UCSF oncologist Donald Abrams, MD, has been treating cancer patients for almost 40 years. And there isn’t a day that goes by where he doesn’t see a patient with loss of appetite, nausea, vomiting, insomnia, pain, depression, or anxiety. Fortunately, he has what he calls a valuable intervention – medical cannabis: “Instead of writing a prescription for 5 or 6 pharmaceuticals that could all interact with each other or the chemotherapy I prescribe, I can recommend one very safe botanical.”
Notice the word “recommend.” He explains:
I [don’t] say take this strain, this much, this many times a day. I don’t think cannabis is a medication that needs a package insert. Most people can probably figure out how much to use it. Every patient is different, every strain is different – I think the best recommendation is ‘start low, go slow.’ . . .
I think we should regard it as a botanical therapy that’s been around for 5,000 years and has significant benefits. But to try to say that it’s a medicine using a pharmaceutically dominated paradigm might not be correct. I think it should be treated like saw palmetto and echinacea but regulated like tobacco and alcohol, and let responsible adults use it as they see fit.
This is the approach he takes with patients with chemotherapy-induced nausea and vomiting. Instead of prescribing dronabinol (synthetic THC in a capsule) he recommends they smoke natural whole plant cannabis, which will have varying ratios of CBD to THC. And the difference, he says, is obvious:
… it was very clear to me which patients were on dronabinol because they were in bed pretty much all day long, totally wiped out. Whereas the cannabis patients were all up … cleaning their rooms, and very much more active. So yeah, I think it’s a different kind of medicine.
Same with AIDS patients suffering anorexia, and in cancer end of life care where patients are put on opiates to ease their pain and suffering. In both cases his patients prefer to use their own cannabis as they see fit because they get symptom relief and they’re able to function. As one patient told him, opiates “[don’t] allow me to communicate with my family because I’m way way to stoned.”
While Abrams’ approach may seem counterintuitive, I attach great weight to it. Aside from being in the trenches for 40 years and seeing what works and what doesn’t, he’s quite the scholar and researcher. Educated at Stanford, he teaches and researches at UCSF, has a clinical practice at San Francisco General Hosp, co-edited the cancer textbook Integrative Oncology, was named a ‘Top Cancer Doctor’ by Newsweek, and was on the committee that wrote the seminal book on medical cannabis, The Health Effects of Cannabinoids: The Current State of the Evidence, on behalf of the National Academies of Sciences, Engineering and Medicine.
Dr. Abrams seems to be as good as it gets. And that that’s basically what he’s saying about medical cannabis.
(His statements are taken from the recently released book Healing with Cannabis by Cheryl Pellerin; Chapter 13, Cannabinoids and Cancer.)