Do oncologists have enough knowledge to prescribe medical marijuana?
Wednesday, May 23, 2018
Although 30 states and the District of Columbia now allow marijuana use for medical purposes, physicians are expected to guide patients through areas where most have little or no training.
A 2017 study revealed that few medical students were being trained how to prescribe medical marijuana.
The study at Washington University School of Medicine in St. Louis surveyed deans, residents and fellows, and an examined a curriculum database maintained by the Association of American Medical Colleges (AAMC). Each revealed that medical marijuana is not being addressed in medical education.
Two-thirds (66.7 percent) reported that their graduates were not prepared to prescribe medical marijuana. A quarter of deans said their trainees were not even equipped to answer questions about medical marijuana.
They are not taught about the drug or about the body’s so-called cannabinoid system, which affects a wide range of bodily functions, including mood, temperature control, appetite, sleep and balance. In fact, medical students may be getting better training about opioids — how opioids affect organ systems as well as the risks and benefits for patients.
This gap between knowledge and treatment related to medical marijuana is still apparent. A recent study revealed that although most oncologists do not feel informed enough about medical marijuana’s use to make clinical recommendations, at least half still recommend the drug to their patients.
In the study, researchers wanted to examine oncologists’ beliefs, knowledge and practices regarding medical marijuana.
In November 2016, they mailed a survey on medical marijuana to a nationally-representative, random sample of 400 medical oncologists. Main outcome measures included whether oncologists reported discussing the drug with patients, recommended the drug clinically in the past year, or felt sufficiently informed to make such recommendations.
The survey also queried oncologists’ views on medical marijuana’s comparative effectiveness for several conditions, including its use as an adjunct to standard pain management strategies, and its risks compared with prescription opioids.
About 63 percent of those surveyed responded. Only 30 percent of oncologists felt sufficiently informed to make recommendations regarding medical marijuana, yet 80 percent conducted discussions about the drug with patients, and 46 percent recommended medical marijuana, clinically.
Nearly 67 percent felt that medical marijuana is a helpful adjunct to standard pain management strategies, and 65 percent thought medical marijuana is equally or more effective than standard treatments for anorexia and cachexia.
These findings reveal a concerning discrepancy between oncologists’ self-reported knowledge and their beliefs and practices regarding medical marijuana.
Although 70 percent of oncologists do not feel knowledgeable enough to make clinical recommendations regarding medical marijuana, most still conduct discussions with patients about the drug, and nearly one-half recommend its use clinically. Most of the oncologists who were surveyed believe that medical marijuana is useful for certain indications.
According to Dr. Ilana Braun, chief of the division of adult psychosocial oncology at the Dana-Farber Cancer Institute in Boston, who led the new research, the study findings are clinically important and suggest critical gaps in research, medical education and policy regarding medical marijuana.
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