Medical Marijuana’s Effects On Chemotherapy-Related Nausea
Funding for research into the use of medical marijuana for chemo nausea and other side effects has been written into some state laws since the late 1970s. However, scientific research into the ways in which cannabis could help patients receiving chemotherapy still lacks depth and rigor. Despite the lack of large-scale clinical trials, some initial research and a wealth of anecdotal evidence testify to the many benefits cannabis can bring to cancer patients.
Chemotherapy is an aggressive form of cancer treatment that has debilitating effects on some patients. Medical-grade cannabis can help alleviate some of the symptoms that make chemotherapy challenging, providing therapeutic benefits for side effects ranging from nausea and vomiting to appetite loss, pain, and insomnia.
Potential Benefits of Medical Marijuana for Patients Receiving Cancer Chemotherapy
Cancer patients have two main options when choosing cannabis-based medications; FDA-approved medications that require a specific prescription from a doctor, and other cannabis-based products that can be recommended by budtenders at a medical dispensary.
Two FDA-Approved Synthetic Cannabinoid Formulations Can Relieve Nausea and Vomiting
Two synthetic cannabinoid-based drugs have been approved by the FDA to treat chemotherapy-induced nausea: Dronabinol and Nabilone. You will need a prescription from your doctor to obtain either of these medications.
Dronabinol
Dronabinol is used to prevent or treat nausea and vomiting that can occur after treatment with cancer medications. It is only used when other kinds of medication for nausea and vomiting haven’t been effective. This product is available in solution or capsule forms and can only be purchased with a doctor's prescription.
Usually, Dronabinol is taken 4-6 times a day, with the first dose taken on an empty stomach. Though it is a synthetically made cannabinoid, it works in the same way as marijuana, attaching to the same receptors in your brain and body to reduce nausea and vomiting and improve your appetite.
Nabilone
Nabilone works in much the same way as Dronabinol but is more potent. As with any cannabinoid, patients must take this medication as instructed, as overuse can result in dependency.
Non-Prescription Medical Marijuana Products for Nausea from Chemotherapy
The limited pool of research into the way in which cannabis affects chemotherapy-induced nausea suggests a positive correlation between the consumption of medical marijuana and the reduction of nausea and vomiting.
In a systematic review by Tramèr et al., published in 2001 in BMJ, cannabinoids were more effective than many other conventional medications at reducing nausea and vomiting. Patients preferred cannabinoids over conventional drugs.
In a Cochrane Database Systematic Review published in 2015 by Smith et al., fewer people receiving cannabis-based medications experienced nausea and vomiting than patients given a placebo. Patients who tried both cannabis-based medicine and conventional medicine had a preference for the cannabis-based treatment.
Due to restrictions on scientific research into medical cannabis (the Drug Enforcement Administration currently lists marijuana as a Schedule I controlled substance), there hasn't been enough research into the effects and potential benefits of medical marijuana for chemotherapy nausea for the herb to be prescribed routinely under federal law.
However, when the few studies that exist are considered together with anecdotal reports of medical marijuana being beneficial for chemotherapy-induced nausea, vomiting, and other adverse side effects, the link certainly looks promising.
Which Medical Marijuana Products Are Most Effective for Chemo-Related Nausea?
The effects of various marijuana products on nausea and vomiting were described in the paper “The Effectiveness of Common Cannabis Products for Treatment of Nausea”, published in the Journal of Clinical Gastroenterology in 2022. Based on the results of a three-year study, the researchers noted that:
96% of patients taking cannabis-based products for nausea felt relief within an hour of consuming the product.
Products high in THC were more effective than CBD-rich products for reducing nausea, especially when smoked or vaped. THC directly affects the dorsal vagus nerve, which controls feelings of nausea and vomiting in humans.
Sativa and hybrid strains outperformed indica strains in providing nausea relief.
Smoking yielded better results for relieving symptoms than inhaling cannabis with a pipe or vaporizer.
Taking cannabis products orally removes the need for smoking or vaping, but it can take one to two hours to have an effect. Additionally, it's more difficult to personalize the patient’s dose when cannabis is taken in pill or capsule form.
Though many of the studies included in the analysis uncovered positive results, cannabis's effectiveness in relation to conventional options can't be determined with certainty without further research. The researchers also noted that encouraging the use of cannabis among high-risk populations such as pregnant women and children may not be wise in the long term.
However, for cancer patients suffering from nausea, vomiting, or other symptoms who want to try a different approach or who aren't responding well to more conventional medications, it may be worth trying medical marijuana.
Other Potential Benefits for Patients Receiving Chemotherapy
Though nausea and vomiting are very common side effects of chemotherapy, they are far from being the only ones; loss of appetite, problems sleeping, and even pain are also commonly reported side effects suffered by cancer patients. There is mounting evidence to suggest that cannabis-based products for appetite loss and cannabis strains for sleep can help to alleviate these unpleasant aftereffects as well as relieve nausea and vomiting.
Appetite Loss
Cancer patients frequently struggle with eating and appetite loss, resulting in drastic and unhealthy weight loss. Patients report developing a sensitive stomach, feeling full quickly, and experiencing a general loss of appetite caused by chemotherapy. This, mixed with nausea and vomiting, can create an aversion to food.
Apart from the side effects of chemotherapy, cancer itself can also affect patients' sense of taste and smell, leading to a decreased enjoyment and appreciation of food. Cannabis is often reported to increase appetite or cause cravings—an effect referred to as "the munchies"—in recreational use, and it seems that this is also the case when medical cannabis is used for cancer-related appetite loss.
Academic Studies Back Up Claims That Medical Marijuana Increases Appetite
A Canadian study that ran from 2006-2008 reported overwhelmingly positive results in cancer patients who were given THC capsules for 18 days. At the end of the study, they observed that 73% of THC-treated patients reported an increased interest in food. Participants in the study also reported savory foods such as meat tasting better, reversing a common complaint that protein-rich foods taste worse as a result of cancer.
Such research, though limited, backs up the accounts of medical marijuana users who claim that cannabis use has the potential to encourage cancer sufferers to eat more.
Insomnia
Insomnia is one of the most common cancer symptoms, with as many as 64% of cancer patients in one study reporting sleep disturbances.
While studies generally conclude that medicinal cannabis does indeed help patients with insomnia and other sleeping difficulties, there is also clinical evidence that an increasing tolerance to cannabis can eventually make it less effective. Patients who take cannabis daily to help with sleep issues should be aware of the effects of tolerance and withdrawal; withdrawal can result in vivid nightmares, hallucinations, dysphoria, confusion, and insomnia.
Though results from various studies into marijuana's effect on insomnia are compelling, the relationship between pain management and improved sleep may be inextricably linked. In effect, patients using marijuana for cancer pain management may have the added bonus of improved sleep due to being more comfortable with reduced pain.
Cannabis: A Sleep Aid with Only Mild Side-Effects
Mainstream prescription drugs for insomnia are often associated with unpleasant side effects that may discourage patients from taking them. In contrast, patients in various clinical trials reported mild or no adverse side effects when taking cannabis as a sleep aid. The best cannabis strain for sleep may differ from person to person; ask your doctor or an expert at your local medical dispensary for advice when choosing a strain.
Cancer-Related Pain
Marijuana may be helpful for cancer-related pain management when other, more conventional treatments have been tried and have been either ineffective or the patient has experienced adverse effects.
In cases of severe pain caused by cancer or chemotherapy, opioid-based medications are still the standard pain-relief solution. However, there is evidence that taking medical marijuana at the same time as prescription medications can reduce the amount of prescription meds needed because cannabis decreases pain signals in the brain.
The Legality of Taking Medical Marijuana for Chemotherapy Side Effects
Obtaining medical marijuana (and more recently recreational marijuana) is legal in states such as Arizona, but you’ll still need a medical marijuana card to purchase cannabis products excise-tax-free. If you are an Arizona resident, are 18 or above, and are suffering from cancer or severe nausea—both of which are AZ qualifying conditions, you can apply for an Arizona medical marijuana card online and your card should be approved in five working days.
The process required to obtain an MMJ card in other states might be different from the process in Arizona, and some states don’t have a medical marijuana program. Check with your state laws before purchasing, possessing, or consuming marijuana.
Other Things to Consider Before Taking Medical Marijuana
If you decide you are interested in taking medical marijuana to alleviate nausea or any other symptom of cancer and chemotherapy, there are some important considerations to keep in mind before starting treatment.
1. Consult Your Primary Care Physician
After obtaining a medical marijuana card (if available in your state), you’ll need to discuss products and dosages with a doctor before commencing treatment. If you’re taking other medications for cancer, consulting a medical professional is especially vital.
When choosing a medical marijuana doctor to oversee your care, look for someone who’s experienced with cannabis use for cancer and chemotherapy-related symptoms and who understands how cannabis and cancer medications interact. If you want to change your dosage or medicine a few months into your treatment, consult your MMJ doctor first.
2. Find a Good Dispensary with Knowledgeable Staff
Your best bet for finding quality marijuana will be to find a medical dispensary if you have one where you live. Staff in medical dispensaries should be knowledgeable about products that can help you and will focus on medical rather than recreational use.
When you go to visit your nearest medical dispensary, go with a list of your medications and supplements, and tell them if you have any allergies. This will help the staff recommend products that are appropriate for you.
3. Learn What You Can About Medical Cannabis
Though medical dispensary staff can advise you about different products, it's important to learn about medical cannabis yourself so that you understand things like the difference between THC and CBD, the effects of different cannabinoids and terpenes, and how each of the chemicals in cannabis works in the body to help with your symptoms.
4. Consider the Cost
Medical marijuana isn't covered by insurance in the United States and the costs can quickly add up. You will also need to pay for the medical marijuana card (with some exceptions) and any appointments with your MMJ doctor.
5. Be Prepared to Experiment
Everyone reacts to cannabis differently, so finding what works best for you will be a question of trial and error. As a rule of thumb, "start low and go slow" is a good policy; from there, you can increase your dosage as needed (in consultation with your doctor).
6. Think about Consumption Methods
Smoking or vaping may not be the safest choice for people receiving lung cancer chemotherapy. Similarly, those with underlying lung conditions should discuss their options with a doctor before smoking or vaping cannabis products. Fortunately, there are many alternatives, including tinctures, capsules, and cannabis-infused edibles that can help if you’re not able (or prefer not to) smoke.
7. Find Out if Taking Cannabis Will Put Your Livelihood at Risk
Some professionals, including teachers, drivers, corrections officers, and government workers, may have clauses in their contracts that prohibit cannabis use, even for medical reasons. Check your employer's cannabis policy before starting to take cannabis-based products.
Medical Marijuana: Treatment for a Lot More Than Just Nausea In Chemotherapy Patients
There is compelling evidence to suggest the efficacy of marijuana in reducing nausea as well as appetite loss, insomnia, and pain in chemotherapy patients. Though more academic and scientific research is needed, anecdotal evidence suggests that it may be something worth exploring for people suffering from a range of debilitating side effects from their cancer treatment.
As with any medical treatment, it is important to treat medical marijuana with caution, always using it as directed and buying it from a legal and reputable source. With the right support and advice, many cancer patients can benefit from the therapeutic properties of medical marijuana.
