Cannabinoid Dose and Label Accuracy in Edible Medical Cannabis Products

Vandrey, Ryan G.; Raber, Jeffrey C.; Raber, Mark E.; Douglass, Brad; Miller, C. A.; Bonn‐Miller, Marcel O.

doi:10.1001/jama.2015.6613

Cited by 309 publications

(201 citation statements)

References 6 publications

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“…1,2 However, it is unclear whether registered outcomes accurately reflect the trial protocol and whether registration improves the reporting of primary outcomes in publications. We evaluated adherence to trial registration and its association with subsequent publication and reporting of primary outcomes.…”

Section: Association Of Trial Registration With Reporting Of Primary mentioning

confidence: 99%

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Association of Trial Registration With Reporting of Primary Outcomes in Protocols and Publications

Chan

Pello

Kitchen

et al. 2017

JAMA

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cannabidiolic acid (up to 55.73 mg/mL) in 13 of the 84 samples tested (15.48% [95% CI, 9.28%-24.70%]), and cannabigerol (up to 4.67 mg/mL) in 2 of the 84 samples tested (2.38% [95% CI, 0.65%-8.27%]).Discussion | Among CBD products purchased online, a wide range of CBD concentrations was found, consistent with the lack of an accepted dose. Of tested products, 26% contained less CBD than labeled, which could negate any potential clinical response. The overlabeling of CBD products in this study is similar in magnitude to levels that triggered warning letters to 14 businesses in 2015-2016 from the US Food and Drug Administration 3 (eg, actual CBD content was negligible or less than 1% of the labeled content), suggesting that there is a continued need for federal and state regulatory agencies to take steps to ensure label accuracy of these consumer products. Underlabeling is less concerning as CBD appears to neither have abuse liability nor serious adverse consequences at high doses 4,5 ; however, the THC content observed may be sufficient to produce intoxication or impairment, especially among children. 6 Although the exclusive procurement of products online is a study limitation given the frequently changing online marketplace, these products represent the most readily available to US consumers. Additional monitoring should be conducted to determine changes in this marketplace over time and to compare internet products with those sold in dispensaries. These findings highlight the need for manufacturing and testing standards, and oversight of medicinal cannabis products.

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Section: Association Of Trial Registration With Reporting Of Primary mentioning

confidence: 99%

“…This could have resulted in underestimation of safety events due to depletion of susceptible patients from the treatment group. 2,3 Second, the outcome assessment was not anchored to treatment start but to enrollment in the Senior Alert program …”

Section: Conflict Of Interestmentioning

confidence: 99%

Association of Trial Registration With Reporting of Primary Outcomes in Protocols and Publications

Chan

Pello

Kitchen

et al. 2017

JAMA

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“…A survey done between August and October last year found that only 17% of edible cannabis products in San Francisco, Los Angeles and Seattle had accurate labels. More than half had less THC than claimed, and some con tained significantly more 13 . "A lot of people get a rude surprise, " says MacCoun.…”

Section: How Strong Is It?mentioning

confidence: 95%

The cannabis experiment

Cressey¹

2015

Nature

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“…Many oncology physicians are unaware of the potential medical benefits of cannabis 28 and are unwilling or unable to authorize their use. As a result, patients and caregivers might seek out illegal sources ("street marijuana"), which can be fraught, having implications such as dangerously tainted products and potential social and emotional harms [29][30][31][32][33] . A selective review of the best-supported treatments follows.…”

Section: Cannabinoids For Medical Usementioning

confidence: 99%

A User’s Guide to Cannabinoid Therapies in Oncology

Maida

Daeninck

2016

Current Oncology

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ABSTRACT"Cannabinoid" is the collective term for a group of chemical compounds that either are derived from the Cannabis plant, are synthetic analogues, or occur endogenously. Although cannabinoids interact mostly at the level of the currently recognized cannabinoid receptors, they might have cross reactivity, such as at opioid receptors.Patients with malignant disease represent a cohort within health care that have some of the greatest unmet needs despite the availability of a plethora of guideline-driven disease-modulating treatments and pain and symptom management options. Cannabinoid therapies are varied and versatile, and can be offered as pharmaceuticals (nabilone, dronabinol, and nabiximols), dried botanical material, and edible organic oils infused with cannabis extracts. Cannabinoid therapy regimens can be creative, involving combinations of all of the aforementioned modalities. Patients with malignant disease, at all points of their disease trajectory, could be candidates for cannabinoid therapies whether as monotherapies or as adjuvants.The most studied and established roles for cannabinoid therapies include pain, chemotherapy-induced nausea and vomiting, and anorexia. Moreover, given their breadth of activity, cannabinoids could be used to concurrently optimize the management of multiple symptoms, thereby reducing overall polypharmacy. The use of cannabinoid therapies could be effective in improving quality of life and possibly modifying malignancy by virtue of direct effects and in improving compliance or adherence with disease-modulating treatments such as chemotherapy and radiation therapy.

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Cannabinoid Dose and Label Accuracy in Edible Medical Cannabis Products

Abstract: Dr Vandrey had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Cited by 309 publications

References 6 publications

Association of Trial Registration With Reporting of Primary Outcomes in Protocols and Publications

Association of Trial Registration With Reporting of Primary Outcomes in Protocols and Publications

The cannabis experiment

A User’s Guide to Cannabinoid Therapies in Oncology

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