence supporting benefit.”

 

This event, which was presented September 14, 10:00 am (ET), will be available in the on-demand library of education content within 72 hours following the presentation.

 

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