One of my friend’s wife is a therapist at one of the local convalescent centers and she had a story to tell yesterday that I thought was very interesting. A new patient checked in a few days ago and he is an MJ card holder. His main concern was that he would be allowed to smoke MJ at the convalescent center. He was told that if his doctor had prescribed MJ for him that he could eat it, or vaporize it, but would not be allowed to smoke it on the property. I was shocked that he would be allowed to use MJ products even though the facility receives federal funds. Personally, I think that it is great news!
But… there is more to the story! The patient said that he would buy a vaporizer because he needed to get off of the marijuana pills that his doctor had prescribed for him. He said that the pills left him unable to function and that they were extremely expensive and he could not afford them. I was not even aware that the pharmaceutical industry had created such a pill, much less that they had released anything to the commercial market! Here is what I found and apparently it is old news!
"Medical" Marijuana - The Facts
• Medical marijuana already exists. It's called Marinol.
• A pharmaceutical product, Marinol, is widely available through prescription. It comes in the form of a pill and is also being studied by researchers for suitability via other delivery methods, such as an inhaler or patch. The active ingredient of Marinol is synthetic THC, which has been found to relieve the nausea and vomiting associated with chemotherapy for cancer patients and to assist with loss of appetite with AIDS patients.
• Unlike smoked marijuana--which contains more than 400 different chemicals, including most of the hazardous chemicals found in tobacco smoke-Marinol has been studied and approved by the medical community and the Food and Drug Administration (FDA), the nation's watchdog over unsafe and harmful food and drug products. Since the passage of the 1906 Pure Food and Drug Act, any drug that is marketed in the United States must undergo rigorous scientific testing. The approval process mandated by this act ensures that claims of safety and therapeutic value are supported by clinical evidence and keeps unsafe, ineffective and dangerous drugs off the market.
• There are no FDA-approved medications that are smoked. For one thing, smoking is generally a poor way to deliver medicine. It is difficult to administer safe, regulated dosages of medicines in smoked form. Secondly, the harmful chemicals and carcinogens that are byproducts of smoking create entirely new health problems. There are four times the level of tar in a marijuana cigarette, for example, than in a tobacco cigarette
• Morphine, for example, has proven to be a medically valuable drug, but the FDA does not endorse the smoking of opium or heroin. Instead, scientists have extracted active ingredients from opium, which are sold as pharmaceutical products like morphine, codeine, hydrocodone or oxycodone. In a similar vein, the FDA has not approved smoking marijuana for medicinal purposes, but has approved the active ingredient-THC-in the form of scientifically regulated Marinol.
• The DEA helped facilitate the research on Marinol. The National Cancer Institute approached the DEA in the early 1980s regarding their study of THC's in relieving nausea and vomiting. As a result, the DEA facilitated the registration and provided regulatory support and guidance for the study.
• The DEA recognizes the importance of listening to science. That's why the DEA has registered seven research initiatives to continue researching the effects of smoked marijuana as medicine. For example, under one program established by the State of California, researchers are studying the potential use of marijuana and its ingredients on conditions such as multiple sclerosis and pain. At this time, however, neither the medical community nor the scientific community has found sufficient data to conclude that smoked marijuana is the best approach to dealing with these important medical issues.
• The most comprehensive, scientifically rigorous review of studies of smoked marijuana was conducted by the Institute of Medicine, an organization chartered by the National Academy of Sciences. In a report released in 1999, the Institute did not recommend the use of smoked marijuana, but did conclude that active ingredients in marijuana could be isolated and developed into a variety of pharmaceuticals, such as Marinol.
• In the meantime, the DEA is working with pain management groups, such as Last Acts, to make sure that those who need access to safe, effective pain medication can get the best medication available.
Dronabinol(droe nab' i nol)
Last reviewed: September 1, 2008.
Why is this medication prescribed?
Dronabinol is used to treat nausea and vomiting caused by chemotherapy in people who have already taken other medications to treat this type of nausea and vomiting without good results. Dronabinol is also used to treat loss of appetite and weight loss in people who have acquired immunodeficiency syndrome (AIDS). Dronabinol is in a class of medications called cannabinoids. It works by affecting the area of the brain that controls nausea, vomiting, and appetite.
How should this medicine be used?
Dronabinol comes as a capsule to take by mouth. When dronabinol is used to treat nausea and vomiting caused by chemotherapy, it is usually taken 1 to 3 hours before chemotherapy and then every 2 to 4 hours after chemotherapy, for a total of 4 to 6 doses a day. When dronabinol is used to increase appetite, it is usually taken 2 times a day, before lunch and supper, or once a day in the evening or at bedtime. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take dronabinol exactly as directed.
Swallow the capsules whole; do not split, chew, or crush them.
Your doctor will probably start you on a low dose of dronabinol and may gradually increase your dose. Your doctor may also decrease your dose if you experience side effects that do not go away after 1 to 3 days. Be sure to tell your doctor how you are feeling during your treatment with dronabinol.
Dronabinol may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor. Call your doctor if you find that you want to take extra medication.
Dronabinol will control your symptoms only as long as you take the medication. Continue to take dronabinol even if you feel well. Do not stop taking dronabinol without talking to your doctor. If you suddenly stop taking dronabinol, you may experience withdrawal symptoms such as irritability, difficulty falling asleep or staying asleep, restlessness, hot flashes, sweating, runny nose, diarrhea, hiccups, and loss of appetite.
Ask your doctor or pharmacist for a copy of the manufacturer's information for the patient.
What special precautions should I follow?
Before taking dronabinol,
• tell your doctor and pharmacist if you are allergic to dronabinol, other cannabinoids such as nabilone (Cesamet) or marijuana (cannabis), any other medications, or any of the ingredients in dronabinol capsules, including sesame oil. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: amphetamines such as amphetamine (in Adderall), dextroamphetamine (Dexedrine, Dextrostat, in Adderall), and methamphetamine (Desoxyn); atropine (Atropen, in Hycodan, in Lomotil, in Tussigon); anticoagulants ('blood thinners') such as warfarin (Coumadin); antidepressants, including amitriptyline (in Limbitrol), amoxapine, and desipramine (Norpramin); antihistamines; barbiturates including phenobarbital (Luminal) and secobarbital (Seconal, in Tuinal); buspirone (BuSpar); diazepam (Valium); digoxin (Lanoxicaps, Lanoxin); disulfiram (Antabuse); fluoxetine (Prozac, Sarafem); ipratropium (Atrovent); lithium (Eskalith, Lithobid); medications for anxiety, asthma, colds, irritable bowel disease, motion sickness, Parkinson's disease, seizures, ulcers, or urinary problems; muscle relaxants; naltrexone (Revia, Vivitrol); narcotic medications for pain; propranolol (Inderal); scopolamine (Transderm-Scop); sedatives; sleeping pills; tranquilizers; and theophylline (TheoDur, Theochron, Theolair). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with dronabinol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you use or have ever used marijuana or other street drugs and if you drink or have ever drunk large amounts of alcohol. Also tell your doctor if you have or have ever had heart disease, high blood pressure, seizures, dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and that may cause changes in mood and personality), or a mental illness such as mania (frenzied or abnormally excited mood), depression (feelings of hopelessness, loss of energy and/or loss of interest in doing previously enjoyable activities) or schizophrenia (a mental illness that causes disturbed or unusual thinking and strong or inappropriate emotions).
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dronabinol, call your doctor. Do not breast-feed while you are taking dronabinol.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking dronabinol.
• you should know that dronabinol may make you drowsy and may cause changes in your mood, thinking, memory, judgment, or behavior, especially at the beginning of your treatment. You will need to be supervised by a responsible adult when you first begin taking dronabinol and whenever your dose is increased. Do not drive a car, operate machinery or do any other activity that requires mental alertness until you know how this medication affects you.
• do not drink alcoholic beverages while you are taking dronabinol. Alcohol can make the side effects from dronabinol worse.
• you should know that dronabinol may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This may be more common when you first start taking dronabinol. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
What special dietary instructions should I follow?
Talk to your doctor or nutritionist and read the manufacturer's information for the patient to find out about ways to encourage yourself to eat when your appetite is poor and about which types of foods are the best choices for you.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Dronabinol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
• weakness
• sudden warm feeling
• stomach pain
• nausea
• vomiting
• memory loss
• anxiety
• confusion
• dizziness
• unsteady walking
• feeling like you are outside of your body
• ''high'' or elevated mood
• hallucinations (seeing things or hearing voices that do not exist)
• sleepiness
• strange or unusual thoughts
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
• seizures
• fast or pounding heartbeat
Dronabinol may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it in a cool place (between 46-59 °F, 8-15 °C) or in the refrigerator. Do not allow the capsules to freeze. Keep medication away from heat, direct light, and moisture. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
Store dronabinol in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many capsules are left so you will know if any are missing.
In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
• drowsiness
• inappropriate happiness
• sharper senses than usual
• changed awareness of time
• red eyes
• fast heartbeat
• memory problems
• feeling that you are outside of your body
• mood changes
• difficulty urinating
• constipation
• decreased coordination
• extreme tiredness
• difficulty speaking clearly
• dizziness or fainting when standing up too fast
What other information should I know?
Keep all appointments with your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Other names
• Delta-9-tetrahydrocannabinol
• delta-9-THC
Marinol Drug Description
MARINOL®
(dronabinol) Capsules
DRUG DESCRIPTION
WHAT ARE THE POSSIBLE SIDE EFFECTS OF DRONABINOL (MARINOL)?
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Stop using dronabinol and call your doctor at once if you have any of these serious side effects:
• seizure (convulsions);
• paranoia, extreme fear;
• fast heart rate;
• feeling light-headed, fainting; or
• unusual thoughts or behavior.
Continue using dronabinol and talk with your...
Read All Potential Side Effects and See Pictures of Marinol »
Dronabinol is a cannabinoid designated chemically as (6aR-trans)-6a,7,8,10a-tetrahydro-6,6,9- trimethyl-3-pentyl-6H-dibenzo[b,d]pyran-1-ol. Dronabinol has the following empirical and structural formulas:
Dronabinol, the active ingredient in MARINOL® (dronabinol) Capsules, is synthetic delta-9- tetrahydrocannabinol (delta-9-THC). Delta-9-tetrahydrocannabinol is also a naturally occurring component of Cannabis sativaL. (Marijuana).
Dronabinol is a light yellow resinous oil that is sticky at room temperature and hardens upon refrigeration. Dronabinol is insoluble in water and is formulated in sesame oil. It has a pKa of 10.6 and an octanol-water partition coefficient: 6,000:1 at pH 7.
Capsules for oral administration: MARINOL Capsules is supplied as round, soft gelatin capsules containing either 2.5 mg, 5 mg, or 10 mg dronabinol. Each MARINOL Capsule strength is formulated with the following inactive ingredients: 2.5 mg capsule contains gelatin, glycerin, sesame oil, and titanium dioxide; 5 mg capsule contains iron oxide red and iron oxide black, gelatin, glycerin, sesame oil, and titanium dioxide; 10 mg capsule contains iron oxide red and iron oxide yellow, gelatin, glycerin, sesame oil, and titanium dioxide.
Even though it seems to be old news that I was not aware of, it does confirm that there is competition for the medical properties of the marijuana plant. Even the DEA admits that the plant has medical properties and can be useful.
Any thoughts, any possible connections??
