Cannabis Patient Care - March/April 2021

Cannabis Patient Care - March/April 2021

Issue link:

Contents of this Issue


Page 27 of 34

28 cannabis patient care | vol. 2 no. 1 research focus In that study, Boehnke and his colleagues will be recruiting people, giving them CBD, THC, or the combination, and doing a wide range of assessments with everything from neuroimag- ing to quantitative sensory testing—which is a way of testing people's sensory function, such as pain thresholds. They will also be looking at how inflammatory biomarkers change after a course of a controlled cannabinoid treatment. "I'm definitely interested in trying to better understand the role of CBD, either by itself or with lower THC doses. I think that that's an important place to target because I think some peo- ple will respond to CBD alone, but a lot will likely require a bit of THC," he said. "So figuring out how to do that in a thoughtful way that translates very well to clinical practiceis important." "I think it's also important to frame our findings in terms of mitigating opioid overuse. For example, we know that people use CBD, they use cannabis as an opioid substitute, but how do they specifically do that? Do they use a CBD product? Do they use a THC product? Do they use a combo? Is it so individ- ualized that there's no point in coming up with a protocol? I think these are all open questions that would be really inter- esting to try to figure out moving forward. "It would also be great for the medical cannabis industry to move in a direction that supports these open questions. I've heard many concerns from physicians and scientists that this industry is making a huge amount of money selling cannabis products, but that they aren't actually testing whether these products are safe and effective. Supporting research efforts would both improve that image and also help integrate medi- cal cannabis into existing healthcare." Only time will tell if Boehnke's research can encourage a thoughtful integration of cannabis into the medical system. References (1) (2) E.K. Choo, S.W. Feldstein Ewing, and T.I. Lovejoy, "Opioids Out, Cannabis in Negotiating the Unknowns in Patient Care for Chronic Pain" JAMA 316(17), 1763–64 (2016). (3) K.F Boehnke, E. Litinas, and D.J Clauw, "Medical Cannabis Use Is Associated with Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients with Chronic Pain" J. Pain 17(6), 739-44 (2016). (4) K.F Boehnke, J.R. Scott, and E. Litinas, et al., "Pills to Pot: Observational Analyses of Cannabis Substitution Among Medical Cannabis Users with Chronic Pain" J. Pain 20(7), 830-841 (2019). (5) K.F Boehnke, J.R. Scott, and E. Litinas, et al., "High-Frequency Medical Cannabis Use Is Associated with Worse Pain Among Individuals with Chronic Pain" J, Pain 21(5-6), 570-58 (2020). (6) K.F. Boehnke, S. Gangopadhyay, and D.J. Clauw, et al., "Qualifying Conditions of Medical Cannabis License Holders In The United States" Pharm Med Tech. 38(2), 295-302 (2019). CONTINUED FROM PAGE 12 profession, Hildebrand explained. The plant's legal status in much of the world and consistency through batches has made clinical research challenging, and the availability of verifiable data hasn't kept pace with patient demand. "Dealing with pain or struggling with a chronic health con- dition can be very isolating. Worrying about securing med- ication and paying out-of-pocket only adds to the stress of illness, and can compound symptoms," Blecher said. "In many cases, cost is the single-largest barrier for patients, and the reason why they revert back to cheaper, covered, and often more dangerous and addictive medications." But many producers are providing ample support for their patients—both insured and uninsured. In the case of Starseed, it offers compassionate pricing for low-income patients, first responders, veterans, and seniors, including full, complimen- tary access to virtual medical consultations with it suite of professionals. Blecher added: "The cost of cannabis has long been a huge barrier for patients, as it isn't regarded in the same way that traditional pharma is—there is no government reimbursement, with the exception of veteran coverage, so it's up to private insurers, employers, union groups, and licensed producers to step up and affirm their core commitment to patient care." Hildebrand confirms many of her patients reporting the greatest improvements are those who are supported, moni- tored, and following a thoughtful treatment plan designed for the individual—not only the disease or condition. "Medicine is both an art and a science. Many doctors forget about the art and the intuition in our practice—balancing both and really caring for our patients gives them the best chance at recovery," she said. As for Theriault, nowadays when in his garage, he is def i- nitely not sitting around anymore. Instead, he is grabbing a shovel to clear snow, or gathering landscape tools to prune hedges, or mowing the lawn—returning to a life full of sim- ple moment s that remind him that life is indeed back to normal. References (1) H. Meng, M.G. Page, P. Ajrawat, A. Deshpande, B. Samman, M. Dominicis, K.S Ladha, J. Fiorellino, A. Huang, Y. Kotteeswaran, A. McClaren- Blades, L.P. Kotra, and H. Clarke, Can. J. Anaesth. doi: 10.1007/s12630- 020-01903-1 (2021) (2)

Articles in this issue

Links on this page

view archives of Cannabis Patient Care - March/April 2021 - Cannabis Patient Care - March/April 2021