MEDICINAL MARIJUANA - A COMPREHENSIVE REVIEW

Considerable controversy exists regarding the role of marijuana as a t herapeutic agent; however, many practitioners are taught very little a bout existing marijuana data. The authors therefore undertook a compre hensive literature review of the topic. References were identified usi ng textbooks, review and opinion articles, and a primary literature re view in MEDLINE. Sources were included in this review based primarily on the quality of the data. Some data exists that lends credence to ma ny of the claims about marijuana's properties. In general, however, th e body of literature about marijuana is extremely poor in quality. Mar ijuana and/or its components may help alleviate suffering in patients with a variety of serious illnesses. Health care providers can best mi nimize short term adverse consequences and drug interactions for termi nally ill patients by having a thorough understanding of the pharmacol ogy of marijuana, potential adverse reactions, infection risks, and dr ug interactions (along with on-going monitoring of the patient). For c hronic conditions, the significance and risk of shea and long term adv erse effects must be weighed against the desired benefit. Patients who are best suited to medicinal marijuana will be those who will gain su bstantial benefit to offset these risks, and who have failed a well-do cumented, compliant and comprehensive approach to standard therapies.