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 $37_ Fsdorsl Re_st_ / Vc|. S4, No. 249 / P_dey. December 29. 19_ I Not_e8
 _ To proper_y evaluate the that ora_|y h_gest_ THC was _ups_ior to snttemetic in patients rscelvmg
 effective_ess of a new an_iemetic dn_ smoked msriju_o methotrexate chemotherspyo ,A_ou_h
 researchers muse perform ccereful]y 29. A|though TI-.IC is _,ual_y a Dr, Ch_an8 found that smoked mariju_
 conducted randomized_ double-blind const_ent present in marijuan¢, since was more reliable than oral THC L_
 testing of the dru8 against either a marijuana a_so contain,_ at least _ ether achievlng therapeutic blood leveler he
 placebo or an established antiemeti_ active _annsbinoids In varyln_ also found that it had drawbacks ha
 using a statisticeUy significant patient quartettes, the results of antiemet_o patient acceptability: patients
 population, Several factors are _els train8 THC cara_ct be extrapolated complained of Its adverse taste, which
 _portant when p_anrdn8 or evaJuatir_ h_ evaluating m_r_iuana'e _emetic induced nausea and vomiting in some
 an autiemetic stud_ these _clude: (a} p_pert_es, For example, cannabidlol, a _nstances. He also _urndsed that
 S_andardization o_ the em_ti_ stL_xult_ ©onstituent present in marl_uena_ c_ patients who are nonsmokers may nor
 (b} accuracy tu data collection, w_ tim potsntia_e some effecm of THC_ while be wi|ling and/or able to smoke
 use ot objective pResets:K, such as the suppres_i_ other effects, _cludin8 the marijuana. Based upon these
 number of emstifeptsodes and the autiemet_c effect drewback_ Dr. Chang concluded th_
 voltune and duration of emes_ (c} 30_ No forn_aL we_.,contr_ed stu_e_ "an alternative parenterel drug mute
 : standardlzat_on of patient popula_ior_ h_ been conducted which compare needs to be established if THC [or
 with an in_catinn ot whether _r not marijuana'e effectiveness _ an marijuana] Is to have wide clinlca|
 patients had pr_viot_ly received a_tiemet_c against any of the cun_ntly acceptabfli_yY In additioz_ he
 chemotherapy° and (d) proper selectlo_t evailab|e anemometres such _s determined that additional studies
 ...... of route of adi_L,dstratio_ and _J_ _etoclopm_d_ ha|opt_d_ relating to drug tolerance, effecttvenes_
 schedule and dosage, based upon proper dexamethasone, prochlorpe_azlneo agaln_t nausea and vomiting produced
 , trials with the agents In edition, it _ nabi[one, lorezepam, or any of the by other chemotherapy regimens, and
 Impotent to determine quantitatively hi_h|y effective _ombination_ o_ c_mparlsons with c_nven_onai
 the efficacy of ant_emet_c agents used available ant_emet_c_ _t_emetics needed to b_ c_nductecL
 s_.gularly, so that results can be _'1o The ordy studies which have been 3_. A study conducted by Stephen E
 compared and further _al_ includ]r_ conducted using marijuana _s an S_llan_ M.D., which is cited by beth
 combination studies, can be plannod ant_emetlc in_u_e the fo_owLug: (I) The HORML and ACT, involved a double-
 appzol:niatsly, state proteins (discussed p_viously)_ blincL randomized evaluation of th_
 For a new an_eme_c _ to be (2) _e study mentioned above which 'autlemstlc effect of synthetic TPIC
 considered effect_veo it mu_ be _ _mpar_ smok_i marijuana to oral capsu|es in IS patients rscelvir_
 effective or more effective in COn_L_ sy_the_._ THC and concluded thee THC chsmothe_py (although 22 patients
 emests than'the _.trrontly_vaflab|e was tours effsct_ve; (3) • pa_pated in the study, only 18
 %ompaselonate" study conducted by _eceived oral THC), Them t_ no
 ant_emet_c_ Thomas _. Urger]elder Involving 18 bone _ndlcatlon a_ to what types of
 _. Relatively few eclsnt_fl_ or me:_ca_ marrow _snsp|ant pat_entso In that chemotherapeutic asents wars
 etudes have been conducted to eva|trots study° the e_cacy of the dr_ wet _clndnlstered to the patients durln8 the
 mariiuan£s effectlvenose _s au meas_d orgy by sub_sctlv_ tee_r.8 study_ Dr. Sallan concluded that THC
 antlemeti_ _Jormat_on conceraL_ technique: and (4) a study c_uducted had ant_emet_c effects,_ In addition, he
 m_ri|u_na's ant_eme_c properties is by A_fa,_d _ Char_ which _olv_d _5 made some '_r_Iminary obeervstinng _
 p_mt_y anecdotal The research that paSents 1_3eivin8 m_thotra_te compa_8 the antiemetic effect of
 hat been conducted with mari|usna has chtem_the_W, smoked mariluana and oral THC
 been primarily in the form of loos_ _2_ The purpose of the Chan8 atudy cap_ule_ based upon some patients'
 uncon_l|ed studies which provide little was _o compare the ant_emet_u t_lJc_t use of marijuana which was
 valuable information as to the drug's effectiveness of THC to a placebos neither qualitatively nor quantitatively
 : .....
 effectiveness, Most research with initially _ the study, patients randomly controlled. He found that "[f_ or most
 marijuana has been conducted undor received either an oral THC capsule or petlents, both smoked and oral routes
 state protocols. The state sponsored placebo cap_le p_or to che_therapy, had ldentice| effects." This study was
 _search conducted thus far has not Neither _e patients nor the _eee_ not a scien_ic comparstlve study of
 employed carefully contro|_ed doubl_ were aware _f which drt_ they rscelve_L smoked m_riJuana and oral TH,CC_ but
 bllnd, randomized to, tin8 of maz_juan_ Th_s separate chemotherapy tz_sls rather • formal compa_son between
 nor has It involved large patient were conducted dur_a8 the sttrdyo O_|y oral synthetic THC and placebo.
 populations. As a result |Itt_e mllab|_ ff the patient vomited durin8 e trial 34. Even _ its limited use. marijuana
 t._ormatlon can be gleaned from th@_ would he or _he recslve a msrljuana has not been shown to be very effectiv_
 types of studies, cigarette for the remafh_._n_ _o_s of that In reducln_ nausea and vomi_L_ whe_
 Based upon the lack _f quMJW chemotherapy trial. AI_ patients who used with chemotherapeutic agents
 testiS, msJ_tjuana'e ant_emetic actuary received _.s_ju_ c_arette® were which produce severe emesie.
 not as established as that of THC or expe_enoed smok_ Tbe study _oes _o In _n_st to ma_juana, s_u_hefl_
 other evailab|e antiemetlc_ _l_ers am not _d_c_te how _y patients r_soztsd oral THC (dronablnol), nabilon_,
 no double-blind randomized st_u:Ue_ m _mo_ marlju_n_ dur_rt_ each _L metoclopramide, end other ourren_y
 which have concluded that marijuan_t _ Since sLx patients did not vomit at: all on available an_emetlc_ have been teste_
 ae effective or more eff_ctlve than the THC they _d not receive marijuana extensively through well-desi_nocL
 _ynthetic THCC or a_y of the other cf_a_ttes. The purpo_ ot the s_uc_y was cont_Red double-blind studies for botl_
 currently avatleble a_tieme_lce. In fact, not to comp_J_ the eff_cttv_eu o_ oral chew and efficacy. For example, mo_,
 in lg8¢ the o_y controlled, r_ndomLv,e_,t. THC to marijuana buL rather, t_ than _,3_0 patients were tested with
 doubl_-bi_nd, crossover study compel ©_p_ THCs effec_Iven_ a_aL_st a eynthetic T_C before it was mode
 the antieme_c effec_venass of smoke_i placebo, Dr, _ con_ud_i that thee avaLlable as a Sch_:lule 11 druB.
 marijuana to orally ingested synthe_c combustion ot oral THC and smoked M_'_ju_Js_ on the other hand_ _ o_y
 '_qPIC involved _ patlenm and concluded maHJ_a_ _ _ _t_ghly efface,re been tested in 20 pat_e_m in a f_'m_

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