MARIJUANA TO PREVENT NAUSEA AND VOMITING IN CANCER-PATIENTS - A SURVEY OF CLINICAL ONCOLOGISTS

Marijuana, if rescheduled by the Drug Enforcement Agency, would be the only Food and Drug Administration (FDA)-approved drug to be administe red by smoking. American physicians need timely, factual information a bout probable usage patterns and potential adverse effects of medical marijuana, and a factual complete review of the literature on the subj ect. We mailed a survey to 1,500 American clinical oncologists. Of par ticular interest was whether and how often in the past 24 months these physicians recommended smoked marijuana, synthetic tetrahydrocannabin ol, or 5-HT3 (serotonin) antagonists (ondansetron [Zofran], granisetro n [Kytril]) for their patients. We also inquired whether and how often the oncologists would prescribe marijuana in the form of cigarettes, were it to be FDA-approved. Completed surveys were received from 1,122 (75%) of the oncologists. The percentages of oncologists who prescrib ed or recommended selected antiemetics more than five times between 19 92 and 1994 were 98% for 5-HT3 antagonists, 6% for dronabinol (Marinol ), and 1% for smoked marijuana. We also found that 332 (30%) of the on cologist-respondents to this nationwide survey supported rescheduling of marijuana for medical purposes; however, two thirds (67%) of the 33 2 respondents who were in favor of rescheduling estimated that they wo uld write less than one prescription per month for marijuana cigarette s. A comprehensive literature review failed to provide persuasive evid ence to recommend marijuana as a needed antiemetic medicine.