Medical marijuana cardholders had less antiemetic overuse during cancer chemotherapy | Research

The takeaway

Cancer patients with medical marijuana cards were 24% less likely to experience antiemetic overuse during chemotherapy compared to non-cardholders, suggesting cannabis may allow more appropriate antiemetic prescribing.

Cancer patients on chemotherapy, oncologists, medical marijuana program administrators

24% lower odds of antiemetic overuse

What the researchers found

Medical marijuana cardholders had significantly lower odds of antiemetic overuse (aOR 0.76, p<0.05) compared to non-cardholders. Antiemetic overuse was identified in 7.5% of chemotherapy cycles overall.

Why it matters

Antiemetic overuse during chemotherapy is a quality concern highlighted by ASCO. If cannabis can reduce unnecessary antiemetic prescribing while maintaining nausea control, it could improve chemotherapy care quality and reduce costs.

The numbers in context

20,558 patients, 436 (2.1%) had MMJ cards. Antiemetic overuse in 7.5% of chemotherapy cycles. MMJ cardholders aOR 0.76 for overuse (p<0.05).

How the study worked

Retrospective cohort using linked Arkansas All Payers Claims Database (2013-2020) and medical marijuana cardholder registry (2013-2019). 20,558 cancer patients aged 18+ with outpatient chemotherapy within 12 months of diagnosis. Antiemetic overuse defined per ASCO Choosing Wisely recommendations.

What this study cannot tell us

Cardholder status does not mean patients actually used cannabis. Arkansas MMJ program may not represent other states. Cannot determine whether cannabis replaced antiemetics or if cardholder characteristics drove the difference. Small MMJ group (436 of 20,558).

How to read the evidence

Population-based retrospective cohort with claims data linkage, but cannot confirm actual cannabis use and has a small cardholder group.

When this study was published

2024 analysis of Arkansas claims and MMJ registry data from 2013-2020

The bigger picture

This study approaches the cannabis-cancer question from a quality improvement angle rather than just symptom management. Reducing antiemetic overuse aligns with value-based care principles and could decrease side effects from unnecessary medications.

Questions still open

Are MMJ cardholders refusing antiemetics that they actually need? Does cannabis use during chemotherapy affect treatment adherence or cancer outcomes?

Common questions

What is antiemetic overuse?

Using more anti-nausea medications than recommended by clinical guidelines for the level of nausea risk from a specific chemotherapy regimen. ASCO identified this as a practice to reduce in their Choosing Wisely campaign.

Does this prove cannabis replaces anti-nausea drugs?

Not definitively. Having an MMJ card was associated with less overuse, but the study could not confirm patients actually used cannabis or determine the specific mechanism behind the association.

Read the original research

Association Between Medical Marijuana Cardholder Status and Antiemetic Overuse.

Cannabis and cannabinoid research

View on PubMed ↗Publisher’s paper ↗

Citation

Baltz, Alan P; Peng, Cheng; Gressler, Laura; Bhatti, Sajjad; Lewis, Kanna. (2024). Association Between Medical Marijuana Cardholder Status and Antiemetic Overuse.. Cannabis and cannabinoid research. https://doi.org/10.1089/can.2024.0083