Talking With Patients About Cannabis Use

As the use of cannabis becomes more widespread, physicians and healthcare providers should be aware of the possible impacts on health and the value of conversations with patients about cannabis.

Although cannabis is often marketed as “safe,” some studies have demonstrated a link between the substance and adverse health effects.

For example, new research from Washington State University suggests that using cannabis alongside other drugs may cause harmful drug-drug interactions, such as toxicity or overdose. Senior author Dr. Philip Lazarus urges physicians to be aware of possible toxicity or lack of response when patients are simultaneously using cannabinoids. “It’s one thing if you’re young and healthy and smoke cannabis once in a while, but for older people who are using medications, taking CBD or medicinal marijuana may negatively impact their treatment,” he explains.

In addition to harmful drug interactions, heavy cannabis use during pregnancy may negatively affect fetal growth and development. Research by Icahn School of Medicine neuroscientist Dr. Yasmin Hurd found that use of the substance during pregnancy was connected to increased levels of stress, anxiety, aggression and hyperactivity in young children. According to Hurd, these results don’t mean that every child who is exposed to cannabis in utero will develop similar issues, but it does suggest that the exposure could put children at greater risk. To address this, Hurd recommends that women and physicians have more discussions about cannabis use: “This is not about stigmatizing women. It’s the opposite. … It’s about the more knowledge you have, the more power you have.”

Initiating conversations about cannabis with patients may help improve care by filling critical information gaps. According to one study cited by Healio, more than 40% of breast cancer patients reported using cannabis to manage treatment symptoms but did not discuss its use with a physician. Among 612 patients with breast cancer, only 39% discussed cannabis use with a physician, and 76% of patients initiated the conversations themselves.

“Not knowing whether or not our cancer patients are using cannabis is a major blind spot in our ability to provide optimal care,” says study author Dr. Marisa Weiss. “As health care providers, we need to do a better job of initiating informed conversations about medical cannabis with our patients to make sure their symptoms and side effects are being adequately managed while minimizing the risk of potential adverse effects, treatment interactions or non-adherence to standard treatments due to misinformation about the use of medical cannabis to treat cancer.”