{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:07Z","timestamp":1787008207356,"version":"build-2736575974"},"reference-count":58,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T00:00:00Z","timestamp":1590710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The opioid epidemic has spurred investigations for nonopioid options, yet limited research persists on medical marijuana's (MMJ) efficacy in managing cancer-related symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We sought to characterize MMJ's role on symptomatic relief and opioid consumption in the oncologic population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective chart review of MMJ-certified oncology patients was performed. Divided patients into MMJ use [MMJ(+)] versus no use [MMJ(\u2212)], and Edmonton Symptom Assessment System (ESAS)-reported pain cohorts: \u201cmild-moderate\u201d versus \u201csevere.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Medical records were reviewed for ESAS, to measure physical and emotional symptoms, and opiate consumption, converted into morphine milligram equivalents (MME). Minimal clinically important differences were determined. Wilcoxon signed-rank tests determined statistical significance between MMJ-certification and most recent palliative care visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Identified 232 patients [95\/232 MMJ(\u2212); 137\/232 MMJ(+)]. Pain, physical and total ESAS significantly improved for total MMJ(\u2212) and MMJ(+); however, only MMJ(+) significantly improved emotional ESAS. MMJ(\u2212) opioid consumption increased by 23% (97.5\u2013120\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004), while it remained constant (45\u201345\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.522) in MMJ(+). Physical and total ESAS improved in mild-moderate-MMJ(\u2212) and MMJ(+). Pain and emotional symptoms worsened in MMJ(\u2212); while MMJ(+)'s pain remained unchanged and emotional symptoms improved. MMJ(\u2212) opioid consumption increased by 29% (90\u2013126\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012); while MMJ(+)'s decreased by 33% (45\u201330\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.935). Pain, physical, emotional, and total ESAS scores improved in severe-MMJ(\u2212) and MMJ(+); opioid consumption reduced by 22% in MMJ(\u2212) (135\u2013106\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.124) and 33% in MMJ(+) (90\u201360\u2009mg\/day MME,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.421).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>MMJ(+) improved oncology patients' ESAS scores despite opioid dose reductions and should be considered a viable adjuvant therapy for palliative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jpm.2019.0374","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T11:33:35Z","timestamp":1582716815000},"page":"809-816","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["The Efficacy of Medical Marijuana in the Treatment of Cancer-Related Pain"],"prefix":"10.1177","volume":"23","author":[{"given":"Ian M.","family":"Pawasarat","sequence":"first","affiliation":[{"name":"Inspira Health Network, Vineland, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Schultz","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin C.","family":"Frisby","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Camden, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Mehta","sequence":"additional","affiliation":[{"name":"Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Angelo","sequence":"additional","affiliation":[{"name":"MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel S.","family":"Hardy","sequence":"additional","affiliation":[{"name":"MD Anderson Cancer Center at Cooper University Health Care, Camden, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Won B.","family":"Kim","sequence":"additional","affiliation":[{"name":"Cooper Bone and Joint Institute, Cooper University Hospital, Camden, New Jersey, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.12.340"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2006.05.015"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3109\/15360288.2014.941132"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(03)00068-X"},{"key":"e_1_3_2_6_2","first-page":"25","article-title":"Long-term opioid therapy for chronic pain and the risk of opioid addiction","volume":"1","author":"Burgess H","year":"2014","unstructured":"Burgess H, , Siddiqui A, , Burgess F: Long-term opioid therapy for chronic pain and the risk of opioid addiction. R I Med J, 2014; 1:25\u201328.","journal-title":"R I Med J"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.010"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12094-016-1529-6"},{"key":"e_1_3_2_9_2","first-page":"119","article-title":"Adjunctive nabilone in cancer pain and symptom management: A prospective observational study using propensity scoring","volume":"6","author":"Maida V","year":"2008","unstructured":"Maida V, , Ennis M, , Irani S, et al.: Adjunctive nabilone in cancer pain and symptom management: A prospective observational study using propensity scoring. J Support Oncol, 2008; 6:119\u2013124.","journal-title":"J Support Oncol"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.13.1757"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.108"},{"key":"e_1_3_2_12_2","unstructured":"U.S. Food and Drug Administration. MARINOL (dronabinol) capsules for oral use. Updated August 2017. www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/018651s029lbl.pdf"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.07.022"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0500"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.10.370"},{"key":"e_1_3_2_16_2","unstructured":"Calculating Total Daily Dose of Opioids for Safer Dosage. www.cdc.gov\/drugoverdose\/prescribing\/guideline.html"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27791"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30839"},{"key":"e_1_3_2_19_2","first-page":"83326","article-title":"Oxycodone recycling: A novel hypothesis of opioid tolerance development in humans","author":"Linares OA","year":"2014","unstructured":"Linares OA, , Fudin J, , Schiesser WE, et al.: Oxycodone recycling: A novel hypothesis of opioid tolerance development in humans. Med Hypotheses, 2014; 83326\u201383331.","journal-title":"Med Hypotheses"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2018.0415"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00153"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.01.023"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2016.03.002"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000364"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.02.009"},{"key":"e_1_3_2_26_2","first-page":"2321","article-title":"Opioid switching and variability in response in pain cancer patients","volume":"27","author":"Corli O","year":"2019","unstructured":"Corli O, , Roberto A, , Corsi N, et al.: Opioid switching and variability in response in pain cancer patients. Support Care Cancer, 2019; 27:2321\u20132327.","journal-title":"Support Care Cancer"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028018824724"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12352"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-016-0530-0"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2017.51"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.1552-4604.1975.tb02348.x"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1089\/can.2018.0022"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6358"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.102.045575"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.01.003"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.008"},{"key":"e_1_3_2_37_2","first-page":"e102","article-title":"Medical cannabis in patients with chronic pain: Effect on pain relief, pain disability, and psychological aspects. A prospective non randomized single arm clinical trial","volume":"169","author":"Poli P","year":"2018","unstructured":"Poli P, , Crestani F, , Salvadori C, et al.: Medical cannabis in patients with chronic pain: Effect on pain relief, pain disability, and psychological aspects. A prospective non randomized single arm clinical trial. Clin Ter, 2018; 169:e102\u2013e107.","journal-title":"Clin Ter"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.22.3.240.33552"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.0155"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers11020129"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7303.16"},{"key":"e_1_3_2_42_2","unstructured":"CDC Centers for Disease Control Opioid Overdose. Updated December 19 2018. www.cdc.gov\/drugoverdose\/epidemic\/index.html"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.370"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1627"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgh026"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2017.09.009"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2017.1333630"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.j.pain.0000460316.58110.a0"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1885"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.12.340"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-032013-182406"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/107327481502200404"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(20000501)88:9<2164::AID-CNCR24>3.0.CO;2-5"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-008-0522-1"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2010.04.020"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.1221"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187795"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2013.04.034"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-017-0183-9"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jpm.2019.0374","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2019.0374","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2019.0374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:06:38Z","timestamp":1777655198000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jpm.2019.0374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,29]]},"references-count":58,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1089\/jpm.2019.0374"],"URL":"https:\/\/doi.org\/10.1089\/jpm.2019.0374","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,29]]}}}