BackgroundMedical cannabis (MC) is used by Canadian Veterans to manage a wide range of health issues. However, there is little information comparing the reasons for MC use and its perceived ...effectiveness between Veterans and non-Veterans.ObjectsWe compared MC use among a convenience sample of Canadian Veterans and with non-Veteran controls, including demographics, reasons and patterns of use, and perceived effectiveness.MethodsBetween November and December 2021, Canadian Veterans using cannabis were invited to participate in a survey using a national press release, social media, and announcements on online platform dedicated to promoting health among Canadian Veterans and non-Veterans during the pandemic (www.MissionVav.com). The survey was also mentioned in a monthly newsletter from Veteran Affairs Canada. Self-reported effectiveness was evaluated using a 0 to 10 visual analogue scale (0 being not all effective, 10 being the most effective).ResultsThe survey was completed by 157 people, including 108 (69%) males and 49 (31%) females. The mean age was 57 years (range 19 to 84). Among responders, 90 (63%) identified as Veterans. The most common reasons for MC use among Veterans included: insomnia (80%), anxiety (73%), and depression (52%). Veterans reported medical conditions such as chronic pain (88%) and arthritis (51%). Compared with non-Veterans, Veterans were significantly more likely to be male (83% vs. 49%), have a higher BMI (35.2 vs. 30.9), to report problems with sleep, anxiety, depression, and PTSD, and to use cannabis in edible form (51% vs. 22%). Self-reported mean effectiveness scores for MC were highest for PTSD (8.4), insomnia (8.2), anxiety (8.1), depression (8.0), and chronic pain (7.6).ConclusionsWe found important differences in user characteristics and cannabis use patterns between Canadian Veterans and non-Veterans. Further controlled studies are required to validate these findings, but these data suggest that orally administered cannabis products may be worth further study.
This study explores the application of sustainable organic and biorefinery methods to increase the production of therapeutic hemp. Specifically, it focuses on Solodiol, Carmagnola, and Doctor Seedman ...strains. The study was carried out for 60 days in a highly controlled setting. It employed a unique combination of Murashige and Skoog (MS) media, supplemented with 2,4-D (0.5 mg/L) and kinetin (0.5 mg/L), and augmented with organic additions such as coconut water. This distinctive amalgamation facilitated extraordinary expansion across all varieties. The Solodiol strain demonstrated remarkable growth characteristics in terms of the number of branches, leaves, shoots, and height, whilst Carmagnola and Doctor Seedman indicated significant differences in diameter. Carmagnola, specifically, flourished in specific conditions: a strict 16-h period of light followed by 8 h of darkness, particularly when exposed to blue light. The Carmagnola strain, grown using MS feed (2StemMS), produced a hemp oil extract with a high concentration of 3.85%, compared to the Solodiol and Doctor Seedman strains, and also showcases their potential in promoting an environmentally friendly and therapeutically helpful medicinal hemp industry.
•Hemp yield and sustainable study focused on Solodiol, Carmagnola, Doctor Seedman strains.•Organic components crucial for medical hemp development.•Light conditions, notably wavelength and photoperiod, are vital for hemp cultivation.•Study offers recommendations for premium medicinal hemp cultivation.•This study's findings emphasize efficient, quality-focused hemp farming.
This research explores the impact of patient education on reducing historical and current stigma.
Participants were recruited through social media, parenting with community organizations, and ...snowball sampling. A pretest posttest method was utilized. Participants viewed five balanced educational videos about medicinal cannabis. Attitudes toward medical cannabis were measured with a modified version of the medical component of the Recreational and Medical Cannabis Attitudes Scale (RMCAS). In total, 111 participants completed all requirements of the study.
Results of a Wilcoxon Sign Rank Test demonstrated a significant increase in the modified medical component of the RMCAS (1.18, p = 0.029).
Health education is an effective intervention to reduce stigma associated with medical cannabis. Future health policies must take a balanced, education-focused, and proactive stance in reducing barriers to care that exist due to the negative stigma associated with cannabis use.
Innovation: Historically, patient education has focused on areas such as tobacco, automobile safety, vaccinations, obesity, and the like. This research applied patient education to the area of medical cannabis to improve attitudes toward it and improve patient access.
•Health education reduces stigmas faced by patients using medical cannabis•Broad support for patients with PTSD use of medical cannabis•Medical cannabis Health policy should include education component
Background: Although Uruguay was the first country to legalize cannabis at a national level, regulations for the medicinal component have been slow in coming. The integration of medical cannabis into ...the healthcare system remains a challenge, and the regulatory framework is still under review. In this context, physicians' opinions must be considered. This study aims to determine the medical community's attitudes towards cannabis.
Methods: We conducted an anonymous self-administered online survey. Several national physician organizations collaborated in the dissemination process. The questionnaire inquired about cannabis-related topics such as knowledge, experience, attitudes, and the perceived barriers they encounter.
Results: A total of 275 physicians responded to the survey. The vast majority stated that they had been consulted by their patients about cannabis, although only half of them had formally or informally recommended it. Finally, we found almost unanimous agreement among physicians that medical cannabis should be legal.
Discussion: Uruguayan physicians have a positive view regarding the legalization of medical cannabis and are in favor of recommending its use. The main barrier to doing so is the lack of knowledge about incorporating it into their clinical practice. Medical cannabis should be addressed by public policies by providing training opportunities and institutional support.
As the medical cannabis industry in Canada moved from a single government producer to an open market model in 2014, this paper provides insight into how entrepreneurs from illegal medical cannabis ...dispensaries, as well as legal licensed producers, protect their position and reputation in this 'emerging' market. On the one hand, MCDs are illegal, niche-filling entities that have historically been 'boxed out' by the legal framework, trying to survive untouched by enforcement and supported by faithful clientele. Licensed producers (LPs), on the other hand, are new legal entities that follow a strict government regulated framework, and are essentially stepping on their illegal predecessor's territory. This project draws on 63 in-depth qualitative interviews, when medical cannabis access transitioned to an open market model. In this context, we see that rather than attempts to construct a credible shared identity for legitimacy, the emphasis is on building a distinct identity narrative in the face of market competition. The emergence of legal cannabis markets and the future of cannabis legalization in Canada presents a fruitful avenue for continuing the study of both the micro and macro processes in emerging markets, organizations, and entrepreneurial activities.
Abstract
Study Objectives
We conducted a systematic review to explore the effectiveness of medical cannabis for impaired sleep.
Methods
We searched MEDLINE, EMBASE, CENTRAL, and PsychINFO to January ...2021 for randomized trials of medical cannabis or cannabinoids for impaired sleep vs. any non-cannabis control. When possible, we pooled effect estimates for all patient-important sleep-related outcomes and used the GRADE approach to appraise the certainty of evidence.
Results
Thirty-nine trials (5100 patients) were eligible for review, of which 38 evaluated oral cannabinoids and 1 administered inhaled cannabis. The median follow-up was 35 days, and most trials (33 of 39) enrolled patients living with chronic cancer or noncancer chronic pain. Among patients with chronic pain, moderate certainty evidence found that medical cannabis probably results in a small improvement in sleep quality versus placebo (modeled risk difference RD for achieving the minimally important difference MID, 8% 95% CI, 3 to 12). Moderate to high certainty evidence shows that medical cannabis vs. placebo results in a small improvement in sleep disturbance for chronic non-cancer pain (modeled RD for achieving the MID, 19% 95% CI, 11 to 28) and a very small improvement in sleep disturbance for chronic cancer pain (weighted mean difference of –0.19 cm 95%CI, –0.36 to –0.03 cm; interaction p = .03). Moderate to high certainty evidence shows medical cannabis, versus placebo, results in a substantial increase in the risk of dizziness (RD 29% 95%CI, 16 to 50, for trials with ≥3 months follow-up), and a small increase in the risk of somnolence, dry mouth, fatigue, and nausea (RDs ranged from 6% to 10%).
Conclusion
Medical cannabis and cannabinoids may improve impaired sleep among people living with chronic pain, but the magnitude of benefit is likely small.
Cancer is a major public health problem as the leading cause of death. Palliative treatment aimed to alleviate pain and nausea in patients with advanced disease is a cornerstone of oncology. In 2007, ...the Israeli Ministry of Health began providing approvals for medical cannabis for the palliation of cancer symptoms. The aim of this study is to characterize the epidemiology of cancer patients receiving medical cannabis treatment and describe the safety and efficacy of this therapy.
We analyzed the data routinely collected as part of the treatment program of 2970 cancer patients treated with medical cannabis between 2015 and 2017.
The average age was 59.5 ± 16.3 years, 54.6% women and 26.7% of the patients reported previous experience with cannabis. The most frequent types of cancer were: breast (20.7%), lung (13.6%), pancreatic (8.1%) and colorectal (7.9%) with 51.2% being at stage 4. The main symptoms requiring therapy were: sleep problems (78.4%), pain (77.7%, median intensity 8/10), weakness (72.7%), nausea (64.6%) and lack of appetite (48.9%). After six months of follow up, 902 patients (24.9%) died and 682 (18.8%) stopped the treatment. Of the remaining, 1211 (60.6%) responded; 95.9% reported an improvement in their condition, 45 patients (3.7%) reported no change and four patients (0.3%) reported deterioration in their medical condition.
Cannabis as a palliative treatment for cancer patients seems to be well tolerated, effective and safe option to help patients cope with the malignancy related symptoms.
There is a substantial growth in the use of medical cannabis in recent years and with the aging of the population, medical cannabis is increasingly used by the elderly. We aimed to assess the ...characteristics of elderly people using medical cannabis and to evaluate the safety and efficacy of the treatment.
A prospective study that included all patients above 65 years of age who received medical cannabis from January 2015 to October 2017 in a specialized medical cannabis clinic and were willing to answer the initial questionnaire. Outcomes were pain intensity, quality of life and adverse events at six months.
During the study period, 2736 patients above 65 years of age began cannabis treatment and answered the initial questionnaire. The mean age was 74.5 ± 7.5 years. The most common indications for cannabis treatment were pain (66.6%) and cancer (60.8%). After six months of treatment, 93.7% of the respondents reported improvement in their condition and the reported pain level was reduced from a median of 8 on a scale of 0–10 to a median of 4. Most common adverse events were: dizziness (9.7%) and dry mouth (7.1%). After six months, 18.1% stopped using opioid analgesics or reduced their dose.
Our study finds that the therapeutic use of cannabis is safe and efficacious in the elderly population. Cannabis use may decrease the use of other prescription medicines, including opioids. Gathering more evidence-based data, including data from double-blind randomized-controlled trials, in this special population is imperative.
•The most common indications for cannabis in the elderly were pain and cancer.•At six months of cannabis treatment, 93.7% reported improvement in their condition.•At six months of treatment, the number of reported falls was significantly reduced.•Medical cannabis decreased the use of prescription medicines, including opioids.
Clinicians play an important role in promoting safe and responsible medical cannabis use. One essential component to safe use is considering a patient's risk of neurocognitive impairment. However, ...there remains a lack of practical guidance on how clinicians can evaluate this risk for medical cannabis patients. Here, a practical framework is presented for clinicians to assess and stratify cannabis-associated impairment risk. The proposed framework is intended to practically guide healthcare providers in gaining a more comprehensive review of a patient's impairment-related factors. This framework can be used to assess impairment risk for patients currently using or considering medical cannabis and is recommended for all patients who perform safety-sensitive duties. Healthcare providers (HCP) managing patient's medical cannabis or those conducting assessments to determine risk of impairment for safety-sensitive workplaces can utilize this framework to stratify patients' risk of impairment. Such assessments can inform patient-specific needs for support, education, and guidance, to ensure cannabis is used safely and responsibly.
We conducted a review of systematic reviews (SRs) and randomized-controlled trials (RCTs) to analyze efficacy and safety of cannabis-based medication in patients with mental disorders. Five data ...bases were systematically searched (2006—August 2018); 4 SRs (of 11 RCTs) and 14 RCTs (1629 participants) were included. Diagnoses were: dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette`s disorder. Outcome variables were too heterogeneous to conduct a meta-analysis. A narrative synthesis method was applied. The study quality was assessed using the risk-of-bias tool and SIGN-checklists. THC- and CBD-based medicines, given as adjunct to pharmaco- and psychotherapy, were associated with improvements of several symptoms of mental disorders, but not with remission. Side effects occurred, but severe adverse effects were mentioned in single cases only. In order to provide reliable treatment recommendations, more and larger RCTs with follow-up assessments, consistent outcome measures and active comparisons are needed.
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