cannabis

In a survey looking at physicians’ choice of drugs to treat wasting, the first line choice of 80 percent of the care providers was megestrol with dronabinol being used by 54 percent of feminized marijuana seeds. Dronabinol was also the second line choice of most providers. Problems that have been identified with dronabinol are that patients feel “too stoned”; are unable to titrate their dose properly; note delayed onset of effect, prolonged duration of effect, or problems with malabsorption; and “not the same feeling as smoked marijuana.”

Vinciguerra and colleagues (1988) studied smoked marijuana in an open trial in 74 patients who previously had no improvement with standard antiemetic agents. Nearly 25 percent of patients who initially consented to participate later refused treatment citing bias against smoking, harshness of smoke, and preference for oral dronabinol. Of the remaining 56 patients, 18 (34 percent) rated it very effective and 26 (44 percent) moderately effective feminized seeds. Twelve (22 percent) noted no benefit. Sedation occurred in 88 percent, dry mouth in 77 percent, and dizziness in 39 percent. Only 13 percent were free of adverse effects.

There was also a clear dose-response relationship for sedation, mental clouding, and other central nervous system (CNS) related side effects. Because of sedation, the 20-mg dose was judged to be “of limited value for most patients.” The second study in 36 cancer patients compared placebo, 10, and 20 mg of 9-THC and 60 and 120 mg of codeine over a 7-hour observation period (Noyes et al. 1975b) cannabis seeds. Codeine 120 mg and 9-THC 20 mg were similar to each other and significantly superior to placebo for the sum of the pain intensity differences and total pain relief, while other pairwise contrasts were not significant. Relative potency analysis was not performed.