Abstract
BackgroundDespite the absence of rigorous prospective studies, there has been an increase in the use of cannabis-based medicinal products. During the study period, the use of medical cannabis in Israel was tightly regulated by national policy. Through a prospective study of approximately 10,000 patients, we aimed to characterize the medical cannabis patient population as well as to identify treatment adherence, safety, and effectiveness.Methods and FindingsIn this study of prescribed medical cannabis patients, adherence, safety, and effectiveness were assessed at 6 months. Treatment adherence was assessed by the proportion of patients purchasing the medication out of the total number of patients (excluding deceased cases and patients transferred to another cannabis clinic). Safety was assessed by the frequency of the side-effects, while effectiveness was defined as at least moderate improvement in the patient condition without treatment cessation or serious side-effects. The most frequent primary indications requiring therapy were cancer (49.1%), followed by non-specific pain (29.3%). The average age was 54.6 ± 20.9 years, 51.1% males; 30.2% of the patients reported prior experience with cannabis. During the study follow-up, 1,938 patients died (19.4%) and 1,735 stopped treatment (17.3%). Common side-effects, reported by 1,675 patients (34.2%), were: dizziness (8.2%), dry mouth (6.7%), increased appetite (4.7%), sleepiness (4.4%), and psychoactive effect (4.3%). Overall, 70.6% patients had treatment success at 6 months. Multivariable logistic regression analysis revealed that the following factors were associated with treatment success: cigarette smoking, prior experience with cannabis, active driving, working, and a young age. The main limitation of this study was the lack of data on safety and effectiveness of the treatment for patients who refused to undergo medical assessment even at baseline or died within the first 6 months.ConclusionsWe observed that supervised medical-cannabis treatment is associated with high adherence, improvement in quality of life, and a decrease in pain level with a low incidence of serious adverse events.
Highlights
In recent years, there has been an increase in the use of cannabis-based products for a wide range of medical purposes, despite a lack of sufficient scientific evidence supporting cannabis therapies [1]
This study was conducted based on clinical data collected as part of the treatment program in Israel’s largest cannabis clinic
During 3 years of study period, 10,713 subjects received their first cannabis treatment license: 2.6% died before starting treatment, 4.2% opted not to receive the treatment, and 9,985 patients (93.2%) initiated treatment
Summary
There has been an increase in the use of cannabis-based products for a wide range of medical purposes, despite a lack of sufficient scientific evidence supporting cannabis therapies [1]. Non-purified products of the cannabis plant are the most frequently consumed by cannabis users [2], and contain three families of components, terpenes, flavonoids, and cannabinoids [3]. Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) are the two most common cannabinoids found in the cannabis plant [4]. CBD is non-intoxicating at medically relevant doses [4]; and when combined with THC, may counterbalance the psychoactivity of THC [6], while increasing THC tolerance [7]. Despite the absence of rigorous prospective studies, there has been an increase in the use of cannabis-based medicinal products. Through a prospective study of approximately 10,000 patients, we aimed to characterize the medical cannabis patient population as well as to identify treatment adherence, safety, and effectiveness
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