“Is medical cannabis safe for my patients?” A practical review of cannabis safety considerations

Abstract

Medical cannabis use is increasing worldwide. Clinicians are commonly asked by patients to provide guidance on its safety and efficacy. Although there has been an increase in research on the role of medical cannabis for a number of different conditions, we found that there was a paucity of clear safety guidance on its use. We aim to address this issue by answering two pertinent clinician safety questions:1 Can medical cannabis be safely used in this patient? 2. What strategies can be used to ensure that any harms from medical cannabis are mitigated?To address these questions, we reviewed available evidence and provided expert clinical opinion to summarize the fundamental components for evaluating medical cannabis safety and strategies to reduce risk from its use. Our review resulted in a safety-focused framework for medical cannabis initiation and utilization. We provide clear recommendations for patients being considered for cannabis (e.g. precautions, contraindications and drug interactions). Risk mitigation strategies such as appropriate chemovar (strain) selection, routes of administration, and dosing are reviewed. As with any other pharmacotherapy, we review the key components of monitoring and address potential issues that may arise while using medical cannabis. We propose a structured assessment and monitoring strategy that can be used by clinicians recommending cannabis (CRC) to guide patients through each step of their cannabis journey. This framework can be used to ensure that medical cannabis utilization is associated with the lowest possible risk to the patient.

Adherence, Safety, and Effectiveness of Medical Cannabis and Epidemiological Characteristics of the Patient Population: A Prospective Study

“…The adverse events in this study were modest, and no significant difference in the occurrence of serious adverse effects was found ( 43 ). These results may be attributed to the safety-focused approach implemented; a guided choice of chemovar and route of administration, a slow titration method, an initial follow-up after 1 month, and a follow-up after 6 months, could be the strategy that ensured that harms from medical cannabis were mitigated ( 44 ).…”

Potential Mechanisms Underlying Marijuana-Associated Periodontal Tissue Destruction

“…Recent relevant reviews are available on, for example, phytocannabinoid structure and biosynthesis (Tahir et al 2021), the influence of cannabinoids on neural inflammation (McKenna and McDougall 2020), the modulation of inflammasomes (Suryavanshi et al 2020), their use in cancer and immune medicine (Sledzinski et al 2020), CBD-specific immune suppression (Nichols and Kaplan 2020), and safety considerations for medicinal use (MacCallum et al 2021). The strengths and limitations of the extant epidemiologic studies that have examined the relationship between cannabis and periodontitis are eloquently presented by Mayol et al (2021), including discussion of several lower-quality or older papers not discussed herein.…”

Digital Medical Cannabis as Market Differentiator: Second-Generation Artificial Intelligence Systems to Improve Response

“…The increase in strength of THC-plants composition is related to legalization, globalization, pharmaceutical-related factors ( 3 , 4 ). The increased use of medical cannabis for multiple diseases and legalization of its use in many countries have led to the increase in variety of products available.…”