WASHINGTON, Aug. 13, 2020 /PRNewswire/ -- Individuals
with sickle cell disease (SCD) who receive medical marijuana to
treat pain may require fewer visits to the hospital, according to a
new study in Blood Advances. Adults with SCD who requested
and obtained medical marijuana were admitted to the hospital less
frequently than those who did not obtain it.
SCD is the most common inherited red blood cell disorder in
the United States, affecting an
estimated 100,000 people. According to the Centers for Disease
Control and Prevention, SCD affects one out of every 365 Black or
African American births and one out of every 16,300 Hispanic
American births. SCD is characterized by abnormal, sickle-shaped
red blood cells that can adhere to and block blood vessels,
preventing oxygen from reaching the tissues. When this occurs,
individuals living with SCD experience severe pain events which may
drive them to seek emergency care. It is estimated that there
are more than 100,000 SCD-related hospital stays in the United States each year.
There is a need for other options for management of pain so that
individuals with SCD do not have to go through the time, hardship,
and expense of hospitalization and can manage their symptoms at
home. Previous studies have shown that cannabis and cannabinoid
products can effectively treat chronic pain associated other
conditions such as cancer. More controlled studies of marijuana for
the treatment of pain in SCD are still needed.
"When we offered medical marijuana as an option to our patients
with sickle cell disease, we found the majority of people who were
interested were already using illicit marijuana to treat pain,"
said the study's lead author Susanna
Curtis, MD, of the Yale School of
Medicine and Yale Cancer Center. "Illicit marijuana is not
regulated, so its quality and contents are not standardized. And
particularly for people with sickle cell disease, many of whom
identify as Black, we know that while Black and white people use
marijuana at similar rates, Black people are four times more likely
to be arrested for possession. We didn't want our patients using
unsafe products or being arrested for trying to control the pain of
their condition."
Dr. Curtis and her team examined data from 50 individuals with
SCD at the Adult Sickle Cell Program at Yale New Haven Hospital who
were certified for medical marijuana use. Of those certified, 29
obtained medical marijuana and 21 did not. Those who obtained
medical marijuana visited the hospital less frequently on average
over the following six months. Several patients even reduced their
hospital admission rates by three, four, or five visits. Receiving
medical marijuana was not associated with a change in emergency
room or infusion center visits, total health care utilization, or
opioid use. Researchers did not observe any change to
hospitalization rates in individuals who did not obtain medical
marijuana.
Dr. Curtis suggested a possible reason for the reduced
hospitalization rates could be that medical marijuana helps
individuals better tolerate their pain at home.
The researchers also sought to understand why many patients were
unable to access medical marijuana, and why some continued to
occasionally use illicit cannabis despite obtaining medical
marijuana. In a survey, individuals who obtained medical marijuana
reported that they felt it was safer than illicit marijuana and
they felt it was effective at controlling their pain; however, they
did also report barriers such as greater expense and difficulty of
access.
Race and socioeconomic status may also be barriers for patients
with SCD. "About 80% of our clinic population identifies as Black,
and another 15% as Latinx, and unfortunately people of color who
visit the hospital with pain are often not believed or accused of
being drug-seeking. Medical marijuana is associated with
significant stigma, and stigma is already a big part of the life of
a person with sickle cell," said Dr. Curtis.
Cannabis and cannabinoid products also present legal and medical
challenges. While 33 states have medical marijuana laws, only five
of those states list SCD as a qualifying condition. Medical
marijuana products vary greatly in their chemical content and forms
of administration. In the study, patients who obtained medical
marijuana were more likely to use edible products as opposed to
inhaled products. Previous research suggests the pain-relieving
effect of edible products has a slower onset but a longer duration
than that of inhaled products. This variability between different
products can cause difficulty for patients trying to manage their
symptoms.
Dr. Curtis highlighted the need for further research to
understand the efficacy, side effects, and drug interactions of
various cannabis products on SCD treatment. "My patients are living
with a very difficult disease that causes them a lot of pain. We
need controlled trials to look at each product, and the effects of
how it is taken, so that we can offer regulated,
pharmaceutical-grade treatment options."
Blood Advances is a peer-reviewed, online only, open
access journal of the American Society of Hematology (ASH), the
world's largest professional society concerned with the causes and
treatment of blood disorders.
Blood Advances® is a registered trademark of the American
Society of Hematology.
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SOURCE Blood Advances
