Congress Abstracts 2006

159

COMPARISON OF DRONABINOL AND MEDICAL MARIJUANA. Ellen DeBondt, RN, BSN, OCN^®, Seattle Cancer Care Alliance, Seattle, WA.

The Institute of Medicine's 1999 report on medical marijuana stated, "the accumulated data indicate a potential therapeutic value for cannabinoid drugs, particularly for symptoms such as pain relief, control of nausea and vomiting, and appetite stimulation." These symptoms are very prevalent in the oncology patient, and many oncology patients are using Dronabinol (Marinol) and/or Medical Marijuana for symptom relief.

The purpose is to provide a pharmacological and evidence based comparison of Dronabinol and Marijuana.

The comparison will include indication, routes of administration, cost, onset and duration of action, side effects and safety concerns. Scientists have identified approximately 66 chemical compounds in Marijuana known as cannabinoids. The active ingredient in Marinol, synthetic delta-9-tetrahydrocannabinol, is an analogue of one such compound, THC. Dronabinol contains only one of the 66 cannabinoids present in Marijuana. In the past 15 years scientist have identified a biological system, the endocannabinoid system and are working to understands its role in pain, normal brain function, the nervous system, and effects on appetite. Marijuana is most commonly smoked but can be used as a vaporizer, a tincture, or orally when prepared in food.

Oncology nurses are experts on symptom control and it is important that we understand the differences of Dronabinol and Medical Marijuana. Following review of this educational poster Nurses will be able to provide a vital nursing intervention, patient education.

As Rose Mary Carroll-Johnson wrote in her editorial 'Highs and Lows' (Oncology Nursing Forum, July 2005), "Some serious questions remain.. leaving us in a difficult situation when patients or family members ask for advice. The best we can do is offer the facts as we know them, avoid condoning illegal behavior, and encourage a full, responsible, impartial, and scientific approach to rational decision making." There is much research, education, and discussion that needs to be done and it is important that we as Oncology Nurses who are experts in symptom management are involved in this.