Marinol/marijuana use

Specialties Hospice

Published

Patient is asking about marijuana use for his cancer/brain mets pain. His asked me for dronabinol/Marinol and how many he can smoke in a day? How would you persue this if it was you pt?

First of all I hope this client is on a good dose of Decadron, at least 16 mg daily. Secondly, there is no doubt in my mind that marajuana would help in several ways. MJ is also an anti-inflamatory which may help with the inner cranial pressure. It will help with nausea and vomiting and anxiety, not to mention depression. I would guess this client in terminal since you mentioned brain mets. I don't think MJ will hurt him in anyway and smoking it is the best delivery system.

And you know this because...?? Honestly, I think this is a scare tactic used by the DEA:uhoh21:

Because we had a mom in labor come in recently who tested positive for both and admitted to smoking a joint with meth in it. I don't remember that she worked for the DEA.:rolleyes:

I'm not saying ALL pot is laced with it - I'm just saying it happens.

steph

We are talking about hospice pts. using MJ here, not recreational use. And just because you had an experience with that situation does not mean that other people can't obtain MJ without harmful additives.

If I were caring for a hospice pt. who used MJ, no way would I judge him/rat him out. If it makes the pt. feel better, whatever. While I won't break the law by obtaining it for him, there's no way I would interfere with his "source." Of what benefit would it serve to make someone suffer, just so I could be morally superior?

Marinol may work for some, but there has been some anecdotal evidence to suggest that the actual smoking of pot causes changes in the chemical composition and has added benefits that the synthetic tablet form does not.

Because we had a mom in labor come in recently who tested positive for both and admitted to smoking a joint with meth in it. I don't remember that she worked for the DEA.:rolleyes:

I'm not saying ALL pot is laced with it - I'm just saying it happens.

steph

If she knew the joint had meth in it, then how was it such a surprise? Maybe people are intentionally mixing the two.

We are talking about hospice pts. using MJ here, not recreational use. And just because you had an experience with that situation does not mean that other people can't obtain MJ without harmful additives.

I think there's enough "unpure" pot out there that for someone who didn't know better, it could be potentially dangerous. Let's say a hospice patient who just started smoking when they felt they needed it medically, lives in a state where medical marijuana is not legal, and asked a "friend who knows someone" to get some for them- a lot of low-quality marijuana off the street has unknown stuff added to it. Like bug spray. Seriously!

I'm not saying people can't get MJ without harmful additives, but does eveyone know where to get it? Of course not.

No, certainly there is a risk. But if someone knows where to obtain it without harmful additives, I would not interfere.

i have been known to bring a few hospice patients outside for some 'fresh air' and did them a world of good. yeah, i had mixed feelings but ultimately did what i felt was morally right.

leslie

Specializes in Nursing student...graduation 6/28 7pm!!!.

I couldn't help it, I had to post a response. As far as what you should advise you patient to do, I do not know. I do know however that marijuana does help tremendously (sp?) with pain. My father lives in Hawaii (a state where medicinal marijuana use is legal) and he has a Medical Marijuana license. He doesn't have glacoma, he has severe rheumetoid arthritis as well as arthritis of the spine, since he has had the MM license he has made a complete turn around in what he can do. To eliminate the problem of buying marijuana that has been laced with something he grows his own under the provision of the license. He is allowed to have 7 plants at a time, 4 of which are mature. That way at least he knows where he is getting it from. The doctor did also supply some THC pills that he can use while he is travelling to the states where use is illegal. I just wanted to share that with everyone.

I guess it comes down to whether or not your state approves Medical Marijuana use. Good luck with your decision! :coollook:

I would call his MD and get the order for Marinol if able. At this point, if the patient thinks Marinol will help and it's legal in that state then that is what I would do. I have had patients who had prescriptions for Marinol so I know it's used in NC. Of course, if marijuana were legal then you could just tell him to go ahead and smoke that if he thought it would help. Our patient care unit allows patients to drink and smoke...if marijuana were legal I'm sure it would be allowed also.

I would call his MD and get the order for Marinol if able. At this point, if the patient thinks Marinol will help and it's legal in that state then that is what I would do. I have had patients who had prescriptions for Marinol so I know it's used in NC. Of course, if marijuana were legal then you could just tell him to go ahead and smoke that if he thought it would help. Our patient care unit allows patients to drink and smoke...if marijuana were legal I'm sure it would be allowed also.

I think Marinol is legal in every state. I'm not aware of any pharmaceutical drug that is legal in some states but not legal in others.

I've only had a few patients who had Marinol. None of them had found it made an appreciable difference for them.

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