May 2019

Yes. In 2007, Abrams et al. published an article entitled “Vaporization as a smokeless cannabis delivery system: A pilot study” in the Journal of Clinical Pharmacology and Therapeutics. In this study, Abrams et al. administered either smoked or vaporized cannabis of 3 different strengths to 18 healthy subjects. While vaporizing resulted in higher plasma concentrations of THC compared to smoking cannabis at 30 and 60 min at each strength, there was no significant difference between smoking and vaporizing in the 6-hr area under the plasma THC concentration-time curve. This data implies that drug absorption across the alveolar membrane is faster with vaporization as compared with smoking, but as time elapses the phytocannabinoid plasma concentrations equalize.

A “personal caregiver” is a person who has agreed to assist with a qualifying patient’s medical use of marijuana. Some medical marijuana states do not require that a personal caregiver agreement be in writing, but the existence of such an agreement, and its terms, are more evident if in writing, hence a written agreement is recommended.

Water pipe filtration systems primarily cool cannabis smoke. This technology is not particularly efficient at eliminating the toxic byproducts of combustion. In contrast, vaporizers heat marijuana to a point where cannabinoid vapors form, but below the point of combustion. Vaporizers allow consumers to experience the rapid onset of the plant’s effects while avoiding many of the respiratory hazards associated with smoking like coughing and wheezing.

Marijuana is most often inhaled – either through a cigarette (joint), pipe, water pipe (also known colloquially as a ‘bong’), or vaporizer. Cannabis’ effects are almost immediately experienced after inhalation. This outcome allows one to easily moderate the amount consumed.

Grown outdoors, the cannabis plant typically achieves maturity within three to five months. Cultivated indoors under optimum heat and lighting, the plant may reach maturity within as few as 60 days.

Marijuana (or marihuana) is defined as all parts of the plant Cannabis sativa, whether growing or not, including the seeds, the resin extracted from any part of the plant and every compound, derivative, mixture, or preparation of the plant. Marijuana contains the psychoactive phytocannabinoid tetrahydrocannabinol (THC) along with other phytocannabinoids.

If one searches the PDR, no information about marijuana can be found. The PDR contains FDA-approved product labeling and information, and marijuana is not an FDA-approved drug. Of note, Marinol can be found in the PDR. Marinol is 100% synthetic delta-9-THC, the most psychoactive component of cannabis. Epidiolex is another FDA-approved cannabinoid-based medication.

There is an important distinction to be made between writing a prescription and making a recommendation for medical marijuana. While prescribing a Schedule I controlled substance is a violation of federal law, the same cannot be said for recommending marijuana to a patient. In a case decided by the Ninth Circuit for the United States Court of Appeals, the Court held that a physician may not be prosecuted for recommending marijuana to qualified patients, with the good faith belief that such a patient will benefit from the consumption of marijuana. The Court made a distinction between a prescription, which is a federally regulated action, and a recommendation or certification, which is a protected expression of a physician’s First Amendment right to freedom of speech and belief. See Conant v Walters, 309 F3d 629, 632 (9th Cir 2002).

Palliative care is often less expensive than standard care. Various reports have noted that pharmacy bills, laboratory expenses and ICU/hospitalization costs are all significantly reduced. Health care costs following hospital discharge were also lower for interdisciplinary palliative care patients as compared to standard care patients.