Transcript Report/Results

NH Medical Society
Herbal Marijuana Survey
Presented by Seddon R. Savage MD, MS
Survey Goals
• Learn current and anticipated engagement by
NH clinicians in use of herbal marijuana for
therapeutic purposes
• Assess clinician understanding of marijuana
effects and side effects
• Link mailed to
– 2642 physicians with four reminders
– 900 APNPs on one occasion
– Total 3540
• 467 responses
– 239 physicians
– 64 APRNs
– 164 unknowns
• Response rate overall: 13.2%
If you know a patient uses or want to try MJ, how
often do you advise them on risks & benefits
Advise risks/benefits if using
250
200
150
Advise risks/benefits if using
100
50
0
Never
Rarely
Sometimes
Often
NA
How often have you recommended a trial
of marijuana for clinical purpose
Recommend MJ
400
350
300
250
200
Recommend MJ
150
100
50
0
Never
Rarely
Sometimes
Often
NA
How often have you recommended a
trial of cannabinoid medications?
400
350
300
250
Recommend Cannabinoid
Med
200
150
100
50
0
Never
Rarely
Sometimes
Often
NA
Will you be willing to certify a patient’s medical
condition and symptoms for certification to use MJ?
160
140
120
Willing to certify
100
80
60
40
20
0
Never
Rarely
Sometime
Often
NA
Would you want to be on a list of physicians
willing to certify patients for Clinical Cannabis?
List MJ Providers?
450
400
350
300
250
200
150
100
50
0
Yes
No
How would you rate your knowledge of herbal
marijuana/cannabis effects?
160
140
Knowledge
400
120
300
100
200
80
0
100
0 to 2
3 to 5
60
40
20
0
None
0
1
2
3
4
5 Comprehensive
Marijuana Knowledge Challenges
• Herbal marijuana primarily studied in terms of
outcomes and effects of illicit use
• Cannabinoids studied in terms of therapeutic effects
and side effects
• Less research on therapeutic effects of herbal MJ
– Highly variable herb with 50-200 biologically active
chemicals (>50 cannabinoids all with different actions)
• Cannot extrapolate from research on cannabinoids
to herbal marijuana
• Cannot extrapolate from one strain of marijuana to
another strain
Marijuana
Sources of “Evidence”
• Research related to illicit use
• Few research studies of therapeutic use
– Few randomized controlled clinical trials
•
•
•
•
Observation and experience
Clinical case reports in popular media
Extrapolation from cannabinoid research
Expert consensus reached by any or all of above
Perception of Evidence
Acute Therapeutic Effects
450
400
350
300
250
200
150
100
50
0
Mod-Strong
None-Sketchy
Perception of Evidence
Acute Side-Effects
450
400
350
300
250
200
150
100
50
0
Mod-Strong
None-Sketchy
Perception of Evidence
Chronic Side-Effects
450
400
350
300
250
200
150
100
50
0
Mod-Strong
None-Sketchy
Key Messages
• Education is needed to enhance clinician
understanding of
– Potential effects and side effects
– Possible risks
• Patient counseling is needed to ensure
understanding
– Potential effects and side effects
– Possible risks
• Data collection and research are needed to
determine actual effects, side-effects & risks
• Thank you to NHMS for launching survey