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Core Topics => Drugs => Cannabis and Cannabinoids => Topic started by: monkawat on September 26, 2015, 03:26:54 AM

Title: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 03:26:54 AM
Hey everyone,

After discussing a bit of pot related stuff with y'all on my MMT induction thread, I wanted to see about if anyone here has experiences with Marinol (or Cesamet) for chronic nausea and or stomach issues.

Due to both my IBS and (recently diagnosed) Chrohn's disease diagnoses, I suffer from fairly severe nausea much of the time. This was a daily struggle with opioids/opiates adding to the issue. Luckily, methadone causes no nausea for me so I am now only dealing with my usual issues with it. I puke every morning, complete with violent retching and end up with only bile coming out. I have had plenty of endoscopy procedures, scans, tests, etc. and only the two conditions listed above can be identified as potential causes by my two GI docs. I have been dealing with this shit my entire life, starting at age 4-5. It got a bit better during my time in the military but after my shoulder injury in Afghanistan, the stress and pain seemed to send it back full circle at a much worse level than it was in my earlier life.

Anyways, I know marinol is usually scripted for nausea and appetite loss due to chemo and aids wasting syndrome, but can be off-label scripted for other nausea indusing and GI tract irritating conditions. Has anyone here been prescribed it for any reason? If so, what was the experience like as far as how it reduced nausea and increased your appetite?

I have been losing a lot of weight recently (down 12 pounds in a month and a half) and while I have gained 2.5 lbs back in the past 2 weeks, I have got to get my appetite back up.

Oh- and how is the psychoactive effect? Similar to a small amount of a pure sativa strain perhaps?

hope you're all well,
monk
Title: Re: Let's Talk About Marinol
Post by: Opi-ette on September 26, 2015, 03:37:42 AM
Monk I'm sorry to hear about your GI issues. Nothing worse than feeling sick and nauseous.
I had a couple of episodes that sent me to the ER. Puking until there was nothing but foam coming out. I couldn't even walk as my legs were trembling. Rolling around the bed wishing I was dead. I don't suffer with what you have, so my heart goes out to you for having to deal with that on a constant basis.

The only thing my doc would script me for nausea is Zofran, so I'm not much help giving advice
for Marinol, but just wanted to say I hope you get something that helps the nausea and you find relief.
Title: Re: Let's Talk About Marinol
Post by: Mr.pooper on September 26, 2015, 03:45:19 AM
I've never directly taken the labeled synthetic cannabinoid marinol. However I have used an extensive amount of other synthetic cannabinoids.

I too suffer from weird GI issues. Both when I was using, and after I stopped.

When I was using H daily, the synthetic cannabinoids did a great job of reducing my nausea and stomach issues related to my use. Also would stimulate appetite similar to marijuana.

I cannot comment on how the synthetic cannabinoids work when I am not using opiates daily. I stopped use of synthetics, and just starting smoking good ol' Mary Jane. Solves all my GI issues and nausea currently.

Oh and I developed a nasty physical addiction to synthetic cannabinoids. When I was kicking the synthetics I had as much H as I wanted. It barly took the edge off the withdrawals. I put that shit almost on par with H to kick IMO.
Title: Re: Let's Talk About Marinol
Post by: lawyerup on September 26, 2015, 03:46:03 AM
I know what ur going through brotha I have chronic vomiting syndrome and have gone through virtually every anti emetic out there. I had no luck with marinol thc in general exacerbates my nauseua. The only thing I've found to work is zofran for intense nausea, metochloperamide daily to help digestion, and ativan for when i start puking. I used to puke so long blood would start coming up from the constant retching. 
Title: Re: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 03:50:34 AM
Monk I'm sorry to hear about your GI issues. Nothing worse than feeling sick and nauseous.
I had a couple of episodes that sent me to the ER. Puking until there was nothing but foam coming out. I couldn't even walk as my legs were trembling. Rolling around the bed wishing I was dead. I don't suffer with what you have, so my heart goes out to you for having to deal with that on a constant basis.

The only thing my doc would script me for nausea is Zofran, so I'm not much help giving advice
for Marinol, but just wanted to say I hope you get something that helps the nausea and you find relief.

Thanks Opi-ette. How are you doing with your pain issues these days and pill amounts?

I wish I could get by with zofran since docs are so keen on that as their main anti-emetic these days and it would be easy to get.

But I can't take zofran since I am allergic to odansetron and phenothiazine type drugs like compazine and promethazine don't give me much relief.

The only good relief I ever got from my nausea was when I was a daily weed smoker in high school. I especially found Indicas the most effective. I just am too worried about getting arrested for pot out here to try smoking again though.
Title: Re: Let's Talk About Marinol
Post by: Jega on September 26, 2015, 03:54:54 AM
My first thought was Zofran too.

Are you allergic too all Serotonin agents?

It's funny. I cant tolerate SSRIs, SNRIs, TCA's etc. but i can tolerate Zofran and Tramadol with occasional use.
Title: Re: Let's Talk About Marinol
Post by: Opus on September 26, 2015, 04:14:36 AM
Zofran++

Zofran and weed are my instagrabs, fortunately I haven't been having to do that for awhile now, but the Zofran is never far away. I don't think that stuff has failed me yet.
Title: Re: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 04:19:37 AM
My first thought was Zofran too.

Are you allergic too all Serotonin agents?

It's funny. I cant tolerate SSRIs, SNRIs, TCA's etc. but i can tolerate Zofran and Tramadol with occasional use.

Weirdly, no. Isn't trazodone a serotonin agonist? I take it nightly at a high dose for sleep and have had no issues with it.

With zofran I get difficulty breathing, tingling, rash, etc. Found it out the hard way via IV in the hospital in Germany.
Title: Re: Let's Talk About Marinol
Post by: Jega on September 26, 2015, 04:32:50 AM

Weirdly, no. Isn't trazodone a serotonin agonist? I take it nightly at a high dose for sleep and have had no issues with it.

With zofran I get difficulty breathing, tingling, rash, etc. Found it out the hard way via IV in the hospital in Germany.
Trazodone behaves as an antagonist at all of its receptor sites of which it's binding affinity is massive. It is an inhibitor of transporters (SERT), as well. So no.

It still fits with someone sensitive to Serotonin agents like Zofran.

Are you on a benzo and does that make any difference with your nausea?
Title: Re: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 04:40:52 AM

Weirdly, no. Isn't trazodone a serotonin agonist? I take it nightly at a high dose for sleep and have had no issues with it.

With zofran I get difficulty breathing, tingling, rash, etc. Found it out the hard way via IV in the hospital in Germany.
Trazodone behaves as an antagonist at all of its receptor sites of which it's binding affinity is massive. It is an inhibitor of transporters (SERT), as well. So no.

It still fits with someone sensitive to Serotonin agents like Zofran.

Gotcha.

I have no clue how to go about getting a script for marinol. No info on propublica and TX docs don't exactly advertise their usage of it.

Y'all thinking a GI doc or a regular internal med doc? I don't care much for my GI doc because of the size of his practice and the insane wait times to get appointments/inability to EVER get contact with their nurses, docs, or PAs. But I guess I wouldn't mind switching to a new one should I burn the bridge by bringing it up. He is the one who diagnosed me with Chrohn's recently but that was just through his nurse calling me to say that was the diagnosis- I haven't seen him again yet since my last visit.
Title: Re: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 04:46:09 AM

Weirdly, no. Isn't trazodone a serotonin agonist? I take it nightly at a high dose for sleep and have had no issues with it.

With zofran I get difficulty breathing, tingling, rash, etc. Found it out the hard way via IV in the hospital in Germany.
Trazodone behaves as an antagonist at all of its receptor sites of which it's binding affinity is massive. It is an inhibitor of transporters (SERT), as well. So no.

It still fits with someone sensitive to Serotonin agents like Zofran.

Are you on a benzo and does that make any difference with your nausea?

No, I actually get a paradoxical reaction with most benzos, particularly xanax and klonopin, where I get this weird form of nausea when I take them that is unique to their ingestion. I have only ever liked/tolerated one benzo well and that was low dose (2.5-5mg a day) of valium and I still wasn't very fond of it.
Title: Re: Let's Talk About Marinol
Post by: Jega on September 26, 2015, 05:13:54 AM

Weirdly, no. Isn't trazodone a serotonin agonist? I take it nightly at a high dose for sleep and have had no issues with it.

With zofran I get difficulty breathing, tingling, rash, etc. Found it out the hard way via IV in the hospital in Germany.
Trazodone behaves as an antagonist at all of its receptor sites of which it's binding affinity is massive. It is an inhibitor of transporters (SERT), as well. So no.

It still fits with someone sensitive to Serotonin agents like Zofran.

Are you on a benzo and does that make any difference with your nausea?

No, I actually get a paradoxical reaction with most benzos, particularly xanax and klonopin, where I get this weird form of nausea when I take them that is unique to their ingestion. I have only ever liked/tolerated one benzo well and that was low (2.5-5mg a day) of valium and I still wasn't very fond of it.

You need a Gastroenterologist. You can ask your PCP if he can "think" of anything to try and maybe he will throw out Marinol, give it a shot, but you need to make an appointment with your Gastroenterologist asap and if they called and said you had crohn's disease you deserve the next available!
Title: Re: Let's Talk About Marinol
Post by: gutterslut on September 26, 2015, 06:16:06 AM
I was prescribed Zofran through my first pregnancy,  and marinol during my second.  I found it to be fairly effective and without side effects. would definitely suggest it for anyone having uncomfortableb side effects even though I think Zofran was more relieving.
Title: Re: Let's Talk About Marinol
Post by: Jega on September 26, 2015, 06:27:01 AM
Zofran is the gold standard for antiemetics. Promethazine would be second line treatment. Compazine would be third line treatment

If all of those fail then you start pulling from the grab bag. and someone who knows pharmacology.

I'd prescribe you Marinol and a low dose of a benzo but you can't even tolerate that.

You'll probably get your Marinol because there arn't many other options.
Title: Re: Let's Talk About Marinol
Post by: lawyerup on September 26, 2015, 07:22:59 AM
monk have u tried metochloperamide?
Title: Re: Let's Talk About Marinol
Post by: monkawat on September 26, 2015, 07:23:36 AM
monk have u tried metochloperamide?

No- that is reglan right?
Title: Re: Let's Talk About Marinol
Post by: Anti-hero on September 26, 2015, 01:22:37 PM
Pretty sure that a doctor can prescribe off label
Off he wants epically in Texas just read on the Huffington post
About restroil being prescribed off label and the first case j&j settled was in Texas.

I hope you find some relief. You are doing one of the hardest things a person can do. You don't need nasty gi issues holding you back
Title: Re: Let's Talk About Marinol
Post by: Zoops on September 27, 2015, 09:43:17 AM
Hey that sucks, Monk.

But I'm surprised nobody has suggested that you smoke a reefer.

Why not just get stoned? If it's because your wife and kids would have a problem with it, just explain to wifey that one of the primary medical uses of marijuana is for treatment of nausea. I'm sure she's seen how awful your morning vomiting sessions are, and should support something that has been proven (yes PROVEN) to be an effective treatment for nausea.

But maybe she'd just say, "you're trying to get high, and you're using this nausea problem as an excuse to do it." I don't know about what your kids would say, but they don't really need to know - at least right away they don't need to know.

Of course, you'd be breaking the law by smoking it, but damn I'm absolutely sure a nice bong rip of some good bud would give you an appetite (and would get you high as gas too :o).

Kytril is another med that is in the same class as Zofran - a 5HT3 antagonist.

I'm not sure whether I read that you had tried Zofran, but that one is supposed to be awesome for nausea.

A doctor would never (I'm 99% sure of this but usually it's not a good idea to say "never") go straight to Marinol for someone complaining of nausea. Which is strange because if you live in a state where they have medical MJ, you can go in and say you want to smoke weed because you have a chronic nausea problem, you'd be handed a letter from a smiling doctor, saying "hope this helps."

I think I recall you saying something about being super-paranoid from smoking before. So maybe not. But Marinol can be expected to have similar effects. Maybe edibles with MJ?

Now that I think of it, yep that 's the ticket for ya right there buddy, some edible MJ therapy! Seriously.

And Reglan is indeed metoclopramide.

and to Mr. Pooper - yep that synthetic shit would give me serious munchies. I remember crushing a large  pan crust pizza in like 15 minutes about 6 months ago, while under the influence of some "Dr. Feelgood" herbal potpourri (totally not for human consumption).  And if I ate a large meal while under the influence of some synthetic shit, and then I ran out or quit smoking for some reason or whatever, I'd puke it all up.  My theory is that  cannabinoid agonism is necessary for keeping your food down too.

At least when you're activating those receptors that strongly it is.
Title: Re: Let's Talk About Marinol
Post by: _Enduser on September 27, 2015, 10:13:25 AM
Hey that sucks, Monk.

But I'm surprised nobody has suggested that you smoke a reefer.

Why not just get stoned? If it's because your wife and kids would have a problem with it, just explain to wifey that one of the primary medical uses of marijuana is for treatment of nausea. I'm sure she's seen how awful your morning vomiting sessions are, and should support something that has been proven (yes PROVEN) to be an effective treatment for nausea.

But maybe she'd just say, "you're trying to get high, and you're using this nausea problem as an excuse to do it." I don't know about what your kids would say, but they don't really need to know - at least right away they don't need to know.

Of course, you'd be breaking the law by smoking it, but damn I'm absolutely sure a nice bong rip of some good bud would give you an appetite (and would get you high as gas too :o).

Kytril is another med that is in the same class as Zofran - a 5HT3 antagonist.

I'm not sure whether I read that you had tried Zofran, but that one is supposed to be awesome for nausea.

A doctor would never (I'm 99% sure of this but usually it's not a good idea to say "never") go straight to Marinol for someone complaining of nausea. Which is strange because if you live in a state where they have medical MJ, you can go in and say you want to smoke weed because you have a chronic nausea problem, you'd be handed a letter from a smiling doctor, saying "hope this helps."

I think I recall you saying something about being super-paranoid from smoking before. So maybe not. But Marinol can be expected to have similar effects. Maybe edibles with MJ?

Now that I think of it, yep that 's the ticket for ya right there buddy, some edible MJ therapy! Seriously.

And Reglan is indeed metoclopramide.

and to Mr. Pooper - yep that synthetic shit would give me serious munchies. I remember crushing a large  pan crust pizza in like 15 minutes about 6 months ago, while under the influence of some "Dr. Feelgood" herbal potpourri (totally not for human consumption).  And if I ate a large meal while under the influence of some synthetic shit, and then I ran out or quit smoking for some reason or whatever, I'd puke it all up.  My theory is that  cannabinoid agonism is necessary for keeping your food down too.

At least when you're activating those receptors that strongly it is.

My father was given a prescription for Marinol last year when he was dying from Cancer.  I had  to eat like, 15 or 17 of the pills to get ANYWHERE, they were 5mg each and I considered them very very very weak.  Would eat handfuls at a time.  That being said; they suck for all the nice side effects of weed that are medicinal, presumably because Marinol has no CBD or any other alkaloids.   I didn't get the munchies, didn't get that nice body high, and I could see it not doing SHIT for my nausea.  They didn't do ANYTHING for my father's naseau, hence why he gave the pills to me.  They contain a thick brown oil and look like plastic pellets. 

They are also a bitch to get; most of the time requiring prior authorization from a doctor so that your insurance will cover script, and many pharmacies don't carry it etc. I wouldn't fuck with it IMO, kinda worthless.  Smoke real weed; it contains all the helpful alkaloids; after using Marinol I've concluded the medicinal value of weed DOES NOT come from THC
Title: Re: Let's Talk About Marinol
Post by: monkawat on October 19, 2015, 11:19:22 PM
So-

Update here.

Fuck marinol or sativex or whatever.

I just got a hookup for some really high quality shatter/wax/and bud.

I plan on getting myself some bud from the guy first just to test the waters and see if I like the cannabis high still.

Who knows- maybe this will help my ptsd. He really wants me to try his shatter. I've tried it before and it was a great high and didn't reek like actual weed does, which is a plus. But I think it's too strong for someone like me at this point so I'll hold off for a while.

Title: Re: Let's Talk About Marinol
Post by: Bhoris on October 20, 2015, 12:45:39 AM
So-

Update here.

Fuck marinol or sativex or whatever.

I just got a hookup for some really high quality shatter/wax/and bud.

I plan on getting myself some bud from the guy first just to test the waters and see if I like the cannabis high still.

Who knows- maybe this will help my ptsd. He really wants me to try his shatter. I've tried it before and it was a great high and didn't reek like actual weed does, which is a plus. But I think it's too strong for someone like me at this point so I'll hold off for a while.

Yea, Marinol sucks. They tried to single out the specific cannibinoids that help with nausea while eliminating all the other fun cannibinoids/CBDs that give you a body high and all that. A failed experiment, if you ask me. One might as well just smoke actual weed. It's cheaper, easier to get, and it actually has some recreational value.

A random side note, I was really into making shatter for a while 3-5 years ago before shatter really got huge. I remember handing my shit out to friends who had no idea what it even was because at that time goopy "hash oil" was the shit to have. The thing people didn't realize then was that the dark, goopy consistency was actually a bad thing. The dark color meant it was over-cooked and the goopy texture meant it still had too much butane left in it. I came up with the bright idea to purge my shit in a vacuum desiccator so I could purge it at extremely low temperatures and viola, shatter!
Title: Re: Let's Talk About Marinol
Post by: DirtyJerzy on December 26, 2015, 12:39:29 AM
I had a script for marinol a few years back just to be able to smoke pot while being tested. Doc was a family friend, told me it could only be written for chronic wasting and some cases of SEVERE nausea.

I can say that the seasame oil it's suspended in will have your breath, BO, and burps smelling pretty fucking weird, for me at least.

It contains only THC-A, which means it hasn't been decarboxulated, and has no "high" at all, NONE. Also since it only contains that one chemical, THC-A, if they would've labbed my piss the gcms would've found all the other related cannibinoids, and knew I was ingesting more then marinol. Thankfully they weren't that smart.

If I were you I just use straight ganj. Part of the plants magic is the synergy created amongst all it's different cannabinoids. When you isolate just one, and the shittiest one at that, your losing it's medicinal value.

But it is a good way to smoke pot while on paper, if you can find a doc to write it.

It will actually increase your appitite though, that I can say. Other then that it's crap. But hey if that's what your after maybe give it a try. I would still recommend just ingesting cannabis though. In fact that's what almost every Dr. Told me, but then again I was in the Bay Area, and most of them were "pot docs".

@enduser: THC is a very huge part of the effect of cannabis, it's just not THC-A it's Delta9 THC, which is what THC-A converts to once decarboxalated. 
Title: Re: Let's Talk About Marinol
Post by: Zoops on January 27, 2016, 01:41:45 PM
While raw cannabis contains amounts of THC-a or ("THC- acid"), Marinol does NOT.

It actually contains delta-9-THC, just like you get when you smoke weed.

"Decarboxylation" is a chemical reaction whereby a carboxylic acid group is removed from a molecule. So, in order to be decarboxylated, a molecule must contain a carboxylic acid group.

The structure of the compound in Marinol, dubbed "dronabinol" which is just another term for THC proper, is as shown in the diagram below:


* dronabinol structure.jpg (4.89 kB . 184x131 - viewed 412 times)

as you can see, there is no -COOH group there.

So, I would say that the lack of any perceived effects from taking Marinol orally comes from the fact that there are none of the other cannabinoids found in marijuana in that product. Kind of mystifying to me. While I've never had the opportunity to take Marinol, I always thought it would be great fun. But I guess it's nothing to it.
Title: Re: Let's Talk About Marinol
Post by: theSWPK on January 27, 2016, 04:23:45 PM
While raw cannabis contains amounts of THC-a or ("THC- acid"), Marinol does NOT.

It actually contains delta-9-THC, just like you get when you smoke weed.

"Decarboxylation" is a chemical reaction whereby a carboxylic acid group is removed from a molecule. So, in order to be decarboxylated, a molecule must contain a carboxylic acid group.

The structure of the compound in Marinol, dubbed "dronabinol" which is just another term for THC proper, is as shown in the diagram below:


* dronabinol structure.jpg (4.89 kB . 184x131 - viewed 412 times)

as you can see, there is no -COOH group there.

So, I would say that the lack of any perceived effects from taking Marinol orally comes from the fact that there are none of the other cannabinoids found in marijuana in that product. Kind of mystifying to me. While I've never had the opportunity to take Marinol, I always thought it would be great fun. But I guess it's nothing to it.

I bought a few back in highschool and was less than impressed.
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