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Cannabis and Cannabinoids

Educational Objectives To review studies on Cannabis and Cannabinoids use in therapeutics.
1 Credit CME

In the US, 25 states and the District of Columbia now permit some medical use of botanical marijuana (Cannabis sativa).1 It has been used for centuries to treat various ailments, but non-standardization of dosage makes available data difficult to interpret. Cannabis contains >60 pharmacologically active cannabinoids.2

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Article Information

Once a month, The Medical Letter provides a previously published article to JAMA to be republished.

Previous Publication: This article was published in The Medical Letter on Drugs and Therapeutics. August 1, 2016;58(1500):97-98 and updated on August 17, 2016. It is reprinted here with permission from ©The Medical Letter Inc.

For a free trial subscription to The Medical Letter, go to www.medicalletter.org/tmlj. The Medical Letter—Essential to your practice.

About The Medical Letter: The Medical Letter is a nonprofit organization that publishes biweekly new drug evaluations and treatment recommendations. The Medical Letter does not accept advertisements, gifts, grants, or donations. Financial support comes solely from sales of subscriptions, books, software, continuing education materials, and licenses.

Editors: Mark Abramowicz, MD, President; Gianna Zuccotti, MD, MPH, Vice President and Executive Editor; Jean-Marie Pflomm, PharmD, Editor in Chief

References
1.
National Conference of State Legislatures. State medical marijuana laws. www.ncsl.org/research/health/state-medical-marijuana-laws.aspx. Accessed July 21, 2016.
2.
Whiting  PF, Wolff  RF, Deshpande  S,  et al.  Cannabinoids for medical use: a systematic review and meta-analysis.  JAMA. 2015;313(24):2456-2473.PubMedGoogle ScholarCrossref
3.
Wilkie  G, Sakr  B, Rizack  T.  Medical marijuana use in oncology: a review.  JAMA Oncol. 2016;2:670.PubMedGoogle ScholarCrossref
4.
 Rolapitant (Varubi) for prevention and delayed chemotherapy-induced nausea and vomiting.  Med Lett Drugs Ther. 2016;58(1487):17-18.PubMedGoogle Scholar
5.
Portenoy  RK, Ganae-Motan  ED, Allende  S,  et al.  Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial.  J Pain. 2012;13(5):438-449.PubMedGoogle ScholarCrossref
6.
Hill  KP.  Medical marijuana for treatment of chronic pain and other medical and psychiatric problems: a clinical review.  JAMA. 2015;313(24):2474-2483.PubMedGoogle ScholarCrossref
7.
Yadav  V, Bever  C  Jr, Bowen  J,  et al.  Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology.  Neurology. 2014;82(12):1083-1092.PubMedGoogle ScholarCrossref
8.
Devinsky  O, Marsh  E, Friedman  D,  et al.  Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial.  Lancet Neurol. 2016;15(3):270-278.PubMedGoogle ScholarCrossref
9.
Friedman  D, Devinsky  O.  Cannabinoids in the treatment of epilepsy.  N Engl J Med. 2015;373(11):1048-1058.PubMedGoogle ScholarCrossref
10.
Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists. Committee Opinion: Marijuana use during pregnancy and lactation. Number 637, July 2015. www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Marijuana-Use-During-Pregnancy-and-Lactation. Accessed July 21, 2016.
11.
Hartman  RL, Brown  TL, Milavetz  G,  et al.  Controlled cannabis vaporizer administration: blood and plasma cannabinoids with and without alcohol.  Clin Chem. 2015;61(6):850-869.PubMedGoogle ScholarCrossref
12.
 Inhibitors and inducers of CYP enzymes and P-Glycoprotein.  Med Lett Drugs Ther. 2016;58(1491):e46-e47.PubMedGoogle Scholar
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