Medicinal Use Of Cannabis Research Articles

Medicinal cannabis use in palliative care.

Legislative change in recent years allows the prescription of medicinal cannabis for patients receiving palliative care. There appears to be widespread community support of its use in this context. The aim of this article is to provide an overview of current research on the use ofmedicinal cannabis within the palliative care context for both children and adults. The evidence needed to support the useof medicinal cannabis for symptom control is limited and still emerging. It is unlikely that medicinal cannabis will be used as a first-line agent for the management of pain, nausea and other specific symptoms, but it may have an adjuvant or complementary role in symptom management within palliative care. Consistent with the Therapeutic Goods Administration advice, these authors recommend that general practitioners encourage patients to participate in trials or programs that objectively monitor benefit and toxicity ofmedicinal cannabis.

Mental health among LGBTQ cannabis users during the COVID-19 pandemic: Analysis of the COVID-19 cannabis health study.

The purpose of this study is to compare the responses of LGBTQ cannabis consumers and their non-LGBTQ counterparts on anxiety, depression, substance use, and COVID-19 coping and stress during the pandemic. Data from an internet-survey of cannabis users during the COVID-19 pandemic were analyzed (N = 2,319). Approximately 18% of the sample identified as LGBTQ. Bivariate analyses were used to examine the relationship between LGBTQ identity and symptoms of anxiety and depression, substance use, and pandemic-related coping strategies and stressors. Logistic regression models were used to evaluate the association between pandemic stressors and coping strategies with LGBTQ identity, while adjusting for sex, age, and race and ethnicity. Differences in the proportion of medicinal cannabis use among LGBTQ respondents (74.6%) and non-LGBTQ respondents (75.3%) were insignificant. LGBTQ cannabis users were more likely to report COVID-19 related stressors and coping behaviors, including increased alcohol use. After adjustment for covariates, LGBTQ cannabis users were more likely to report symptoms of depression and anxiety than non-LGBTQ cannabis users. These results show that compared to their cisgender heterosexual counterparts, LGBTQ cannabis users are experiencing more problematic mental health outcomes during the COVID-19 pandemic.

Attitudes of Cancer Patients to Medicinal Cannabis Use: A Qualitative Study

ABSTRACT As cancer patients face long-term health and psychosocial issues from their diagnosis and treatment, many patients are seeking medicinal cannabis to manage their symptoms and treatment side effects. This qualitative study aimed to explore attitudes, barriers, and concerns of cancer patients from one regional community in Australia to gain a better understanding of the experiences faced in using medicinal cannabis. Participants (n = 16) engaged in focus groups or semistructured individual interviews, and an inductive thematic analysis of data was undertaken. Four themes emerged from the data: perceived benefits, access difficulties, uncertainty, and issues of support. The findings revealed a need to provide easy access to accurate information and address the barriers faced by cancer patients in using medicinal cannabis. IMPLICATIONS Despite the growing body of clinical evidence, cancer patients may be faced with bureaucratic and social challenges in gaining access to medicinal cannabis that will require social workers’ individual advocacy. Social workers should consider the roles that might be appropriate for them in advocating for policy and legislation changes around access, cost, and other barriers. Social workers working in oncology should consider the roles that might be appropriate for them in linking cancer patients to community support and resources, and in assisting cancer patients interested in medicinal cannabis, including an advocacy role.

Archaeobotanical evidence of the use of medicinal cannabis in a secular context unearthed from south China

Ethnopharmacological relevanceAs one of the first plants used by ancient people, cannabis has been used for medicinal purposes for thousands of years. The long history of medicinal cannabis use contrasts with the paucity of archaeobotanical records. Moreover, physical evidence of medicinal cannabis use in a secular context is much rarer than evidence of medicinal cannabis use in religious or ritual activities, which impedes our understanding of the history of medicinal cannabis use. Aim of the studyThis study aims to provide archaeobotanical evidence of medicinal cannabis use and analyse the specific medicinal usage of cannabis in a secular context in ancient times. Materials and methodsPlant remains were collected from the Laoguanshan Cemetery of the Han Dynasty in Chengdu, South China, with the archaeological flotation process and were identified based on morphological and anatomical characteristics. The examination of the medicinal significance of the remains relied on the investigation of the documentation on unearthed medical bamboo slips, the diseases of the tomb occupants, the cemetery's cultural background and Chinese historical records. ResultsThe botanical remains were accurately identified as cannabis. More than 120 thousand fruits were found, which represents the largest amount of cannabis fruit remains that have been statistically analysed from any cemetery in the world thus far. The cannabis fruits are suspected to have been used for medical purposes in a secular context and were most likely used to stop severe bleeding of the uterus and treat lumbago and/or arthralgia. ConclusionsThe cannabis fruit remains reported here likely represent the first physical evidence of medicinal cannabis use for the treatment of metrorrhagia, severe lumbago, and/or arthralgia. This study emphasizes the importance of the evidence of the diseases suffered by the occupants of the tomb in determining the medicinal use of cannabis in a secular context and contributes to a comprehensive understanding of the ancient history of medicinal cannabis.

Two Decades of the International Association for Cannabinoid Medicines: 20 Years of Supporting Research and Activities Toward the Medicinal Use of Cannabis and Cannabinoids.

Emerged from the German Association for Cannabis as Medicine (ACM), a handful of enthusiastic medical doctors from Germany, Switzerland, and Austria supported by experts from other countries established the International Association for Cannabinoid Medicines (IACM) in March 2000. During the past 20 years until today, it evolved toward the most important scientific society for clinical research in the field of cannabis-based medicines. The overarching aim of the IACM is to advance the knowledge on cannabis, cannabinoids, the endocannabinoid system, and related topics especially with regard to their therapeutic potential, which would allow more patients to profit from a treatment with cannabis-based medicines and ease legislators to adopt their policies. To reach this goal, the IACM organizes international scientific conferences, biweekly publishes the IACM-Bulletin-currently in six different languages-reaching more than 5000 people worldwide, and is working closely together with patient associations, international partner organizations, and IACM ambassadors. In 2019, a collaborative partnership with the journal Cannabis and Cannabinoid Research was established.

International Association for the Study of Pain Presidential Task Force on Cannabis and Cannabinoid Analgesia: research agenda on the use of cannabinoids, cannabis, and cannabis-based medicines for pain management.

The President of the International Association for the Study of Pain established a task force on cannabis and cannabinoid analgesia to systematically examine the evidence on (1) analgesic pharmacology of cannabinoids and preclinical evidence on their efficacy in animal models of injury-related or pathological persistent pain; (2) the clinical efficacy of cannabis, cannabinoids, and cannabis-based medicines for pain; (3) harms related to long-term use of cannabinoids; as well as (4) societal issues and policy implications related to the use of these compounds for pain management. Here, we summarize key knowledge gaps identified in the task force outputs and propose a research agenda for generating high-quality evidence on the topic. The systematic assessment of preclinical and clinical literature identified gaps in rigor of study design and reporting across the translational spectrum. We provide recommendations to improve the quality, rigor, transparency, and reproducibility of preclinical and clinical research on cannabis and cannabinoids for pain, as well as for the conduct of systematic reviews on the topic. Gaps related to comprehensive understanding of the endocannabinoid system and cannabinoid pharmacology, including pharmacokinetics and drug formulation aspects, are discussed. We outline key areas where high-quality clinical trials with cannabinoids are needed. Remaining important questions about long-term and short-term safety of cannabis and cannabinoids are emphasized. Finally, regulatory, societal, and policy challenges associated with medicinal and nonmedicinal use of cannabis are highlighted, with recommendations for improving patient safety and reducing societal harms in the context of pain management.

Sourcing Cannabis sativa L. by thermogravimetric analysis

Marijuana, dried and ground Cannabis, is the most consumed illicit drug in the world. Many undesirable and risky effects to human health are caused by its use. The medicinal use or legal recreational use of Cannabis has also been rising in many countries. These facts make traceability methodologies increasingly important whether for forensic use, such as drug trafficking eradication, or for quality control purposes of legal medicinal Cannabis. Consequently, the objective of this study was to analyze Cannabis by means of thermogravimetric analysis (TGA) in order to assess the capability of this technique to trace the geographical origin of Cannabis cultivated in Colorado, United States of America. TGA appears to be sensitive enough to detect the degradation/decarboxylation of cannabinoids and terpenes, at least to some extent; also, the degradation of cellulose, hemicellulose and lignin was indicated. Overall, the temperature ranges we analyzed using linear discriminant analysis showed high accuracies, with the 200 to 300 °C and 600 to 700 °C ranges achieving 100% accuracy.

Konopie siewne Cannabis sativa L. – jeden z najstarszych gatunków roślin użytkowych

The species Cannabis sativa L. (hemp) includes fiber hemp (Cannabis sativa L. var. sativa) and indian hemp (narcotic) (Cannabis sativa L. var. indica), differing in the level of cannabinoids, mainly Δ9THC, which in fiber hemp is below 0.2%. Fiber hemp is a plant widespread around the world, cultivated mainly for its fiber, used for a variety of purposes. The seeds are used in the food, cosmetic industries and birds food. The medicinal use of cannabis has been known for over 5,000 years. The pharmacological properties of the cannabinoids dominant in indian hemp make them useful in the treatment of various diseases. The presence of the psychoactive Δ9THC is controversial.

Human Laboratory Models of Cannabis Use: Applications for Clinical and Translational Psychiatry Research.

Cannabis is increasingly used by individuals with mental health diagnoses and often purported to treat anxiety and various other psychiatric symptoms. Yet support for using cannabis as a psychiatric treatment is currently limited by a lack of evidence from rigorous placebo-controlled studies. While regulatory hurdles and other barriers make clinical trials of cannabis challenging to conduct, addiction researchers have decades of experience studying cannabis use in human laboratory models. These include methods to control cannabis administration, to delineate clinical and mechanistic aspects of cannabis use, and to evaluate potential treatment applications for cannabis and its constituents. In this paper, we review these human laboratory procedures and describe how each can be applied to study cannabis use in patients with psychiatric disorders. Because anxiety disorders are among the most common psychiatric illnesses affecting American adults, and anxiety relief is also the most commonly-reported reason for medicinal cannabis use, we focus particularly on applying human laboratory models to study cannabis effects in individuals with anxiety and related disorders. Finally, we discuss how these methods can be integrated to study cannabis effects in other psychiatric conditions and guide future research in this area.

Clinical Evidence of Magistral Preparations Based on Medicinal Cannabis.

Cannabis has been widely used as a medicinal plant for millennia; however, studies related to its main components were first conducted in 1960. Subsequently, laboratories have produced new components and structures related to its active biological properties. Countries that have approved the medicinal use of cannabis impose regulations that govern its clinical and scientific use. One means of administering medicinal cannabis is via a magistral preparation that must have a medical prescription and be prepared in an establishment that meets quality standards to ensure the quantities of its main components, such as tetrahydrocannabinol (THC) and cannabidiol (CBD). Furthermore, suppliers must have a clear indication of its use in the patient before prescription. This review shows the published evidence regarding the clinical use of medicinal cannabis magistral preparations in the management of post-chemotherapy nausea and vomiting, neuropathic pain in multiple sclerosis, and anorexia and cachexia in patients with HIV.

Psychiatric Disorders and Cannabinoid Receptors.

With the increasing global use of medical and adult recreational use of cannabis and cannabinoids, this chapter provides overview of evidence from animal and human studies on psychiatric disorders and cannabinoid receptors. We review and present evaluation of the relationship between changes in the ECS and psychiatric disorders. Evidence suggests the existence of a relationship between changes in components of the ECS, and some of the symptoms present in psychiatric disorders. Both CB1Rs and CB2Rs are components of the endocannabinoid system with different cellular and tissue localization patterns that are differentially expressed in the CNS and PNS and are emerging targets for the treatment of number psychiatric disorders. As cannabis preparations are widely used for recreation globally, it is predictable that cannabis use disorders (CUDs) will increase and there is currently no available treatment for CUDs. Although major advances have been reported from cannabinoid and ECS research, there are gaps in scientific knowledge on long-term consequences of cannabis use. Adolescent and cannabis use during pregnancy presents further challenges, and more research will uncover the signaling pathways that couple the gut microbiota with the host ECS. Development of cannabis and cannabinoid nanomedicine for nanotherapy will certainly overcome some of the shortcomings and challenges in medicinal and recreational use of cannabis and cannabinoids. Thus, nanotechnology will allow targeted delivery of cannabinoid formulations with the potential to elevate their use to scientifically validated nanotherapeutic applications as the field of cannabis nanoscience matures.

PSY28 The Effect of Medicinal Cannabis on Quality of Life in the Management of NON-Cancer Chronic PAIN: A Systematic Review

Medicinal cannabis (MC) is an emerging therapeutic option for non-cancer chronic pain. However, its effects on a patient’s quality of life are still widely unknown, and its use still illegal in many countries. The aim of this systematic review was to examine the results of randomised controlled trials (RCTs) that study the effect of medicinal cannabis on quality of life in the treatment of non-cancer chronic pain. This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) protocol and was registered with PROSPERO. A search of Cochrane Library, MEDLINE, Embase and Web of Science was undertaken for literature published on the use of medicinal cannabis for the treatment of non-malignant chronic pain, and its effect on quality of life. Relevant data was extracted from studies and methodological quality assessed using the Cochrane Risk of Bias tool. The search identified 659 research articles. Six studies were selected following application of the inclusion and exclusion criteria. The qualitative review of these studies showed methodological quality was medium/high. The included studies show an overall improvement in quality of life with the use of medicinal cannabis using recognised assessment tools such as the EQ-5D and SF-36. This reached statistical significance in four studies. For the improvement of pain, five of the studies favoured medicinal cannabis over comparators, while one RCT favoured the use of dihydrocodeine. The low number of included studies highlights the lack of trials and research in the use of medicinal cannabis in non-cancer chronic pain for this purpose. This review suggests that medicinal cannabis has positive effects on patients’ quality of life in treating chronic pain. However, further research of its clinical effectiveness is required with consideration of longer term safety data.

Implications of the 2018 Canadian Cannabis Act: Should regulation differ for medicinal and non-medicinal cannabis use?⋆

The regulatory framework for access to medical cannabis has been established in Canada since 2001, with the number of patients seeking access growing substantially over the years. With the novel enactment of the Cannabis Act in October 2018, Canada now maintains two distinct mechanisms for accessing cannabis - one for medical cannabis and the other for non-medical cannabis. With two regulatory access mechanisms in place, questions have arisen in the country as to the necessity of maintaining regulatory separation and the integrity of the medical access framework. A single framework would remove the gate-keeping function that the medical profession currently holds, streamlining processes and simplifying the current regulatory landscape. This approach has been advocated for by the Canadian Medical Association, despite objections from multiple stakeholders. Critical questions arise should the medical access framework be dissolved into a single, non medical-based regulatory framework. Insurance coverage, control mechanisms, market incentives, and patient obligations represent some examples of these issues. This paper will expand upon these considerations and highlight why maintaining two separate access mechanismss best serves the Canadian public. As medicinal cannabis continues to be liberated in international jurisdictions, this paper can help to illuminate the current status of medical cannabis in Canada, and provide insights to those from other countries on our current approach and domestic challenges.

Symptoms, adverse events, and outcomes in the use of medicinal cannabis in children and adolescents with autism spectrum disorder: a scoping review protocol.

The objective of this scoping review is to map and identify the symptoms, adverse events, and outcomes in the use of medicinal cannabis in children and adolescents with autism spectrum disorder. Autism spectrum disorder is a neurodevelopmental disorder that impacts social communication and social interaction, and is associated with restrictive and repetitive behaviors and interests. Medicinal cannabis has become a potential area of interest for parents for the treatment of autism spectrum disorder symptoms in their children. There is some evidence that cannabinoids may be involved in autism spectrum disorder, laying a potential foundation for medicinal cannabis utility; however, previous reviews did not identify any clinical research on this topic. This scoping review will consider all published and unpublished studies that investigate the use of medicinal cannabis in autism spectrum disorder, where at least 50% of the participants have a diagnosis of autism spectrum disorder and at least 50% of the study population is 0 to 18 years of age, or where pediatric data are reported separately. Studies undertaken in any context (hospital or community) and in any geographic location will be included. We will search MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar, and the gray literature sources for studies. Two independent team members will screen titles and abstracts, review full texts for potential inclusion, and extract data for all studies. The results will be presented as a narrative synthesis and in tabular form.

Development of cannabidiol as a treatment for severe childhood epilepsies.

In recent years, there has been a growing appreciation by regulatory authorities that cannabis-based medicines can play a useful role in disease therapy. Although often conflagrated by proponents of recreational use, the legislative rescheduling of cannabis-derived compounds, such as cannabidiol (CBD), has been associated with the steady increase in the pursuit of use of medicinal cannabis. One key driver in this interest has been the scientific demonstration of efficacy and safety of CBD in randomised, placebo-controlled clinical trials in children and young adults with difficult-to-treat epilepsies, which has encouraged increasing numbers of human trials of CBD for other indications and in other populations. The introduction of CBD as the medicine Epidiolex in the United States (in 2018) and as Epidyolex in the European Union (in 2019) as the first cannabis-derived therapeutic for the treatment of seizures was underpinned by preclinical research performed at the University of Reading. This work was awarded the British Pharmacological Society Sir James Black Award for Contributions to Drug Discovery 2019 and is discussed in the following review article.

History of cannabis and the endocannabinoid system .

This article retraces the story of cannabis from the earliest contacts of humans with the plant to its subsequent global expansion, its medicinal uses, and the discovery of the endocannabinoid system in the 20th century. Cannabis was attested to around 12 000 years ago near the Altai Mountains in Central Asia, and since then, cannabis seeds have accompanied the migration of nomadic peoples. Records of the medicinal use of cannabis appear before the Common Era in China, Egypt, and Greece (Herodotus), and later in the Roman empire (Pliny the Elder, Dioscorides, Galen). In the 19th century, orientalists like Silvestre de Sacy, and Western physicians coming into contact with Muslim and Indian cultures, like O’Shaughnessy and Moreau de Tours, introduced the medicinal use of cannabis into Europe. The structure of the main psychoactive phytocannabinoid, tetrahydrocannabinol (THC), was determined in Israel by Mechoulam and Gaoni in 1964. This discovery opened the gate for many of the subsequent developments in the field of endocannabinoid system (ECS) research. The advances in the scientific knowledge of the ECS place the debate on cannabis liberalization in a new context.

Medicinal cannabis in Thailand: 1-year experience after legalization.

Medicinal cannabis in Thailand: 1-year experience after legalization.

Societal issues and policy implications related to the use of cannabinoids, cannabis, and cannabis-based medicines for pain management.

Societal issues and policy implications related to the use of cannabinoids, cannabis, and cannabis-based medicines for pain management.

The COVID-19 cannabis health study: Results from an epidemiologic assessment of adults who use cannabis for medicinal reasons in the United States

Background: Clinical indications for medicinal cannabis include chronic conditions; thus users (MCUs) are at an increased risk of morbidity and mortality resulting from SARS-CoV-2 infection (COVID-19). The study aimed to provide data on cannabis use and self-reported behavioral changes among MCUs with preexisting chronic conditions in response to the pandemic.Methods: An internet-based questionnaire was administered to adults ≥18 who self-reported medicinal cannabis use within the past year. Data are from respondents between March 21 and April 23, 2020; response rate was 83.3%. Health conditions and cannabis frequency, route, and patterns of use were assessed via the COVID-19 Cannabis Health Questionnaire (Vidot et al. 2020).Results: Participants (N = 1202) were predominantly non-Hispanic white (82.5%) and 52.0% male (mean age 47.2 years). Mental health (76.7%), pain (43.7%), cardiometabolic (32.9%), respiratory (16.8%), and autoimmune (12.2%) conditions were most reported. Those with mental health conditions reported increased medicinal cannabis use by 91% since COVID-19 was declared a pandemic compared to those with no mental health conditions (adjusted odds ratio: 1.91, 95% CI: 1.38–2.65). 6.8% reported suspected COVID-19 symptoms. Two percent (2.1%) have been tested for COVID-19 with only 1 positive test result. Some MCUs (16%) changed their route of cannabis administration, switching to nonsmoking forms.Conclusions: The majority of MCUs reported at least one preexisting chronic health condition. Over half report fear of COVID-19 diagnosis and giving the virus to someone else; yet only some switched from smoking to nonsmoking forms of cannabis. Clinicians may consider asking about cannabis use among their patients, particularly those with chronic health conditions.

Prevalence and Correlates of Medicinal Cannabis Use Among Adolescents

PurposePrior studies of medicinal cannabis use (MCU) have focused primarily on adults. This study examined the prevalence and correlates of self-reported MCU among adolescents. MethodsSecondary school students (grades 9–12; N = 3,221) completed a cross-sectional survey in classrooms across Ontario, Canada, in 2016–2017. Participants reported on cannabis use behavior, cannabis dependence, other drugs use, and general health and sleep. Participants reporting cannabis use in the past year were grouped based on whether they reported MCU or not (i.e., recreational cannabis use only [RCU-only]). ResultsAn estimated 6.89% (95% confidence interval 5.48%–8.63%) of students reported MCU, representing one quarter of the students reporting current cannabis use. Relative to the RCU-only group, the MCU group reported using cannabis more frequently, were more likely to report vaping and eating cannabis, had greater risk for cannabis dependence, perceived cannabis as less harmful, were more likely to report tobacco use, recreational use of other drugs, and medicinal use of sedatives or tranquilizers, and were less likely to report good health and sleeping for seven or more hours per night. Frequency of cannabis use accounted for differences between MCU and RCU-only groups in cannabis dependence risk, recreational use of other drugs, and perceiving cannabis as harmful, but it did not account for the other differences. ConclusionsA sizable portion of secondary school students report MCU, which appears to be associated with more frequent cannabis use and certain substance use and health-related correlates. Research is needed to further characterize motives for self-reported MCU among adolescents.