Desperation and the Search for Alternatives: An Unfortunate Case of Cannabinoid Poisoning

Cancer is one of the most prevalent diseases on the planet. According to the National Cancer Institute, nearly 40% of all men and women in the United States will be diagnosed with some form of the disease in their lifetimes. Hundreds of billions of dollars are spent annually on health care for cancer patients, with some chemotherapy treatments costing thousands of dollars per month. The effects of chemotherapy are well known, and are sometimes described as being worse than the disease. Increasingly, medical cannabis is being prescribed for cancer patients, in addition to chemo, due to its palliative effects. While there is little to no evidence that cannabis is an effective treatment for the disease, it can make the symptoms easier to bear.

Given just how devastating cancer is, it’s not surprising that people are looking for inexpensive and effective therapeutic options. However, the desire for relief can sometimes drive people to extreme lengths, and make them willing to try unconventional treatments. This creates an opportunity for unlicensed “doctors” to do more harm than good. The subject of today’s article describes just such a situation, in which an untested cannabis-based treatment was administered under the guise of legitimate medicine, and ended up harming an already very sick cancer patient.

THE STUDY

This case study, published in the journal Clinical Therapeutics, was written by a team of doctors from the University of Newcastle, in New South Wales, Australia, and describes their experience treating a patient with Stage IV ovarian cancer. The patient, a 56-year old woman, came to the hospital in a state of cachexia. This word describes a range of symptoms that are often associated with cancer, such as muscle wasting, loss of appetite, and fatigue. However, she was brought in because she was experiencing fevers, severe abdominal pain and distension, paranoia, and hallucinations. The patient was admitted for treatment and given a workup.

Questioning of the patient revealed that, two days prior, she had received an abdominal injection of “cannabis oil”, and had been given several capsules to swallow. Medical cannabis is legal in Australia, but a subsequent investigation found that the “health center” this patient attended was using illegally obtained products of unknown composition. The injection consisted of a crude cannabis resin mixed with coconut oil which supposedly contained twelve grams of mixed cannabinoids. This explained the patient’s altered psychological state and fevers.  It may also explain the abdominal pain and swelling, since there are documented cases of cannabis-induced pancreatitis; further, debris in the oil mixture could have blocked abdominal blood vessels, leading to swelling and pain.

Following this revelation, the doctors began to monitor the patient’s bodily fluids for THC, CBD, and their metabolites. Seven days after the injection, the patient’s blood plasma THC levels were measured at 43ng/mL. According to current pharmacological data, THC levels greater than 5ng/mL are associated with severe psychological and physical impairment. No cannabidiol was detected. Several days later, they determined the speed at which her body was processing the THC, and estimated that it would take forty-nine days to get below the 5ng/mL threshold. After sixteen days in the hospital, the patient was moved to a rehabilitation center to deal with the lingering effects.

CONCLUSIONS

This case illustrates several very important issues when it comes to the use of medical cannabis. For one, it demonstrates the need for proper regulation of all pharmacological treatments, including cannabis. Clinical evidence has shown that, for most users, the side effects of medical cannabis are mild and well-tolerated. It’s easy to see how an unlicensed medical practitioner could construe this as “safe” and try to develop their own therapies, all the while forgetting or ignoring the tightly-controlled dosages and conditions that are in place for clinical research. In this case, an individual made and sold a treatment that had undergone no clinical testing, using ingredients of unknown origin and potency, and ended up directly harming someone who was already suffering from end-stage cancer. This is the exact opposite of how science-based medicine is supposed to work, and for good reason.

Furthermore, this case highlights the need for more research on medical cannabis, particularly on routes of administration. Currently, no data exists regarding the abdominal injection of cannabis oils, in either healthy or sick people. This patient’s doctors had no idea how long she would be suffering from the effects of THC poisoning, nor were they aware of any treatment options to remove it from her system. They had no choice but to treat her symptoms and wait it out. With more available research, they may have been able to devise an emergency treatment, or at the very least make more informed decisions for their patient’s care.

Finally, this case shows the value of exercising caution when considering “alternative” medicines or seeking care outside the traditional medical system. While the staff of the “health center” in this case were most likely well-intentioned and believed in the effectiveness of their treatments, they were not qualified to make the right decisions for this patient, and ended up causing more misery to someone already deathly ill. Before taking any type of medicine, it’s important to ensure that it is being prescribed by a licensed medical professional, and that it has been approved for use.

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