UF physician recommends against marijuana as first choice for pain relief

With marijuana use becoming legal in more states, researchers at the University of Florida and their colleagues advise caution for clinicians contemplating recommending medical use of marijuana to their patients.

“Smoked marijuana is a nonmedical, nonspecific and potentially hazardous method of drug delivery,” wrote Gary M. Reisfield, M.D., of the University of Florida College of Medicine and Robert L. DuPont, M.D., of the Institute for Behavior and Health and Georgetown University in a “Clinical Decisions” feature released in the Feb. 28 issue of The New England Journal of Medicine. “Although marijuana probably involves little risk in this context, it is also unlikely to provide much benefit.”

In this interactive online feature, the physicians responded to a case vignette recommending against the use of medical marijuana. The patient in the case has metastatic breast cancer and is undergoing chemotherapy. Reisfield and DuPont argue that while some research points to marijuana’s role in relief for certain kinds of pain, it does not relieve all types of pain.

The researchers point out that most of the compounds in cannabis have not been thoroughly studied. They also question possible side effects from smoking marijuana, including how it might affect the patient’s pulmonary problems or tumor.

The Food and Drug Administration has approved two oral cannabinoids, one a synthetic form of THC, the most widely studied component in marijuana, and the other a close relative of THC. However, the researchers also point out that there are other medications that should be tried that show better results with fewer side effects.