Abstract
With the medical use of cannabis permitted in Canada since 2001, patients seek to use this botanical drug to treat a range of medical conditions. However, many healthcare practitioners express the need for further scientific evidence around the use of medical cannabis. This real-world evidence study aimed to address the paucity of scientific data by surveying newly registered medical cannabis patients, before beginning medical cannabis treatment, and at one follow up 6 weeks after beginning medical cannabis treatment. The goal was to collect data on efficacy, safety and cannabis product type information to capture the potential impact medical cannabis had on patient-reported quality of life (QOL) and several medical conditions over a 6-week period using validated questionnaires. The 214 participants were mainly male (58%) and 57% of the population was older than 50. The most frequently reported medical conditions were recurrent pain, post-traumatic stress disorder (PTSD), anxiety, sleep disorders [including restless leg syndrome (RLS)], and arthritis and other rheumatic disorders. Here we report that over 60% of our medical cannabis cohort self-reported improvements in their medical conditions. With the use of validated surveys, we found significant improvements in recurrent pain, PTSD, and sleep disorders after 6 weeks of medical cannabis treatment. Our findings from patients who reported arthritis and other rheumatic disorders are complex, showing improvements in pain and global activity sub-scores, but not overall changes in validated survey scores. We also report that patients who stated anxiety as their main medical condition did not experience significant changes in their anxiety after 6 weeks of cannabis treatment, though there were QOL improvements. While these results show that patients find cannabis treatment effective for a broad range of medical conditions, cannabis was not a remedy for all the conditions investigated. Thus, there is a need for future clinical research to support the findings we have reported. Additionally, while real-world evidence has not historically been utilized by regulatory bodies, we suggest changes in public policy surrounding cannabis should occur to reflect patient reported efficacy of cannabis from real-world studies due to the uniqueness of medical cannabis's path to legalization.
Highlights
Cannabis has been used for centuries to treat ailments in humans [1], with the earliest peer-reviewed clinical studies reported in 1843 [2]
We conclude that in general, this real-world data shows that a large proportion of medical cannabis patients report moderate to substantial benefits from cannabis, both in terms of their overall condition and general well-being
While these results are promising, cannabis treatment was not a remedy for all, as our findings show that medical cannabis did not lead to significant improvements in all conditions we examined
Summary
Cannabis has been used for centuries to treat ailments in humans [1], with the earliest peer-reviewed clinical studies reported in 1843 [2]. In contrast to THC, CBD is non-intoxicating at medically relevant doses [8]. While each of these cannabinoids have been tied to specific physiological effects on their own, some authors have proposed that cannabinoids, including minor cannabinoids other than THC and CBD, and/or terpenes work together synergistically, in what has been termed the “entourage effect”(14). Different ratios of THC:CBD may have different therapeutic effects. This makes the interpretation and application of the currently available scientific data on the efficacy of medical cannabis for a specific medical condition complex and unlike standard pharmaceuticals, where a single drug compound is approved for one medical condition
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