二八杠技巧:Will medical marijuana replace opioids in war on cancer?

President Trump recently told reporters he will likely support a congressional effort to end the federal ban on marijuana, which could finally help cut through the red tape blocking scientists from conducting large-scale trials on the benefits of medical marijuana in cancer patients.

"We need to be very careful in how we define the benefits of medical marijuana and that’s because there’s been few randomized, controlled, placebo-based trials using medical marijuana," Dr. Nick Spirtos, an oncologist at the Women's Cancer Center of Nevada, told Fox News. “I think there are some diseases or conditions that are likely to benefit from the use, such as chemo-induced nausea and vomiting, chronic pain and peripheral neuropathy and anorexia, but studies need to be done properly.”

Medical marijuana is still a controversial topic when it comes to doctors recommending it to their cancer patients. According to new research published in the Journal of Clinical Oncology, less than 30 percent of oncologists surveyed felt knowledgeable enough about medical marijuana to make recommendations.

"Its upon us as a community to re-up our skills in knowing about this aspect of supportive oncology."

- Dr. Andrew Epstein

“The amount of information we have is still relatively nascent and evolving and therefore its upon us as a community to re-up our skills in knowing about this aspect of supportive oncology,” Dr. Andrew Epstein, an oncologist at Memorial Sloan Kettering Cancer Center in New York, and an American Society of Clinical Oncology (ASCO) patient care expert, told Fox News.

Spirtos is on a mission to fill that knowledge gap, but he knows that stereotypes and regulations are big obstacles that could take years to overcome.

“The misconception is that people are using that [medical marijuana] as an excuse to get high. The reality is our average patient is 55-years-old,” Spirtos said. “These people aren’t out drug seeking. These are real people with real problems that are looking for an alternative that may be more effective.”

Some doctors like Spirtos are looking into whether medical marijuana could turn into an alternative for opioids. Every day 116 people die from opioid-related drug overdoses in America.

A recent report in JAMA Internal Medicine, found a 14 percent reduction in opioid prescriptions in states that allow easy access to medical marijuana.

“In order to get someone off their opioids you need to duplicate that feeling of satisfaction, of comfort and that you do with the THC, on the other part you need the CBD to actually effect the inflammatory condition that is causing the actual pain,” Spirtos said.

THC and CBD are chemical compounds found in marijuana. For decades’ researchers have known that THC is responsible for the psychological cannabis high, but recent studies have shined light on CBD and its function on treating pain.

A 2017 research review report from the National Academies of Sciences, Engineering, and Medicine showed there was conclusive evidence that certain oral cannabinoids were effective in preventing and treating adults with chemotherapy-induced nausea and vomiting.

Currently there are 29 states plus the District of Columbia that have passed laws legalizing medical marijuana, but federal regulations have made it complicated to conduct large-scale trials.

"Cancer research and symptom research takes time and when you’re in a constantly evolving landscape that exists on a non-medical level in terms of political and legal landscapes with something like medical marijuana these are the reasons why it will take time," Epstein said.

Spirtos, who is also the CEO of The Apothecary Shoppe, a dispensary in Las Vegas, presented his own self-funded observational pilot study to doctors at ASCO’s annual meeting on whether using a marijuana-based syrup could help patients with their pain and replace their opioids.

The syrup was developed by Spirtos and uses a combination of THC and CDB. 

Twenty-five patients with chronic opiate use were given the cannabis-laced syrup every four-to-six hours and were allowed to use their opioids only for break through pain.

"We showed that there was a significant decrease from almost 75 percent across the board, with six patients completely getting off their opiates."

- Dr. Nick Spirtos

"We showed that there was a significant decrease from almost 75 percent across the board, with six patients completely getting off their opiates, which was stunning in a four-week period of time," Spirtos said.

Although Spirtos' research seems promising, the oncology community may not be ready to accept marijuana as a substitute just yet.

"We need a lot more research to clearly state whether or not medical marijuana can treat cancer pain as effectively as opiates,” Epstein said. “I think it’s a helpful adjunct to pain medicines, [but] I do not think there are data to suggest or even show that they are just as good."