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Published in: Supportive Care in Cancer 3/2015

01-03-2015 | Original Article

Inhaled medicinal cannabis and the immunocompromised patient

Authors: Rosa Ruchlemer, Michal Amit-Kohn, David Raveh, Lumír Hanuš

Published in: Supportive Care in Cancer | Issue 3/2015

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Abstract

Medicinal cannabis is an invaluable adjunct therapy for pain relief, nausea, anorexia, and mood modification in cancer patients and is available as cookies or cakes, as sublingual drops, as a vaporized mist, or for smoking. However, as with every herb, various microorganisms are carried on its leaves and flowers which when inhaled could expose the user, in particular immunocompromised patients, to the risk of opportunistic lung infections, primarily from inhaled molds. The objective of this study was to identify the safest way of using medicinal cannabis in immunosuppressed patients by finding the optimal method of sterilization with minimal loss of activity of cannabis. We describe the results of culturing the cannabis herb, three methods of sterilization, and the measured loss of a main cannabinoid compound activity. Systematic sterilization of medicinal cannabis can eliminate the risk of fatal opportunistic infections associated with cannabis among patients at risk.
Literature
1.
go back to reference Abrams DI, Vizoso HP, Shade SB, Jay C, Kelly ME, Benowitz NL (2007) Vaporization as a smokeless cannabis delivery system: a pilot study. Clin Pharmacol Ther 82:572–578PubMedCrossRef Abrams DI, Vizoso HP, Shade SB, Jay C, Kelly ME, Benowitz NL (2007) Vaporization as a smokeless cannabis delivery system: a pilot study. Clin Pharmacol Ther 82:572–578PubMedCrossRef
2.
go back to reference Cescon DW, Page AV, Richardson S, Moore MJ, Boerner S, Gold WL (2008) Invasive pulmonary aspergillosis associated with marijuana use in a man with colorectal cancer. J Clin Oncol 26:2214–2215PubMedCrossRef Cescon DW, Page AV, Richardson S, Moore MJ, Boerner S, Gold WL (2008) Invasive pulmonary aspergillosis associated with marijuana use in a man with colorectal cancer. J Clin Oncol 26:2214–2215PubMedCrossRef
3.
go back to reference Chusid MJ, Gelfand JA, Nutter C, Fauci AS (1975) Letter: pulmonary aspergillosis, inhalation of contaminated marijuana smoke, chronic granulomatous disease. Ann Intern Med 82:682–683PubMedCrossRef Chusid MJ, Gelfand JA, Nutter C, Fauci AS (1975) Letter: pulmonary aspergillosis, inhalation of contaminated marijuana smoke, chronic granulomatous disease. Ann Intern Med 82:682–683PubMedCrossRef
4.
go back to reference Denning DW, Follansbee SE, Scolaro M, Norris S, Edelstein H, Stevens DA (1991) Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 324:654–662PubMedCrossRef Denning DW, Follansbee SE, Scolaro M, Norris S, Edelstein H, Stevens DA (1991) Pulmonary aspergillosis in the acquired immunodeficiency syndrome. N Engl J Med 324:654–662PubMedCrossRef
5.
go back to reference Gargani Y, Bishop P, Denning DW (2011) Too many mouldy joints—marijuana and chronic pulmonary aspergillosis. Mediterr J Hematol Infect Dis 3:e2011005PubMedCentralPubMedCrossRef Gargani Y, Bishop P, Denning DW (2011) Too many mouldy joints—marijuana and chronic pulmonary aspergillosis. Mediterr J Hematol Infect Dis 3:e2011005PubMedCentralPubMedCrossRef
6.
go back to reference Hamadeh R, Ardehali A, Locksley RM, York MK (1988) Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient. Chest 94:432–433PubMedCrossRef Hamadeh R, Ardehali A, Locksley RM, York MK (1988) Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient. Chest 94:432–433PubMedCrossRef
7.
go back to reference Kagen SL (1981) Aspergillus: an inhalable contaminant of marihuana. N Engl J Med 304:483–484PubMed Kagen SL (1981) Aspergillus: an inhalable contaminant of marihuana. N Engl J Med 304:483–484PubMed
9.
go back to reference Marks WH, Florence L, Lieberman J, Chapman P, Howard D, Roberts P, Perkinson D (1996) Successfully treated invasive pulmonary aspergillosis associated with smoking marijuana in a renal transplant recipient. Transplantation 61:1771–1774PubMedCrossRef Marks WH, Florence L, Lieberman J, Chapman P, Howard D, Roberts P, Perkinson D (1996) Successfully treated invasive pulmonary aspergillosis associated with smoking marijuana in a renal transplant recipient. Transplantation 61:1771–1774PubMedCrossRef
10.
go back to reference Mechoulam R, McCallum NK, Burstein S (1976) Recent advances in the chemistry and biochemistry of cannabis. Chem Rev 76:75–112CrossRef Mechoulam R, McCallum NK, Burstein S (1976) Recent advances in the chemistry and biochemistry of cannabis. Chem Rev 76:75–112CrossRef
11.
go back to reference Nations U (2009) Recommended methods for the identification and analysis of cannabis and cannabis products. Manual for use by national drug analysis laboratories In: Editor (ed)^(eds) Book Recommended methods for the identification and analysis of cannabis and cannabis products. Manual for use by national drug analysis laboratories Laboratory and Scientific Section, United Nations Office on Drugs and Crime, City. Nations U (2009) Recommended methods for the identification and analysis of cannabis and cannabis products. Manual for use by national drug analysis laboratories In: Editor (ed)^(eds) Book Recommended methods for the identification and analysis of cannabis and cannabis products. Manual for use by national drug analysis laboratories Laboratory and Scientific Section, United Nations Office on Drugs and Crime, City.
12.
go back to reference Scheretz RJ, Belani A, Kramer BS et al (1987) Impact of air filtration on nosocomial aspergillus infection: unique risk of bone marrow transplant recipients. Am J Med 83:709–718CrossRef Scheretz RJ, Belani A, Kramer BS et al (1987) Impact of air filtration on nosocomial aspergillus infection: unique risk of bone marrow transplant recipients. Am J Med 83:709–718CrossRef
13.
go back to reference Schwartz IS (1985) Marijuana and fungal infection. Am J Clin Pathol 84:256PubMed Schwartz IS (1985) Marijuana and fungal infection. Am J Clin Pathol 84:256PubMed
14.
go back to reference Shay AH, Choi R, Whittaker K (2003) Impairment of antibacterial activity and nitric oxide production in alveolar macrophages from smokers of marijuana and cocaine. J Infect Dis 187(4):700–4PubMedCrossRef Shay AH, Choi R, Whittaker K (2003) Impairment of antibacterial activity and nitric oxide production in alveolar macrophages from smokers of marijuana and cocaine. J Infect Dis 187(4):700–4PubMedCrossRef
15.
go back to reference Sutton S, Lum BL, Torti FM (1986) Possible risk of invasive pulmonary aspergillosis with marijuana use during chemotherapy for small cell lung cancer. Drug Intell Clin Pharm 20:289–291PubMed Sutton S, Lum BL, Torti FM (1986) Possible risk of invasive pulmonary aspergillosis with marijuana use during chemotherapy for small cell lung cancer. Drug Intell Clin Pharm 20:289–291PubMed
16.
go back to reference Szyper-Kravitz M, Lang R, Manor Y, Lahav M (2001) Early invasive pulmonary aspergillosis in a leukemia patient linked to aspergillus contaminated marijuana smoking. Leuk Lymphoma 42:1433–1437PubMedCrossRef Szyper-Kravitz M, Lang R, Manor Y, Lahav M (2001) Early invasive pulmonary aspergillosis in a leukemia patient linked to aspergillus contaminated marijuana smoking. Leuk Lymphoma 42:1433–1437PubMedCrossRef
17.
go back to reference Verweij PE, Kerremans JJ, Voss A, Meis JF (2000) Fungal contamination of tobacco and marijuana. JAMA 284:2875PubMedCrossRef Verweij PE, Kerremans JJ, Voss A, Meis JF (2000) Fungal contamination of tobacco and marijuana. JAMA 284:2875PubMedCrossRef
18.
go back to reference Weinrieb RM, Lucey MR (2007) Treatment of addictive behaviors in liver transplant patients. Liver Transpl 13:S79–82PubMedCrossRef Weinrieb RM, Lucey MR (2007) Treatment of addictive behaviors in liver transplant patients. Liver Transpl 13:S79–82PubMedCrossRef
Metadata
Title
Inhaled medicinal cannabis and the immunocompromised patient
Authors
Rosa Ruchlemer
Michal Amit-Kohn
David Raveh
Lumír Hanuš
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 3/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2429-3

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