Saturday, July 7, 2012

Weed and Chemo- Part II

This information is from a great instructional sheet that they give to transplant patients at MA General Hospital.  I didn't write it.  It was written by Camille N. Kotton, MD in October, 2011.  I am just posting it here because it is good, sound advice not only for those who are transplant patients, but for all cancer patients who are using marijuana during their treatment.

By writing this, it doesn’t mean that Dr. Kotton is endorsing marijuana use.  She  is just doing what smart and caring doctors do.  They recognize that their patients are using marijuana.  They know that they have a few choices.  They can either:

·      Ignore it (but if the patient develops a fungal infection later they will still have to address it after the fact and the patient will be much sicker then).
·     Tell their patient not to use it knowing full well that their patient will continue to use it and then will lie about using it because they know their MD will disapprove (you want to have honest communication between your health care team).
·         Or they can do what Dr. Kotton has done.  She knows that some patients will still use marijuana.  She wants them to be honest with her. So she tells them if you are going to use it, here’s the safest way to do it. 

“Information  About Marijuana and Transplant Patients”  by Dr. Camille N. Kotton

"Marijuana use has been linked with pneumonias caused by molds in patients with weakened immune systems.  Molds commonly grow on plant materials and are found in the environment frequently.  Molds, also called fungus infections, include things like Aspergillus, Mucor and other aggressive and invasive, potentially life threatening infections.  Such infections are more likely to occur in transplant patients, and they should be aware of the potential risk of infection with smoking marijuana.

Heat treatment of marijuana is recommended to kill the spores.  This can be accomplished either by baking the marijuana in the oven, using a microwave, or by incorporating marijuana into baked goods.  Burning the marijuana (as in smoking a joint) or using a water pipe are not adequate techniques to reduce the risk of mold infections. 

Some recommend putting marijuana in the microwave for thirty or more seconds  to kill any fungus that might be growing on it.  The exact time needed to kill the fungus will vary depending on the oven settings, the quantity and moisture content of the marijuana, and the wattage of the microwave.  Alternatively the marijuana could be baked in an oven at lower temperatures to kill the spores."

This educational sheet is not intended to permit or encourage use of marijuana, which is still illegal in most states in the U.S.   Rather, for those who use marijuana already, it is intended to educate them about the potential infectious disease risks of marijuana use.  Potential organ transplant recipients should be aware that sometimes insurance companies refuse coverage for organ transplant if the patients are documented to be actively using illegal drugs including marijuana."

Helpful links and related reports:

Transplantation. 1996 Jun 27;61(12):1771-4.  Successfully treated invasive pulmonary aspergillosis associated with smoking marijuana in a renal transplant recipient.  Marks WH, Florence L, Lieberman J, Chapman P, Howard D, Roberts P, Perkinson D.

Chest. 1988 Aug;94(2):432-3.  Fatal aspergillosis associated with smoking contaminated marijuana, in a marrow transplant recipient.  Hamadeh R, Ardehali A, Locksley RM, York MK.

N Engl J Med. 1991 Mar 7;324(10):654-62.  Pulmonary aspergillosis in the acquired immunodeficiency syndrome.  Denning DW, Follansbee SE, Scolaro M, Norris S, Edelstein H, Stevens DA.

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