Abstract
Federal barriers and logistical challenges have hindered measurement of the real time effects from the types of cannabis products used medically by millions of patients in vivo. Between 06/06/2016 and 03/05/2018, 3,341 people completed 19,910 self- administrated cannabis sessions using the mobile device software, ReleafApp to record: type of cannabis product (dried whole natural Cannabis flower, concentrate, edible, tincture, topical), combustion method (joint, pipe, vaporization), Cannabis subspecies (C. indica and C. sativa), and major cannabinoid contents (tetrahydrocannabinol, THC; and cannabidiol, CBD), along with real-time ratings of health symptom severity levels, prior-to and immediately following administration, and reported side effects. A fixed effects panel regression approach was used to model the within-user effects of different product characteristics. Patients showed an average symptom improvement of 3.5 (SD = 2.6) on an 11-point scale across the 27 measured symptom categories. Dried flower was the most commonly used product and generally associated with greater symptom relief than other types of products. Across product characteristics, only higher THC levels were independently associated with greater symptom relief and prevalence of positive and negative side effects. In contrast, CBD potency levels were generally not associated with significant symptom changes or experienced side effects.
Highlights
This is the first study to measure how fundamental characteristics of cannabis products consumed in vivo affect immediate symptom relief and experienced side effects
Www.nature.com/scientificreports in symptoms related to, for example, chronic pain[15], multiple sclerosis and Parkinson’s disease[16], post-traumatic stress disorder[17], and schizophrenia[18] relied on public or commercially available cannabis that has been hybridized for high THC and low CBD contents, suggesting that THC may be an important determinant of user outcomes
While RCTs may be the ‘gold standard’ for measuring the pharmacodynamics of synthetic, standardized medications, they are poorly suited for understanding the effects of a medication with substantial heterogeneity in product characteristics and consumption methods across the estimated 2.2 million state-legal medical cannabis patients in the United States[25]
Summary
This is the first study to measure how fundamental characteristics of cannabis products consumed in vivo affect immediate symptom relief and experienced side effects. Our basic statistical model uses a least squares panel regression approach with repeated observations (sessions) at the patient level to analyze how product characteristics affect symptom relief and side effects.
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