U.S. Trends in Registration for Medical Cannabis and Reasons for Use From 2016 to 2020

Boehnke, Kevin F.; Dean, Owen; Haffajee, Rebecca L.; Hosanagar, Avinash

doi:10.7326/m22-0217

Cited by 49 publications

(42 citation statements)

References 22 publications

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“…The primary outcome was change from baseline in patient scores on the SF-36, 10,11 a widely used measure of health-related quality of life. The SF-36 includes 36 items which form 8 distinct scales, including: (1) limitations in physical activities due to health problems; (2) limitations in social activities due to physical or emotional problems; (3) limitations in usual role activities due to physical health problems; (4) bodily pain; (5) general mental health (psychological distress and well-being); (6) limitations in usual role activities due to emotional problems; (7) vitality (energy and fatigue); and (8) general health perceptions. Scores can range from 0 to 100, with higher values indicating better outcomes.…”

Section: Outcomementioning

confidence: 99%

“…[3][4][5] Moderate evidence exists for cannabinoid efficacy in treating secondary sleep disturbances, and there is limited, insufficient, or absent evidence for other conditions. Despite this, enrollment in medical cannabis programs increased 4.5-fold in the US between 2016 and 2020, 6 and a recent survey conducted in the US and Canada found that 27% of all respondents (n = 27 169) had used cannabis for medical purposes at some point. 7 The term medical cannabis encompasses a vast array of products (eg, dried flower, oils, edibles) containing multiple bioactive constituents including, but not limited to, delta-9tetrahydrocannabinol (THC) and cannabidiol (CBD).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Medical Cannabis and Health-Related Quality of Life

et al. 2023

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ImportanceThe use of cannabis as a medicine is becoming increasingly prevalent. Given the diverse range of conditions being treated with medical cannabis, as well as the vast array of products and dose forms available, clinical evidence incorporating patient-reported outcomes may help determine safety and efficacy.ObjectiveTo assess whether patients using medical cannabis report improvements in health-related quality of life over time.Design, Setting, and ParticipantsThis retrospective case series study was conducted at a network of specialist medical clinics (Emerald Clinics) located across Australia. Participants were patients who received treatment for any indication at any point between December 2018 and May 2022. Patients were followed up every mean (SD) 44.6 (30.1) days. Data for up to 15 follow-ups were reported. Statistical analysis was conducted from August to September 2022.ExposureMedical cannabis. Product types and cannabinoid content varied over time in accordance with the treating physician’s clinical judgement.Main Outcomes and MeasuresThe main outcome measure was health-related quality of life as assessed using the 36-Item Short Form Health Survey (SF-36) questionnaire.ResultsIn this case series of 3148 patients, 1688 (53.6%) were female; 820 (30.2%) were employed; and the mean (SD) age was 55.9 (18.7) years at baseline before treatment. Chronic noncancer pain was the most common indication for treatment (68.6% [2160 of 3148]), followed by cancer pain (6.0% [190 of 3148]), insomnia (4.8% [152 of 3148]), and anxiety (4.2% [132 of 3148]). After commencing treatment with medical cannabis, patients reported significant improvements relative to baseline on all 8 domains of the SF-36, and these improvements were mostly sustained over time. After controlling for potential confounders in a regression model, treatment with medical cannabis was associated with an improvement of 6.60 (95% CI, 4.57-8.63) points to 18.31 (95% CI, 15.86-20.77) points in SF-36 scores, depending on the domain (all P &lt; .001). Effect sizes (Cohen d) ranged from 0.21 to 0.72. A total of 2919 adverse events were reported, including 2 that were considered serious.Conclusions and RelevanceIn this case series study, patients using medical cannabis reported improvements in health-related quality of life, which were mostly sustained over time. Adverse events were rarely serious but common, highlighting the need for caution with prescribing medical cannabis.

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Section: Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of Medical Cannabis and Health-Related Quality of Life

et al. 2023

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“…Additionally, our study results reflect a strong association (3-fold odds) between the use of cannabis for medical purposes and codeine use. While our study was unable to specify which medical condition study participants were using medical cannabis for, this substantial increase in odds of codeine use among individuals who used cannabis for medical purposes may be attributed to experiencing greater pain severity as a majority of people who use cannabis for medical purposes do so for pain relief (Lake et al 2019 ; Boehnke et al 2022 ; Leung et al 2022 ).…”

Section: Discussionmentioning

confidence: 87%

The association between cannabis and codeine use: a nationally representative cross-sectional study in Canada

2022

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Background Due to the growing use of cannabis for the purposes of pain relief, evidence is needed on the impact of cannabis use on concurrent analgesic use. Therefore, our objective was to evaluate the association between the use of cannabis and codeine. Methods We conducted a cross-sectional study using data from the nationally representative Canadian Tobacco, Alcohol and Drugs Survey (2017). The primary explanatory variable was self-reported use of cannabis within the past year. The outcome was the use of codeine-containing product(s) within the past year. We used multivariable binomial logistic regression models. Results Our study sample comprised 15,459 respondents including 3338 individuals who reported cannabis use within the past year of whom 955 (36.2%) used it for medical purposes. Among individuals who reported cannabis use, the majority were male (N = 1833, 62.2%). Self-reported use of cannabis was associated with codeine use (adjusted odds ratio [aOR] 1.89, 95% CI 1.36 to 2.62). Additionally, when limited to cannabis users only, we found people who used cannabis for medical purposes to be three times more likely to also report codeine use (adjusted odds ratio [aOR] 2.96, 95% CI 1.72 to 5.09). Discussion The use of cannabis was associated with increased odds of codeine use, especially among individuals who used it for medical purposes. Our findings suggest a potential role for healthcare providers to be aware of or monitor patients’ use of cannabis, as the long-term adverse events associated with concurrent cannabis and opioid use remain unknown.

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“…In most US states, people seeking cannabis for medical or psychiatric symptoms must obtain state-specific medical cannabis authorization cards to purchase cannabis products from dispensaries ( 4 , 5 ). Enrollment in medical cannabis programs increased 4.5-fold from 2016 to 2020 ( 6 ). While interest in using commercial cannabis products for medical conditions is high, rigorous data on its safety and effectiveness for symptom relief is sparse ( 7 ), and few studies assess longer-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

Development of cannabis use disorder in medical cannabis users: A 9-month follow-up of a randomized clinical trial testing effects of medical cannabis card ownership

Cooke

Potter²,

Jashinski³

et al. 2023

Front. Psychiatry

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BackgroundEvidence for long-term effectiveness of commercial cannabis products used to treat medical symptoms is inconsistent, despite increasingly widespread use.ObjectiveTo prospectively evaluate the effects of using cannabis on self-reported symptoms of pain, insomnia, anxiety, depression, and cannabis use disorder (CUD) after 12 months of use.MethodsThis observational cohort study describes outcomes over 9 months following a 12-week randomized, waitlist-controlled trial (RCT: NCT03224468) in which adults (N = 163) who wished to use cannabis to alleviate insomnia, pain, depression, or anxiety symptoms were randomly assigned to obtain a medical marijuana card immediately (immediate card acquisition group) or to delay obtaining a card for 12 weeks delay (delayed card acquisition group). During the 9-month post-randomization period, all participants could use cannabis as they wished and choose their cannabis products, doses, and frequency of use. Insomnia, pain, depression, anxiety, and CUD symptoms were assessed over the 9-month post-randomization period.ResultsAfter 12 months of using cannabis for medical symptoms, 11.7% of all participants (n = 19), and 17.1% of those using cannabis daily or near-daily (n = 6) developed CUD. Frequency of cannabis use was positively correlated with pain severity and number of CUD symptoms, but not significantly associated with severity of self-reported insomnia, depression, or anxiety symptoms. Depression scores improved throughout the 9 months in all participants, regardless of cannabis use frequency.ConclusionsFrequency of cannabis use was not associated with improved pain, anxiety, or depression symptoms but was associated with new-onset cannabis use disorder in a significant minority of participants. Daily or near-daily cannabis use appears to have little benefit for these symptoms after 12 months of use.

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U.S. Trends in Registration for Medical Cannabis and Reasons for Use From 2016 to 2020

Cited by 49 publications

References 22 publications

Assessment of Medical Cannabis and Health-Related Quality of Life

Assessment of Medical Cannabis and Health-Related Quality of Life

The association between cannabis and codeine use: a nationally representative cross-sectional study in Canada

Development of cannabis use disorder in medical cannabis users: A 9-month follow-up of a randomized clinical trial testing effects of medical cannabis card ownership

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