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Exploring the Use of State Medical Cannabis Legislation as a Proxy for Medical Cannabis Use Among Patients Receiving Chemotherapy

  • Palliative and Supportive Care (MP Davis, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

The use of medical cannabis is expanding in the USA. Due to conflicting, low-quality evidence, many oncologists may not feel confident to recommend it to patients. Given the potential for legal and financial risks when conducting clinical trials with medical cannabis, the use of observational data should be explored. Observational data that directly capture medical cannabis use in relation to prescription medications and track the prevalence and patterns of cannabis use is sparse. To gain insights into the role medical cannabis plays in the pharmaceutical landscape, proxies such as cannabis legislation need to be explored. In the context of recommendation-nonadherent antiemetic prescribing among patients experiencing chemotherapy-induced nausea and vomiting, medical cannabis may be a suitable alternative to an antiemetic in states that allow medical cannabis. Findings suggest that legislation may impact the use of certain antiemetics in states with cannabis legislation in place. The presence or absence of legislation regarding medical cannabis use may serve as an early, observable surrogate marker of medical cannabis use in the community. In light of the paucity of clinical trials and observational datasets that capture cannabis use, there remains a tremendous need for the development of methodologies or standardized datasets that appropriately and reliably capture the use of medical cannabis to facilitate research into its clinical application and effect on prescription medication use. Standardizing the reporting and destigmatizing use could eliminate the dependence upon proxy measures as a substitute for more extensive data and go a long way in improving data capture, thus allowing us to generate knowledge and hypotheses from observational data until research conditions improve and allow for expanded clinical trials involving medical cannabis.

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Acknowledgments

The authors would like to acknowledge Dr. Volker Gressler for his clinical expertise and assistance throughout the study.

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Authors and Affiliations

  1. School of Pharmacy, Department of Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, MD, 21201, USA

    Laura E. Gressler MS, Julia F. Slejko PhD & Eberechukwu Onukwugha PhD

  2. Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Alan P. Baltz MD

  3. USA MEDCOM Pharmacy Service Line, Defense Health Agency, San Antonio, TX, USA

    Ryan C. Costantino MS, PharmD, BCPS

Authors
  1. Laura E. Gressler MS
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  2. Alan P. Baltz MD
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  3. Ryan C. Costantino MS, PharmD, BCPS
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  5. Eberechukwu Onukwugha PhD
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Correspondence to Laura E. Gressler MS.

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The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of any agency of the US government.

Conflict of interest

Laura Gressler, Alan Baltz, and Ryan Costantino have no conflicts of interest to declare. Dr. Onukwugha reports grants from Bayer Healthcare, grants from Pfizer, Inc., and personal fees from IMPAQ, International, outside the submitted work. Dr. Slejko reports grants from PhRMA, grants from PhRMA Foundation, grants from Novartis Pharmaceuticals, grants from Takeda Pharmaceuticals, and other from Pfizer, outside the submitted work. Alan P. Baltz declares that he has no conflict of interest. Ryan C. Costantino declares that he has no conflict of interest. Julia F. Slejko has received research funding from PhRMA, PhRMA Foundation, Novartis Pharmaceuticals, and Takeda Pharmaceuticals and has received a teaching honorarium from Pfizer. Eberechukwu Onukwugha has received research funding from Bayer Healthcare Pharmaceuticals and Pfizer and has received compensation from Novo Nordisk for service as a consultant.

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Gressler, L.E., Baltz, A.P., Costantino, R.C. et al. Exploring the Use of State Medical Cannabis Legislation as a Proxy for Medical Cannabis Use Among Patients Receiving Chemotherapy. Curr. Treat. Options in Oncol. 22, 1 (2021). https://doi.org/10.1007/s11864-020-00803-2

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