Fewer Hospitalizations Seen With Medical Marijuana Use in Sickle Cell Disease

By Anne Harding

August 26, 2020

NEW YORK (Reuters Health) - Medical marijuana use is tied to a reduction in hospital admissions among patients with sickle cell disease (SCD), new findings show.

Five of the 33 U.S. states with medical marijuana programs list SCD as a qualifying condition for medical cannabis, "but there are few data to guide practitioners whether or whom should be certified," Dr. Susanna A. Curtis, assistant director of the Adult Sickle Cell Program at Montefiore Medical Center in New York City, and colleagues note in Blood Advances.

They compared 50 SCD patients certified for medical marijuana, 29 of whom eventually obtained cannabis from a dispensary and 21 of whom did not, to 25 randomly selected SCD patients who did not request medical cannabis.

Seventy-nine percent of the patients who obtained medical cannabis had previously tested positive for illicit cannabis use, compared to 69% of those who didn't obtain marijuana and 6% of those who didn't request certification.

Patients who requested certification for cannabis also used more opioids, with an average of 19.7 mg in oral morphine equivalent of opioids per day for those who obtained medical cannabis; 18.7 mg for those who did not obtain it; and 0.6 mg for patients who did not request certification.

Median six-month hospital admissions were lower among the patients who obtained medical marijuana compared to both of the other groups. Changes in admission rates from baseline six months to six months after certification/obtaining medical marijuana were mostly plus or minus one, but six patients who obtained marijuana had reductions of two or more. This was true of only one patient who did not obtain medical marijuana.

There were no differences among the groups in emergency-department admissions or infusion center use.

Most patients who had requested medical cannabis had used illicit cannabis previously, Dr. Curtis told Reuters Health by phone, and most reported using it for pain.

"We weren't really introducing people to a new substance, we were giving people access to a safer, legal and more regulated version of that substance," she said. "It's really a much safer substance."

Most SCD patients are people of color, and have more trouble accessing adequate pain treatment, Dr. Curtis added.

"One thing that we've known for a long time, but I think is really starting to come to light now with Black Lives Matter, is that we realize that minorities, especially Black patients, have not been getting the same quality of medical care as has been given to white patients," she said.

Healthcare providers can confront their own potential bias, she added, by making sure they offer people of color the same quality of care for pain. "If you would give it to a patient with cancer, you should also give it to someone with sickle cell disease."

"I certify patients with the department of consumer protection so that they can make purchases at the dispensary, so any decisions they make about the products that they are going to use are made at the dispensary. I do think that's a big gap in terms of using it as a medical product," explained Dr. Curtis, who worked on the study while at Yale School of Medicine, in New Haven, Connecticut,

More controlled studies are needed to provide an evidence base for medical cannabis, she added, so clinicians can recommend the potency and formulation that is most effective for a particular patient.

"I want to be working in partnership to be making decisions with patients about their medical care," Dr. Curtis added. "We have a lot that we need to learn. But I think there's real hope."

SOURCE: https://bit.ly/34qeXUK Blood Advances, online August 13, 2020