Increased Use of Medical Marijuana: Skepticism vs. Evidence

The use of medical marijuana-both the psychoactive tetrahydrocannabinol and its nonpsychoactive relative cannabidiol-is a growing practice in facilities served by senior care pharmacists. Currently, 30 states have approved its use under a variety of different regulations and for a number of conditions. Its use is bolstered by a growing number of Americans who support legalization of cannabis. Though oral synthetic cannabinoid compounds are approved by the Food and Drug Administration for chemotherapy-induced nausea and vomiting and appetite stimulation associated with AIDS, synthetic products differ from plant-derived products in several ways. In addition, use of these substances has created a regulatory and legal quagmire that differs considerably depending on the state in which the pharmacist practices. In long-term care, pharmacists face an entirely different set of challenges than pharmacists who practice in other settings: Increasingly, long-term care residents and their attending physicians are asking to use medical marijuana. This manuscript discusses how some long-term care facilities are accommodating this substance that federally and in many states is considered illegal. It also discusses some of the challenges faced by pharmacists who work in dispensaries.