Your Dose of Cannabis Education
Your Dose of Cannabis Education
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Your Dose of Cannabis Education is based on data from the studies and reviews published in the current peer-reviewed medical journals. Whether you are a healthcare provider, patient, caregiver, an individual working in the healthcare sector, or just a curious person, you can benefit from Your Dose of Cannabis Education.
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2025-06-09
Is the effect of marijuana use on chest CT similar to or different than cigarette smoking?
A 2025 study addressed this question "By searching the electronic medical record, we identified patients who were marijuana users who never smoked; current smokers; and non-marijuana never smokers, who underwent chest CT in our healthcare system in 2019. We generated a random sample of 100 marijuana users as well as 100 each age- and sex-matched controls from the current smoker and never-smoker groups. Patients with extensive airspace disease on CT were excluded. Quantitative CT analysis was performed to measure total lung volume (TLV). A thoracic radiologist reviewed chest CTs in a blinded fashion for the presence of emphysema, centrilobular ground glass opacities, mosaic attenuation, bronchial wall thickening, and coronary calcification... TLV was higher in smokers than marijuana users and non-smokers (p<.01 for both). By visual analysis, 62% of smokers had emphysema versus 4% of marijuana users (p<.001). Additionally, centrilobular ground glass opacities were more prevalent in smokers (15%) than in marijuana users (2%) (p_=_0.0008). No significant difference was noted in the occurrence of mosaic attenuation between smokers and marijuana users. In terms of coronary artery calcification, more smokers had moderate to severe coronary artery calcifications compared to marijuana users (43% versus 25%, p=0.01)." Bottom line: "While emphysema and hyperinflation were common in smokers, they were rare in marijuana users."Singh A, Alcali O, Hunsaker AR, Hammer MM. Quantitative and qualitative imaging in marijuana users and smokers. Curr Probl Diagn Radiol. Published online April 26, 2025.
2025-06-06
Why should clinicians counsel patients against inhaled cannabis as the predominant route of administration for chronic noncancer pain management?
"[T]here are several reasons to counsel patients against inhaled cannabis as the predominant route of administration for chronic noncancer pain management. First, cannabis smoke involves the same mechanism of combustion and contains many of the same toxins and carcinogens as tobacco smoke. Second, regular cannabis use is associated with symptoms of chronic bronchitis. Third, there are no long-term studies examining the safety of heavy, long-term use of inhaled cannabis nor of the safety of inhaled use in older patient populations and those with existing lung disease. Studies have not shown that cannabis smoking increases the risk for lung cancer, but these studies are limited because many participants also smoked tobacco, the levels of cannabis use were relatively low, and cannabis was less potent at the time of the studies. Of note, although prior studies have not established whether cannabis smoking increases the risk for head and neck cancer, a recent study found that participants with cannabis use disorder who presumably used cannabis heavily had a 2.5- to 8-fold higher risk for head and neck cancer."Kansagara, D., Freeman, M., & O'Neil, M. (2025). Cannabis or cannabinoids for the management of chronic noncancer pain: Best practice advice from the American College of Physicians. Annals of Internal Medicine. Advance online publication. https://doi.org/10.7326/ANNALS-24-03319
2025-06-05
Which patients are NOT good candidates for medical cannabinoids?
"Individuals with psychotic disorders, unstable cardiovascular disorders, who are pregnant, who are planning to become pregnant, and/or who are breastfeeding, should avoid medical cannabis." Also, "clinicians should counsel the following subgroups of patients that the harms of cannabis or cannabinoid use for chronic noncancer pain are likely to outweigh the benefits: young adult and adolescent patients, ...and frail patients and those at risk for falling." "The contraindications associated with medical cannabis are more closely linked to THC, but... CBD-predominant products may contain THC."Bhaskar A, Bell A, Boivin M, Briques W, Brown M, Clarke H, Cyr C, Eisenberg E, de Oliveira Silva RF, Frohlich E, Georgius P, Hogg M, Horsted TI, MacCallum CA, Muller-Vahl KR, O'Connell C, Sealey R, Seibolt M, Sihota A, Smith BK, Sulak D, Vigano A, Moulin DE. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021 Jul 2;3(1):22. doi: 10.1186/s42238-021-00073-1. PMID: 34215346; PMCID: PMC8252988. AND Kansagara, D., Freeman, M., & O'Neil, M. (2025). Cannabis or cannabinoids for the management of chronic noncancer pain: Best practice advice from the American College of Physicians. Annals of Internal Medicine. Advance online publication. https://doi.org/10.7326/ANNALS-24-03319
2025-06-04
When should medical cannabis treatment be discontinued?
"Discontinuation of medical cannabis treatment should occur if the patient experiences intolerable, moderate, or severe cannabis-related adverse effects, the maximum agreed upon dose is reached and does not benefit the patient, and/or the patient has misuse or diversion associated with cannabis. Reporting of adverse events should be congruent with regional regulatory requirements."Bhaskar A, Bell A, Boivin M, Briques W, Brown M, Clarke H, Cyr C, Eisenberg E, de Oliveira Silva RF, Frohlich E, Georgius P, Hogg M, Horsted TI, MacCallum CA, Muller-Vahl KR, O'Connell C, Sealey R, Seibolt M, Sihota A, Smith BK, Sulak D, Vigano A, Moulin DE. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021 Jul 2;3(1):22. doi: 10.1186/s42238-021-00073-1. PMID: 34215346; PMCID: PMC8252988.
2025-06-03
When a patient is trialing medicinal cannabinoids, how frequently should the patient be seen?
"At the initiation of medical cannabis treatment, clinicians may consider following the patient every 2-4 weeks. In individual patients, more frequent follow-up may be needed, particularly at the beginning of the medical cannabis treatment. Once the patient is at a stable dose or sufficiently knowledgeable with medical cannabis dosing and titration, follow-up may occur once every 3 months or even longer thereafter. However, adherence to local jurisdictional guidance may dictate follow-up frequency."Bhaskar A, Bell A, Boivin M, Briques W, Brown M, Clarke H, Cyr C, Eisenberg E, de Oliveira Silva RF, Frohlich E, Georgius P, Hogg M, Horsted TI, MacCallum CA, Muller-Vahl KR, O'Connell C, Sealey R, Seibolt M, Sihota A, Smith BK, Sulak D, Vigano A, Moulin DE. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021 Jul 2;3(1):22. doi: 10.1186/s42238-021-00073-1. PMID: 34215346; PMCID: PMC8252988.
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