Patient Counseling Guidelines for the Use of Cannabis for the Treatment of Chemotherapy-Induced Nausea/Vomiting and Chronic Pain

J Pain Palliat Care Pharmacother. 2018 Dec;32(4):216-225. doi: 10.1080/15360288.2019.1598531. Epub 2019 May 9.


The use of cannabis medications has grown in recent years for the symptomatic relief of chemotherapy-induced nausea/vomiting (CINV) and chronic pain (cancer-related and non-cancer-related). As states legalize the use of cannabis, it is important for pharmacists and other health care professionals to be aware of how to counsel patients receiving prescriptions for cannabis medications. The aim of this study was to develop patient counseling guidelines for the use of cannabis products in treatment of CINV and chronic pain. A literature search was performed using Medline/PubMed resources and Google Scholar between July 2015 and August 2018 using broad search terms, e.g., cannabinoids adverse effects, cannabis, natural cannabinoids, and tetrahydrocannabinol. Using the American Society of Health-System Pharmacists patient counseling guidelines and medical information on cannabis medications gathered from drug databases, a comprehensive counseling guideline was developed. Medical evidence of the use of natural cannabis medications that are smoked or orally ingested have not been studied as extensively as oral therapeutic agents currently available. Cannabis medications have become more prevalent by approval of legislators in several states. Hence, pharmacists and health care professionals should counsel patients effectively on its use. This guideline needs to be tested to assess its utility in patients.

Keywords: Pain; cancer; cannabidiol; cannabis; chemotherapy; counseling.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Chronic Pain / drug therapy*
  • Counseling / methods
  • Counseling / standards*
  • Humans
  • Medical Marijuana / adverse effects
  • Medical Marijuana / pharmacokinetics
  • Medical Marijuana / pharmacology
  • Medical Marijuana / therapeutic use*
  • Nausea / drug therapy*
  • Neoplasms / drug therapy
  • Patient Education as Topic / methods
  • Patient Education as Topic / standards*
  • Vomiting / drug therapy*


  • Antineoplastic Agents
  • Medical Marijuana