Dental Treatment Planning Considerations in Patients Using Cannabis
Sarah E. Grafton1, Alexandre R Vieira2
1. Department of Comprehensive Care, University of Pittsburgh School of Dental Medicine
2. Department of Oral Biology, University of Pittsburgh School of Dental Medicine
ABSTRACT
Background and Overview. There is a deficit in clinical research on the potential risks involved in treating dental patients using cannabis, either for medicinal or recreational purposes. The aim of this case report is to illustrate the wide variety of available cannabis options and their potential impacts on dental treatment.
Case Description. A 27-year-old African American male presented to the dental clinic with nonrestorable molar requiring extraction. During the review of his medical history, the patient reported taking a “dab” of marijuana approximately five hours prior to his appointment. Due to the admission of recent illicit drug use, no treatment was rendered. The patient was offered an appointment the next day but refused citing the bias in regard to cannabis use.
Conclusions and Practical Implications. The number of Americans using marijuana is rising rapidly. Pending legalization in most states will require dentists to address the possible effects of this increase on dental practices. It is imperative dental providers make clinical decisions based upon scientific evidence regarding the pharmacological and psychological effects of cannabis, not on the societal stigma
Also, marijuana can be seen as being addictive in nature. “Approximately 9% of individuals that use marijuana become addicted” (Marijuana Statistics). Marijuana contains many chemicals, such as tetrahydrocannabinol (THC), which can cause many positive and negative effects to the human body and brain. A major attribute for medical marijuana is the economic advantages that are produced from the distribution of the drug. Also, the legalization of medical marijuana can portray positive and negative outcomes for law enforcement. Therefore, medical marijuana has many positive effects, such as treatment for diseases, and negative effects, such as immune system suppression. Throughout this research paper, medical marijuana will be thoroughly explained to exemplify the advantages and disadvantages of legalizing the
By this point in time, the opioid crisis is well-known and concerning. One potential solution suggested by researchers, medical professionals, and individual patients alike is the use of medical cannabis for treatment of conditions such as chronic pain. In fact, many patients now prefer medical cannabis to opioid treatments. It’s not difficult to see why.
Every day in the United States many use marijuana as a medical substance. “Like many doctors involved in palliative care he was aware that 10% to 15% of his patients used marijuana” as said by Ottawa family physician Don Kilby while referring to one his patient’s other physician (Gray 2). The patient Kilby is treating is an AIDS patient named Jean Charles Pariseau (Gray 1):
Those who disagree with the legalization of marijuana across the United States state various concerns regarding its potential for negative side effects, such as causing addiction and deteriorating cognition (Loflin and Earleywine 293-296). Nonetheless,
The debate on Medical marijuana has been a controversial subject mainly because people have an abundance of opinions and very little scientific research to back up either side of the debate. The most important question here is “will medical marijuana be used for medical purposes or will it be used inappropriately?”
Physician Becker and Tetrault published article on Mayo Clinic Proceedings in (2016) discussed the risk factors of medical marijuana in combination with opioids. After legalization of medical marijuana, long-term user of opioid for chronic pain are frequently combining marijuana in their treatment, which putting patient in a risk of over dosing. The issue is that FDA does not approve marijuana as a medicine, whereas states legalizing it use. Therefore, physicians cannot prescribe marijuana but only recommend. Therefore, multiple providers are in the case for the patient who is using marijuana and opioids. The issues that are faced by the providers; no standard dose for medical marijuana, the unknown risk and benefit of combination use of opioids
In addition, anecdotal evidence exists that marijuana is effective in the treatment of arthritis, migraine headaches, pruritis, menstrual cramps, alcohol and opiate addiction, and depression and other mood disorders. Marijuana could benefit as many as five million patients in the United States. However, except for the eight individuals given special permission by the federal government, marijuana remains illegal-even as medicine! Individuals currently suffering from any of the aforementioned ailments, for whom the standard legal medical alternatives have not been safe or effective, are left with two choices: Continue to suffer from the effects of the disease; or Obtain marijuana illegally and risk the potential consequences, which may include: an insufficient supply because of the prohibition-inflated price or unavailability; impure, contaminated, or chemically adulterated marijuana; arrests, fines, court costs, property forfeiture, incarceration, probation, and criminal records.
The use of cannabis toward medicine should not be shocking to anyone, since it has been around for centuries. As a matter of fact, it has been under medicinal aid for an estimated 5,000 years. Western medicine truly grasped marijuana’s medicinal abilities in the 1850’s. Infact, doctors documented over one hundred papers about how marijuana helped numerous disorders, such as nausea, glaucoma, movement disorders, pain relief, depression, and anxiety. It also helps cancer patients and those with HIV or Aids. Currently, many American patients have access to marijuana use so that they can have effective treatments for their illnesses. Medical marijuana use is achievable because
"Various forms of medicinal cannabis have provided mostly positive responses for patients with different types of pain: Neuropathic, chronic, postoperative, and that related to fibromyalgia, rhematoid arthritis, mutiple sclerosis and cancer" (Borgelt, Franson, & Nussbaum, 2013). In a study outlined in the article The Pharmacologic and Clinical Effects of Medical Cannabis, which evaluated smoked cannabis compared to placebo, significant improvements in pain were observed. The study included 56 patients and used cigarettes wtih varying THC contents. In general, a higher THC content (up to 9.4%) appears to be more effective for pain relief (Borgelt, Franson, & Nussbaum, 2013).
Marijuana is a drug that divides people. Some people claim it as the wonder drug of the '90s, capable of relieving the symptoms of many serious illnesses. Others curse the day the cannabis plant was ever discovered. From pain relief to stimulating the appetites of patients on chemotherapy, marijuana seems to have plenty going for it as a medicine. The legalization of marijuana is a large controversy in many parts of the world today, but the obvious negative effects that the drug induces has kept it from being legalized. Many researchers have a strong positive attitude towards marijuana. It has been said that the drug is “worth investigating and even providing as a medicine for pain relief, severe
Cannabis sativa is used to make synthetic cannabis in the laboratory mainly for medical purposes, such as Alzheimer’s, nausea, alleviating cancer symptoms and depression. However if not correctly done, the desirable properties will not be fully obtained and psychoactive effects will take over and cause the consumer to receive the high. For this reason, more research should go into the understanding of cannabis and its impact on the human body, as there have been several disagreements between the American College of Physicians and the Food and Drug Administration. Currently, cannabis is not known to have a lethal dose and has minimal interactions with other drugs. For this reason, physicians can easily administer the drug in different ways,
The medical use of marijuana has been a discussion that has been in the news and all around us recently. This is currently a hot topic of interest. There is an enormous amount of evidence that marijuana could be effect against many things. For example evidence shows it could be used to help relieve pain during chemotherapy, but along with this there is also evidence that at times marijuana can cause harm to someone as well. As nurses we must see each side of the debate to make our care for our patients sounder. One quote that directly applies to this topic, which is very important, was written in the Journal of Clinical Nursing:
Over the past couple of years, the use of opioid painkillers has skyrocketed. And due to this, so has the number of overdoses. The opioid epidemic is the worst drug crisis that the United States has ever seen. Killing thousands of people and sending many more to either drug rehabilitation programs or prison. Yet doctors continue to prescribe these addictive painkillers, to patients with little to no restrictions. There are many safer options than these opioids, including the use of marijuana, which has been overlooked for far too long.
Marijuana is illegal in fifty states because of its classification as an illicit drug, but controversial issues have been established that this “illicit drug” has improved the course of treatment for suffering patients. Marijuana has beneficial effects when used in medicinal scenarios for the treatment of pain; thus it should be an administered drug for patients who can benefit from the use of this drug. Marijuana has undergone analysis for its use as a medicine and the results have shown improvements in the patients who were treated with this drug. Doctors have expressed opposite opinions, making this issue very controversial.
There is extensive literature evaluating the merits and dangers of legalizing marijuana, or cannabis, for medicinal and recreational use. However, despite the quantity, it is difficult to draw a meaningful conclusion based on the quality of much of this evidence. In reviewing three recent articles addressing medicinal uses for cannabis (Whiting et al., 2015), negative health effects from its use (Gordon, Conley, & Gordon, 2013), and pharmacist recommendations for implementation of its use (Isaac, Bandana, & Chaar, 2016) it is clear that further research is needed on this issue. Two of these studies highlight the limitations and inconsistencies in the current evidence and the need for more investigation (Gordon et al., 2013; Whiting et al., 2015), while the third article exemplifies the role that bias plays in undermining the evidence (Isaac et al., 2016). Recently, investigators have begun to examine in more depth the roles bias and legal barriers play in limiting studies on medical marijuana (Rhodes et al., 2016; National Academies of Science Engineering and Medicine [NASEM], 2017). Research must be encouraged and facilitated at the federal level to reduce bias and promote the production of high quality evidence for or against therapeutic effects of cannabis, and health care providers should be better educated to objectively participate in this process (Evanoff, Quan, Dufault, Awad, & Bierut, 2017).