Dr. Shawn Kwatra discusses dosing, delivery, and side effects of using medical marijuana as an adjunctive treatment for chronic itch.
Shawn Kwatra, MD, is Assistant Professor of Dermatology at Johns Hopkins Medicine, Baltimore, Maryland.
“What’s really helpful is in states that have medical marijuana legalized, there are specific guidelines that are in place for other indications that have been more studied,” says Shawn Kwatra, MD. “So specifically for chronic pain there are specific guidelines that are in place… we followed similar guidance that’s available for pain.”
Dr. Kwatra, Assistant Professor of Dermatology at Johns Hopkins Medicine, Baltimore, Maryland, recently coauthored a case of chronic itch in a 60+ year-old female patient with underlying cholestatic pruritus who was recalcitrant to standard antipruritic therapies, including topical steroids, phototherapy, capsaicin, doxepin, naltrexone, and butorphanol nasal spray.1
When prescribing cannabis for his patient’s itch, Dr. Kwantra wrote for the patient to either smoke tetrahydrocannabinol (THC), 18% Indica flower or sublingually dose a 1:1 THC-cannabinol tincture 2 nights per week. The patient filled her choice at a dispensary.
Dr. Kwantra says he’s not a fan of the smoked form because of the side effects of smoking and the lingering odor. His preferred method is the tincture form because it’s dosed with a dropper and THC enters the bloodstream quickly, therefore, delivering relief.
“The patient had a really excellent, excellent response to that therapy,” says Dr. Kwatra.
Finally, says Dr. Kwantra, he advises patients to take the lowest amount possible the first time using cannabis to gauge reaction.
“In general I always tell patients, the first time you take something, we like to take the lowest amount possible in a very safe setting and just see how your body reacts… you can never know what type of reaction that particular person is going to have.
Reference:
- Roh YS, Sutaria N, Biles NF, Kwatra SG. Treatment of Chronic Pruritus With Medical Marijuana. JAMA Dermatol. Published online April 09, 2021. doi:10.1001/jamadermatol.2021.1194