4 posts tagged “Medical”

Q & A with Dr. David Casarett, author of “Stoned: A Doctor’s Case for Medical Marijuana”

Posted July 22nd, 2015 by

If you’ve been following the blog lately, you might already know Dr. David Casarett – he’s a professor at the University of Pennsylvania’s Perelman School of Medicine and the author of “STONED: A Doctor’s Case For Medical Marijuana.” He recently worked with PatientsLikeMe on a survey that asked members how they felt about marijuana, and the results were just released last week. Below, read what David had to share about the inspiration behind his novel, his thoughts on online communities like PatientsLikeMe and the intertwined future of marijuana and medicine.

 

What inspired you to write “Stoned: A Doctor’s Case for Medical Marijuana?”

A patient – a retired English professor – who came to me for help in managing symptoms of advanced cancer. She asked me whether medical marijuana might help her. I started to give her my stock answer: that marijuana is an illegal drug, that it doesn’t have any proven medical benefits, etc. But she pushed me to be specific, in much the same way that she probably used to push her students. Eventually I admitted that I didn’t know, but that I’d find out. Stoned is the result.

Inside the book, you say “For Caleb. I hope he found the relief he was searching for.” Can you share a little about his story and why you dedicated the book to him?

I describe my meeting with Caleb in the first chapter. He was a young man with advanced colorectal cancer who drove his RV to Colorado to get access to medical marijuana. He got there, and marijuana was legal, but he couldn’t afford it. He had access to other legal drugs like morphine and ativan through his hospice, but he didn’t use them because they didn’t work for his pain, and made him feel sick. The only thing that worked for him–marijuana–was out of reach.

Sounds like you went through some interesting research experiences while you were writing the book. (Pot wine? Marijuana paste on your leg?) How did those experiences influence your perception of marijuana as medicine?

I was trying to understand what the best way is to get the “active ingredients” of marijuana into people. I saw lots of ads for various methods, and all sorts of products are available, but I wanted to know what works. It turns out that some methods, like marijuana tea or beer or wine, aren’t very effective. But others, like vaporizing, definitely are.

What do you think is the biggest misconception about marijuana in the medical community?

The biggest misconception about marijuana in the medical community is probably that it offers no medical benefits. At least, that’s what I thought when I started researching Stoned. Actually, there have been some good studies that have shown very real benefits for some symptoms. True, there isn’t as much evidence as I’d like. But there will be more. New research is coming on line every year, and we’re gradually figuring out whether and how marijuana works.

How do you see online communities like PatientsLikeMe contributing to the medical marijuana discussion?

I think the biggest potential contribution of PatientsLikeMe is a source of crowd-sourced science. Medical marijuana science is lagging far behind the way that people are using it. For instance, in researching Stoned, I spoke with dozens of people who were using marijuana to treat the symptoms of PTSD, but there haven’t been any randomized controlled trials of marijuana for that use. That doesn’t mean that marijuana doesn’t treat PTSD symptoms, just that we don’t know (yet) whether it does.

We need randomized controlled trials, but those trials will take time, and money. That’s where communities like PatientsLikeMe come in. We can learn from PatientsLikeMe members what they’re using medical marijuana for, and how. And we can learn whether they think it’s working. Those reports can help patients learn from each other, and they can help researchers figure out what to focus on.

What did you find most interesting about the PatientsLikeMe survey results?

I was surprised that 87% of people weren’t at all concerned about becoming addicted or dependent on marijuana. We know that although the risk of addiction is small (about 10%), it’s very real. That risk probably isn’t enough to convince most people to avoid medical marijuana, especially if it’s helping them. But we should all be aware of those risks, so we can be alert for signs of dependence, like impairment of function, or effects on work or relationships.

You mention that the future of medical marijuana is the most interesting, yet hardest to answer question. But that said, what do you think the future holds for medical marijuana?

Some of the most exciting advances in the science of medical marijuana, to me, are related to what marijuana tells us about the endocannabinoid system – that’s the system of hormones and neurotransmitters and receptors in all of us. We don’t know a lot about what that system does, but we do know that marijuana ‘works’ by tapping into that system. The cannabinoids in marijuana trick the body by mimicking naturally occurring endocannabinoids like anandamide.

So although it’s fascinating to think about what marijuana could do, and although clinical trials of marijuana are essential, the really neat science of the future may focus on that endocannabinoid system – what it does, how it works, and how we can use it to promote health.

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Results From PatientsLikeMe Survey Highlight Patient Beliefs About Medical Marijuana

Posted July 14th, 2015 by

Cambridge, MA, July 14, 2015—A new survey of 219 PatientsLikeMe members has found that patients with certain conditions who use medical marijuana believe it is the best available treatment for them, with fewer side effects than other options and few risks. The survey, conducted in June 2015, is among the first to gauge patient perceptions about the benefits and risks of medical marijuana and their level of willingness to recommend its use.

PatientsLikeMe’s Vice President for Advocacy, Policy, and Patient Safety, Sally Okun, RN said that while the number of respondents and conditions represented is limited, the survey and its results come at an important time. “As more people consider using medical marijuana, and more states legalize it, patients need to know what others are experiencing. This survey starts to gather real world data about marijuana as medicine—information that may be useful for patients and their physicians as they explore options and make treatment decisions.”

Half of the survey respondents started using medical marijuana in the last five years, while 25% started to do so in the last two years. Smoking (71%), edibles (55%), and vaporizing (49%) were the most commonly used methods for taking the treatment. The top three conditions represented were multiple sclerosis, fibromyalgia and depression. Key findings are as follows:

Usage and Perceived Side Effects

  • About three quarters (74%) of survey respondents agree that medical marijuana is the best treatment available for their health issue. Another 20% are unsure if there is another option available.
  • 76% report that they use medical marijuana because other treatments weren’t working and/or caused too many side effects. About 21% use it to avoid the side effects of other treatments.
  • When asked about the severity of side effects from using marijuana, 86% of PatientsLikeMe members who report using marijuana indicate the side effects are either “none” or “mild.” The same group says those side effects include dry mouth, increased appetite, and sleepiness.

Perceived Benefits and Risks

  • Survey respondents use medical marijuana for more than one reason, including to treat pain (75%), muscle stiffness or spasms (69%), insomnia (67%) and anxiety (55%). The majority (63%) considered marijuana as a treatment option because they think it is more natural.
  • Most (93%) say that they would recommend medical marijuana to another patient.
  • About 61% say their healthcare provider is supportive of their medical marijuana use, and 60% have a letter of recommendation or prescription.
  • Most patients report a low level of concern (“Not at all” or “A little”) with long-term health risks, such as developing lung cancer (89%), long-term lung damage (86%), or becoming addicted/dependent (96%).
  • One in four patients (26%) report being “Somewhat” or “Very” concerned with legal problems.

Infographics on these and other survey results and the complete list of questions and responses are available at http://news.patientslikeme.com.

David Casarett, M.D., a professor at the University of Pennsylvania’s Perelman School of Medicine and the author of the newly-released book STONED: A Doctor’s Case For Medical Marijuana, worked with PatientsLikeMe on the survey. “This is an important first step in crowdsourced science about medical marijuana. Until we have a lot more large, high-quality clinical trials, patients will need to rely on each other to learn about whether and how medical marijuana might help them.”

Medical marijuana refers to the use of the cannabis plant as well as synthetic THC and cannabinoids as medicine. It is legal in Canada, Belgium, Australia, the Netherlands, the United Kingdom, Spain, and in some U.S. states.

Survey Methodology
Between May 26 and June 10, 2015, PatientsLikeMe invited 1,288 members who added medical marijuana to their profile to respond to the survey; 219 completed it. The mean age of the respondents was 49 years (SD: 12.2); the age range was 19 – 84 years. Most respondents (81%) reported their location as the United States, while 13% are from Canada and the rest are from Australia, Europe, South Africa or Israel. Four respondents did not report their location.

About PatientsLikeMe
PatientsLikeMe® (www.patientslikeme.com) is a patient network that improves lives and a real-time research platform that advances medicine. Through the network, patients connect with others who have the same disease or condition and track and share their own experiences. In the process, they generate data about the real-world nature of disease that help researchers, pharmaceutical companies, regulators, providers, and nonprofits develop more effective products, services and care. With more than 350,000 members, PatientsLikeMe is a trusted source for real-world disease information and a clinically robust resource that has published more than 60 peer-reviewed research studies. Visit us at www.patientslikeme.com or follow us via our blog, Twitter or Facebook.

Contact
Margot Carlson Delogne
PatientsLikeMe
mcdelogne@patientslikeme.com
781.492.1039