Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly

Abuhasira, Ran; Schleider, Lihi Bar-Lev; Mechoulam, Raphael; Novack, Victor

doi:10.1016/j.ejim.2018.01.019

Cited by 158 publications

(153 citation statements)

References 34 publications

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“…Previous surveys reporting on the efficacy of medical cannabis in chronic pain conditions generally report patient satisfaction with use, improved pain and psychological well‐being, and only limited side effects (11‐18). It is noteworthy that almost half of users in this present cohort had discontinued cannabis use, giving lack of effect or side effects as their reason for discontinuation.…”

Section: Discussionmentioning

confidence: 99%

“…Our present finding of discontinuation of use is more likely reflective of real‐world experience because many studies reporting favorable effects may be subject to bias, with study settings often in designated cannabis clinics or with data from cannabis dispensaries. Alternately, compliance and success with use may be better when a patient is followed by a qualified health care professional with guidance about products and dosing, such as reported by clinics in Israel (18).…”

Section: Discussionmentioning

confidence: 99%

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Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Fitzcharles

Rampakakis²,

Sampalis

et al. 2020

ACR Open Rheumatology

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Objective. Recreational legalization of cannabis may influence the medical use by patients. When only medical access was legally available in Canada, 4.3% of rheumatology patients reported use. With the current recreational legalization, we have reexamined the prevalence and characteristics of medical cannabis use in this same rheumatology setting.Methods. Consecutively attending rheumatology patients participated in an onsite survey comprising the following two questionnaires: 1) demographic and disease information completed by the rheumatologist and 2) patient anonymous questionnaire of health status, cannabis use (recreational and/or medicinal), and characteristics of cannabis use.Results. Of 1047 attendees from June to August 2019, with 1000 participating, medical cannabis had been used by 12.6% of patients (95% confidence interval 10.7%-14.8%), with half continuing use for mostly pain relief. Discontinuation was due to lack of effect in 57% of patients and side effects in 28% of patients. Ever medical users were younger (61.2 vs. 64.9 years; P = 0.006), more likely unemployed/disabled (16.7% vs. 5.9%; P < 0.001), and had more previous (47.6% vs. 25.5%; P < 0.001) and current recreational cannabis use (17.5% vs. 3.1%; P < 0.001) than nonusers. Most patients used multiple methods of administration, including smoking, vaporizing, and using oral oil preparations, but were poorly knowledgeable of product content, which was bought solely via the legal medical route by only 20%, and only one-third disclosed their use to the rheumatologist.Conclusion. Medical cannabis use has tripled for rheumatology patients since recreational legalization, with users being younger, not working, and having recreational cannabis experience. Concerning issues are the poor knowledge of the product being used, access via the nonmedical route, and nondisclosure to the physician.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Fitzcharles

Rampakakis²,

Sampalis

et al. 2020

ACR Open Rheumatology

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“…41 Medical cannabis programs in other countries, that is, Israel and Canada, have shown the benefits (particularly for pain patients) of having organized, segregated, and well-differentiated medical programs from the recreational realm. 34,35…”

Section: Concerns Related To Medicinal and Recreational Cannabismentioning

confidence: 99%

Cannabis for Chronic Pain: Challenges and Considerations

et al. 2018

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The National Academies of Sciences, Engineering, and Medicine has found substantial evidence that cannabis (plant) is effective for the treatment of chronic pain in adults, and moderate evidence that oromucosal cannabinoids (extracts, especially nabiximols) improve short-term sleep disturbances in chronic pain. The paradoxical superiority of the cannabis plant over cannabinoid molecules represents a challenge for the medical community and the established processes that define modern pharmacy. The expanding and variable legalization of cannabis in multiple states nationwide represents an additional challenge for patients and the medical community because recreational and medicinal cannabis are irresponsibly overlapped. Cannabis designed for recreational use (containing high levels of active ingredients) is increasingly available to patients with chronic pain who do not find relief with current pharmacologic entities, which exposes patients to potential harm. This article analyzes the available scientific evidence to address controversial questions that the current state of cannabis poses for health care professionals and chronic pain patients and sets the basis for a more open discussion about the role of cannabis in modern medicine for pain management. A critical discussion on these points, the legal status of cannabis, and considerations for health care providers is presented.

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“…Recent individual‐level studies addressed some limitations in Olfson et al . by examining prescription opioid and medical cannabis use among chronic pain patients . Substitution patterns from prescription opioids to medical cannabis were common in this population.…”

Section: Introductionmentioning

confidence: 99%

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

Liang

Wallace

Shi

2019

Drug and Alcohol Review

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Introduction and Aims Previous research suggested that cannabis use was associated with increased risks of prescription opioid misuse and use disorder. This study examined whether these associations differed by cannabis use purpose. Design and Methods This is a secondary analysis of cross‐sectional surveys with propensity score matching. Medical cannabis users (N = 1295), cannabis dual users with both medical and non‐medical purposes (N = 707) and non‐medical cannabis users (N = 18 666) were compared with cannabis non‐users (N = 57 196) in the pooled 2013–2016 US nationally representative National Survey on Drug Use and Health. Propensity score models were applied to match cannabis non‐users to cannabis users with different purposes with respect to potential confounders in individual socioeconomic characteristics, other substance use disorders and health conditions. In a matched sample, logistic regressions were used to assess associations. Results Propensity score matching considerably improved the balance of the potential confounders between cannabis non‐users and users. In a matched sample, non‐medical cannabis use was associated with increased risks of prescription opioid misuse (OR = 3.15, 95%CI: 2.89–3.44) and use disorder (OR = 2.52, 95%CI: 2.06–3.10). Cannabis dual use and medical cannabis use were associated with increased risks of prescription opioid misuse (OR = 2.55, 95%CI: 1.78–3.65; OR = 2.15, 95%CI: 1.58–2.91, respectively), but they were not associated with prescription opioid use disorder. Discussion and Conclusions Medical and non‐medical cannabis use both were both associated with increased risks of prescription opioid misuse. Medical cannabis use, however, was not associated with prescription opioid use disorder, and non‐medical cannabis was. There appeared to be differential associations between cannabis use and prescription opioid use disorder by cannabis use purpose.

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Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly

Cited by 158 publications

References 34 publications

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Medical Cannabis Use by Rheumatology Patients Following Recreational Legalization: A Prospective Observational Study of 1000 Patients in Canada

Cannabis for Chronic Pain: Challenges and Considerations

Medical and non‐medical cannabis use and risk of prescription opioid use disorder: Findings from propensity score matching

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