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Marinol as an Alternative to Medicinal Marijuana
Pros and Cons to Combat Cancer Treatment Side Effects
Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology Oncology at the New York Presbyterian Weill Cornell Medical Center.
Marinol (dronabinol) is an FDA approved drug that has been marketed as a safe alternative to medicinal marijuana. Its active ingredient is synthetic THC, a compound that produces the psychoactive effects of marijuana. Studies have shown that THC has medicinal properties that can relieve the symptoms of some diseases and conditions, as well as the side effects of their treatment. Marinol is prescribed to help combat the side effects of cancer treatment, such as loss of appetite, nausea, vomiting, and pain.
One of the greatest things about using Marinol to combat cancer treatment side effects is that it is legal. You don’t have to worry about the legal consequences of using marijuana medicinally if you live in a state where it is prohibited. It only requires a prescription from your doctor and is available at most pharmacies.
Marinol does not need to be smoked—it comes in a pill form. This is especially helpful for those who are concerned with the social stigma and possible health effects of smoking marijuana. This is a plus for many cancer patients who are parents that may be worried about their children being exposed to marijuana, even if it is for medicinal purposes.
Some people do find it to be an excellent alternative to medicinal marijuana. It may take time to find the correct dosage, but many do find that it relaxes them, stimulates the appetite, and controls nausea and vomiting related to cancer treatment.
Marinol is approved for the treatment of chemotherapy-induced nausea only after other treatments have failed. In reality, it is rare not to be able to control nausea with other more potent drugs than Marinol, and in about 10 percent of the cases, Marinol itself can cause nausea. With any drug, there are going to be downsides and Marinol is no exception. One of the greatest cons of taking Marinol is the cost. Depending on the dosage and frequency of use, Marinol can cost several hundreds of dollars a month. Even more troubling is that many insurance plans do not have Marinol in their formulary. If you want Marinol, then you will more than likely have to pay out of pocket for it.
Secondly, Marinol will not provide you with immediate relief. It is an oral medication and the body has a relatively slow absorption rate. You can expect relief about 30 minutes to 2 hours after taking the drug. If you are experiencing nausea/vomiting and are taking Marinol to combat these effects, you may have to make the effort to keep the drug down long enough for it to be absorbed, which may be difficult.
The duration of the appetite stimulation lasts at least 24 hours after using Marinol while the euphoria or “high” usually does not last more than 4 to 6 hours. But for patients who are only seeking to increase their appetite and aren’t seeking a”high,” this can also be seen as an unwanted side effect and may be habit-forming if used for a long time.
Marinol isn’t really recommended for people with a history of psychiatric disorders or seizures, and it should be used with care in people over 65 for whom the side effects can be more pronounced.
Finally, it doesn’t work for everyone. Some people may not find relief from the drug, while others find it highly effective. Some users have reported feeling exaggerated effects that are typical of smoking marijuana while using Marinol—feeling extremely “high” or “loopy,” drowsy, and with clouded thinking. This effect has caused some Marinol users to discontinue the drug. The psychoactive effects of Marinol can last for several hours after taking the drug, so it is not as controlled as using medicinal marijuana.
Marinol has been proven to be an effective alternative to medicinal marijuana. Some people prefer marijuana over Marinol and vice versa—it is a matter of personal choice. Each has its benefits and disadvantages. But the truth is that while there are many drugs that can be prescribed to relieve nausea and vomiting, there aren’t many that can stimulate the appetite without side effects. (It has been reported that some of the steroids-based appetite stimulants, for example, may cause thrombosis in patients with cancer.) With this in mind, marijuana-derived treatments should perhaps be used when appetite stimulation is the real priority.
For those who don't have access or interest in medicinal marijuana, Marinol may be a suitable alternative. Learn the pros and cons for cancer patients.