DKF Med Care

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June 15, 2021
Richard E Bélanger and Christina N Grant

 

Abstract

While cannabis use among adolescents is frequent in Canada, youth do recognize the potential harms, and increasingly expect knowledgeable health care providers to discuss substance use in everyday practice. This practice point provides sound, evidence-based tools to help health professionals address nonmedical (recreational) cannabis use and its related risks. After highlighting how to make the clinical setting a safe space for youth to talk about psychoactive substances, specific strategies for approaching cannabis use in effective, developmentally appropriate ways are described. Consistent with current literature, screening questionnaires to help structure discussion and identify adolescents who may benefit from more specialized interventions are recommended. Because one in six adolescents who experiments with cannabis goes on to misuse it, appraising their willingness to change risky behaviours is a key aspect of care, along with supportive goal-setting and helping families. Recommended resources for practitioners and parents are included.

Keywords
Adolescents, cannabis, counselling, harm reduction, screening

See full report at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202733/

 

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May 31, 2021
Caroline A. MacCallum, Lindsay A. Lo, Michael Boivin
Open Access Published

Highlights


• A safety-focused approach is necessary in each step of patient's cannabis journey. • Prior to initiation, screen for precautions, contraindications & drug interactions. • Patient risk factors guides choice of chemovar and route of administration. • Initiate cannabis using a low dose, slow titration method. • Set monitoring frequency, and adjust for adverse events or medication changes.

Abstract


Medical cannabis use is increasing worldwide. Clinicians are commonly asked by patients to provide guidance on its safety and efficacy. Although there has been an increase in research on the role of medical cannabis for a number of different conditions, we found that there was a paucity of clear safety guidance on its use. We aim to address this issue by answering two pertinent clinician safety questions:
1 Can medical cannabis be safely used in this patient?
2. What strategies can be used to ensure that any harms from medical cannabis are mitigated?
To address these questions, we reviewed available evidence and provided expert clinical opinion to summarize the fundamental components for evaluating medical cannabis safety and strategies to reduce risk from its use. Our review resulted in a safety-focused framework for medical cannabis initiation and utilization. We provide clear recommendations for patients being considered for cannabis (e.g. precautions, contraindications and drug interactions). Risk mitigation strategies such as appropriate chemovar (strain) selection, routes of administration, and dosing are reviewed. As with any other pharmacotherapy, we review the key components of monitoring and address potential issues that may arise while using medical cannabis. We propose a structured assessment and monitoring strategy that can be used by clinicians recommending cannabis (CRC) to guide patients through each step of their cannabis journey. This framework can be used to ensure that medical cannabis utilization is associated with the lowest possible risk to the patient.

Keywords


Cannabinoids
Medical cannabis
Cannabinoid based medicines, CBM
Tetrahydrocannabinol, THC
Cannabidiol, CBD
Marijuana
Safety
Adverse Events, AE
Adverse Drug Reaction, ADR
Side Effects
Pharmacovigilance
Drug Interactions, DI
Comorbidities
Polypharmacy
Contraindications
Precautions

https://www.ejinme.com/article/S0953-6205(21)00152-7/fulltext

 

 

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