Medicinal Cannabis

Medical Marijuana and Stem Cell Transplant: What Do We Know?

Summary: Learn how cannabis products affect mood and pain, how the potency and quality of cannabis varies, and how cannabis use can affect the health of transplant patients.
Marijuana is used by many stem cell transplant recipients to manage a variety of side effects, but caution is advised. The potency and purity can vary, depending on the source, and marijuana can affect the effectiveness of some other medications the patient may be taking.

Presenter: Joseph Bubalo PharmD, BCOP, BCPS, Oncology Pharmacotherapy Specialist, Oregon Health & Science University. Meet Dr. Bubalo: https://www.ohsu.edu/people/joseph-s-bubalo-pharmd

To read transcript, go to: https://www.bmtinfonet.org/video/medical-marijuana-and-stem-cell-transplant-what-do-we-know

Highlights:

– Medical marijuana is used for pain, nausea, appetite, seizures, and muscle spasms. Studies of pain control, however, have not been inconclusive due to methodological limitations.
– Compared to other recreational drugs, cannabis is considered a “soft drug” in terms of lethality, dangers, and addictiveness. But there remain risks which vary with the method of delivery. For instance, oral preparations generally pose less risk than smoking cannabis.
-Transplant patients should consult with their care team before using medical marijuana, as it may cause serious side effects with medications such as Jakafi, tacrolimus or cyclosporine that are often prescribed before or after transplant.

Presented at the 2021 Celebrating a Second Chance of Life Virtual Symposium, April 17-23, 2021
Presentation is 33 minutes long with 21 minutes of Q & A.

Key Points:

(05:27) There are major differences between the cannabinoid THC and CBD. THC produces a psychoactive effect sought by recreational users while CBD does not produce those effects.

(07:43) The dose and response to cannabis can vary greatly depending on whether it is smoked or taken orally.

(09:15) Cannabis can interact with prescription medications and may alter their effects. Depending on the medication, it may intensify or cancel out the intended response to prescription medications.

(10:21) Pharmaceutical cannabis comes in synthetic form with varying blends and differing preparations of THC or CBD.

(12:18) Cannabis comes in different forms: plant, resin cake, tincture, oils infusions, and edibles.

(14:19) Cannabis has varying potency and labels can be misleading. Commercially available synthetic compounds available on the internet are riskier than those from a dispensary using regularly sourced products.

(15:36) Commercially produced synthetic products, called cannabinoids are different than cannabis, and can cause serious side effects such as organ damage.

(21:52) Smoking cannabis delivers four times the particulates you get when smoking a cigarette, and has a similar risk of causing cancer.

(24:32) Cannabis use in people under age 25 can cause long-term problems, including addiction, because their brains are still developing.

(29:02) Cannabis is not a first line treatment. It’s most appropriate for debilitating conditions that have not responded to standard medications or therapies.

(34:47) Since cannabis can modulate the immune system, patients should refrain from using it for at least 100 days after a donor transplant (allogeneic) and 60 days after a transplant using your own stem cells (autologous).

Meet the speaker: https://www.ohsu.edu/people/joseph-s-bubalo-pharmd

WHO WE ARE: BMT InfoNet is dedicated to providing patients and their loved ones with emotional support and high quality, easy-to-understand information about blood stem cell transplants (bone marrow, peripheral blood and cord blood) and other cellular therapies. Whether you are just beginning your transplant or cellular therapy journey, or learning to manage the joys and challenges of survivorship,

BMT InfoNet is here to help before, during and after treatment. Our goal is to empower you with credible information and emotional support, so that you can take a more active role in decisions affecting your health. http://www.bmtinfonet.org

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