{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:36:29Z","timestamp":1773786989738,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":77,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Psychiatry"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Rastafarianism maintains that cannabis is a sacred element of the religious practice, and followers of the religion traditionally engage cautiously with western medicine. This case involves Mr. I, a 72\u2010year\u2010old Rastafari male with acute myelogenous leukemia (AML) and hepatic decompensation, who developed delirium with psychotic features which were initially managed with quetiapine. His family expressed concerns with psychotropic medications and requested using dronabinol, a synthetic cannabinoid, to manage his symptoms considering the spiritual significance of cannabinoids in the Rastafari culture. The psychiatry team\u2019s dissenting recommendations regarding dronabinol was met with resistance, and the family voiced that they felt their religious beliefs were not being respected and considered bringing in their own marijuana products. Following an ethics consultation, a compromise was reached to trial low\u2010dose dronabinol. However, Mr. I\u2019s symptoms worsened, prompting discontinuation of dronabinol and management with olanzapine.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Discussion:<\/jats:bold>\n                    This case exemplifies the complexities of clinical care when religious beliefs conflict with medical necessity. We discuss the limited indications for dronabinol and potential adverse effects on delirium\u2019s behavioral symptoms. Concerns about fungal sensitization from cannabinoid products in the context of immunosuppressive chemotherapy and the effects of cannabinoids on hepatic dysfunction are also explored. Moreover, we emphasize the importance of cultural sensitivity for Rastafari individuals who view marijuana as sacred and therapeutic. Balancing cultural and religious sensitivity with ethical, evidence\u2010based medicine through a thorough discussion of risks and benefits is essential for optimal decision\u2010making in such ethical dilemmas.\n                  <\/jats:p>","DOI":"10.1155\/crps\/6621450","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T03:04:26Z","timestamp":1742353466000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rastafarianism: When Religious Beliefs Conflict With Medical Necessity\u2014A Case Report and Review of the Literature Around an Ethically Complicated Case"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7939-4871","authenticated-orcid":false,"given":"Matthew","family":"Flick","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0356-858X","authenticated-orcid":false,"given":"Casey","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5758-704X","authenticated-orcid":false,"given":"David C.","family":"Fipps","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S126849"},{"key":"e_1_2_9_2_2","unstructured":"Office of the Commissioner FDA and Cannabis: Research and Drug Approval Process 2024 U.S. Food and Drug Administration FDA https:\/\/www.fda.gov\/news-events\/public-health-focus\/fda-and-cannabis-research-and-drug-approval-process."},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-022-02459-1"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200342040-00003"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-neuro-062111-150420"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.620073"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000507998"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.5109"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/00498254.2017.1381779"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001293"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2016.1145794"},{"key":"e_1_2_9_12_2","unstructured":"American Psychiatric Association Position Statement in Opposition to Cannabis as Medicine 2024 American Psychiatric Association https:\/\/www.psychiatry.org\/getattachment\/12aa44f8-016e-4f8c-8b92-d3fb11a7155f\/Position-Cannabis-as-Medicine.pdf."},{"key":"e_1_2_9_13_2","unstructured":"U.S. Food and Drug Administration FDA Marinol (Dronabinol) Capsules for Oral Use 2017 https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2017\/018651s029lbl.pdf."},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1150062"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.6175"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6613"},{"key":"e_1_2_9_17_2","unstructured":"BashJ. The Public Safety Risk of Hemp Products Sold at Unlicensed Retailers 2024 Herald Open Accesshttps:\/\/www.heraldopenaccess.us\/openaccess\/the-public-safety-risk-of-hemp-products-sold-at-unlicensed-retailers."},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2016.12.001"},{"key":"e_1_2_9_19_2","first-page":"39","article-title":"Medical Marijuana and Its Use by the Immunocompromised","volume":"3","author":"McPartland J. M.","year":"1997","journal-title":"Alternative Therapies in Health and Medicine"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13456"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.94.2.432"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.2174\/157015907780866884"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.07.031"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.6109"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/cld.527"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2022.100715"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/cells8111311"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.2174\/138161208785740063"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12263"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30048-3"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.09.020"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.legalmed.2017.10.010"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2020.1035"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.3582"},{"key":"e_1_2_9_35_2","first-page":"1162","article-title":"Cannabis and Mental Illness: A Review","volume":"33","author":"Treisman G.","year":"2018","journal-title":"International Journal of Geriatric Psychiatry"},{"key":"e_1_2_9_36_2","first-page":"691","article-title":"Cannabis Use and Psychiatric Disorders: A Critical Review","volume":"44","author":"Mehling B. M.","year":"2017","journal-title":"Primary Care: Clinics in Office Practice"},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_9_38_2","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2012.14"},{"key":"e_1_2_9_39_2","first-page":"1689","article-title":"Gabapentin Treatment for Cannabis Dependence: A Randomized Controlled Trial","volume":"37","author":"Levin F. R.","year":"2012","journal-title":"Neuropsychopharmacology"},{"key":"e_1_2_9_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.08.013"},{"key":"e_1_2_9_41_2","volume-title":"The Hippocratic Oath and the Ethics of Medicine","author":"Miles S. H.","year":"2004"},{"key":"e_1_2_9_42_2","doi-asserted-by":"publisher","DOI":"10.4314\/ajtcam.v8i5S.5"},{"key":"e_1_2_9_43_2","article-title":"Management of Diabetes During Ramadan Fasting","volume":"5","author":"Munshi M. N.","year":"2017","journal-title":"BMJ Diabetes Research & Care"},{"key":"e_1_2_9_44_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.9.2305"},{"key":"e_1_2_9_45_2","unstructured":"WardK. M.andDahmsN. J. Cannabis Use and Risk of Diabetes 2020 PubMed 33236561."},{"key":"e_1_2_9_46_2","article-title":"Religious Ethics and the Use of Cannabis in Religious Practices","volume":"10","author":"Clohesy E.","year":"2019","journal-title":"Religions"}],"container-title":["Case Reports in Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crps\/6621450","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crps\/6621450","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crps\/6621450","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:58:20Z","timestamp":1773773900000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crps\/6621450"}},"subtitle":[],"editor":[{"given":"Erik","family":"J\u00f6nsson","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/crps\/6621450"],"URL":"https:\/\/doi.org\/10.1155\/crps\/6621450","archive":["Portico"],"relation":{},"ISSN":["2090-682X","2090-6838"],"issn-type":[{"value":"2090-682X","type":"print"},{"value":"2090-6838","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6621450"}}