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  • ∆9-tetrahydrocannabinol (THC), Cannabidiol (CBD), Cannabis
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Medicinal Cannabis and the Intestinal Microbiome

Abstract Historically, the multiple uses of cannabis as a medicine, food, and for recreational purposes as a psychoactive drug span several centuries. The various components of the plant (i.e., seeds, roots, leaves and flowers) have been utilized to alleviate symptoms of inflammation and pain (e.g., osteoarthritis, rheumatoid arthritis), mood disorders such as anxiety, and intestinal problems such as nausea, vomiting, abdominal pain and diarrhea. It has been established that the intestinal microbiota progresses neurological, endocrine, and immunological network effects through the gut–microbiota–brain axis, serving as a bilateral communication pathway between the central and enteric nervous systems. An expanding body of clinical evidence emphasizes that...
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Efficacy and Safety of Transdermal Medical Cannabis (THC:CBD:CBN formula) to Treat Painful Diabetic Peripheral Neuropathy of Lower Extremities

Abstract Introduction: Diabetic peripheral neuropathy (DPN) represents a prevalent neurological complication affecting millions of patients globally. This clinical investigation evaluated the therapeutic efficacy and safety profile of a novel transdermal medical cannabis formulation (THC:CBD:CBN) in treating painful DPN of the lower extremities. Methods: This phase III, double-blind, placebo-controlled, randomized clinical trial was conducted at Don Chan Hospital, Thailand, enrolling 100 participants over a 12-week intervention period. Using a computer-generated randomization sequence, participants were allocated to receive either the standardized cannabis formulation or a matched placebo. The primary outcome measure comprised pain intensity assessment using the validated Thai version of the Neuropathic Pain Symptom Inventory (NPSI-T). Secondary outcomes...
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A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance

Abstract Background Research on cannabis-based medicinal products (CBMPs) in anxiety remains inconclusive due to a paucity of high-quality evidence. Studies indicate a bidirectional relationship between generalized anxiety disorder (GAD) and sleep disruption, but it is unclear how this affects CBMP treatment outcomes. This study aims to compare the patient-reported outcome measures (PROMs) of patients prescribed CBMPs for GAD, with and without impaired sleep. Methods Changes in PROMs were recorded from baseline to 1, 3, 6, and 12 months between those with impaired or unimpaired sleep. Multivariate logistic regression was applied to compare factors associated with a clinically significant improvement in GAD-7 at 12 months. Secondary outcomes...
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Medicinal cannabis extracts are neuroprotective against Aβ1–42-mediated toxicity in vitro

Abstract Background Phytocannabinoids inhibit the aggregation and neurotoxicity of the neurotoxic Alzheimer's disease protein β amyloid (Aβ). We characterised the capacity of five proprietary medical cannabis extracts, heated and non-heated, with varying ratios of cannabidiol and Δ9-tetrahydrocannabinol and their parent carboxylated compounds to protect against lipid peroxidation and Aβ-evoked neurotoxicity in PC12 cells. Methods Neuroprotection against lipid peroxidation and Aβ1–42-induced cytotoxicity was assessed using the thiazolyl blue tetrazolium bromide (MTT) assay. Transmission electron microscopy was used to visualise phytocannabinoid effects on Aβ1–42 aggregation and fluorescence microscopy. Results Tetrahydrocannabinol (THC)/tetrahydrocannabinolic acid (THCA)-predominant cannabis extracts demonstrated the most significant overall neuroprotection against Aβ1–42-induced loss of PC12 cell...
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Cannabinoids Used for Medical Purposes in Children and Adolescents A Systematic Review and Meta-Analysis

Please use this link to access this publication. Key Points Question  What is the adverse event profile of cannabinoids used for medical purposes in children and adolescents? Findings  In this systematic review and meta-analysis of 23 randomized clinical trials including 3612 participants, cannabinoids used for medical purposes in children and adolescents were associated with increased risk of adverse events, serious adverse events, and withdrawals due to adverse events compared with the control group. Meaning  The findings suggest that physicians considering cannabinoids for medical purposes in children and adolescents should weigh the risk and benefit profile of cannabinoids and available therapeutic options as well as the individual’s underlying...
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Legalization of Smokable Medical Cannabis and Changes in the Dispensed Amount of Δ-9 Tetrahydrocannabinol Per Patient

Please use this link to access this publication. Abstract Introduction: Florida’s medical cannabis (marijuana) program is among the largest in the United States. Smokable cannabis forms were not legally available in this program until 2019, and five years after other forms of cannabis were available. This study assessed changes in Δ-9 tetrahydrocannabinol (THC) dispensed per patient following legalization of smokable cannabis in Florida. Materials and Methods: This quasi-experimental study used data from the Florida Department of Health Office of Medical Marijuana Use Reports on THC dispensing from April 6, 2018, through March 13, 2020. Certified medical cannabis user during the study period was included. The exposure...
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Cannabis-involvement in emergency department visits for self-harm following medical and non-medical cannabis legalization

Abstract Aims Cannabis use may increase the risk of self-harm, but whether legalization of cannabis is associated with changes in self-harm is unknown. We examined changes in cannabis-involvement in emergency department (ED) visits for self-harm after the liberalization of medical and legalization of non-medical cannabis in Canada. Methods This repeated cross-sectional study used health administrative data to identify all ED visits for self-harm in individuals aged ten and older between January 2010 and December 2021. We identified self-harm ED visits with a co-diagnosis of cannabis (main exposure) or alcohol (control condition) and examined changes in rates of visits over four distinct policy periods (pre-legalization, medical liberalization, non-medical...
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Medical Cannabis Dosing Trajectories of Patients: Evidence From Sales Data

Please use this link to access this publication. Highlights •Our study reveals diverse Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing patterns among patients with medical conditions, drawn from longitudinal purchase data, providing insights into patient dosing. •Six trajectory groups illustrate varied THC and CBD dosing trends over time, reflecting nuanced patient behaviors and highlighting dynamic dosing trajectories. •Patients exhibit customized dosing preferences, with THC favored by patients with chronic pain and cancer and CBD preferred by those with epilepsy, indicating tailored dosing preferences. •Many patients exhibited fluctuating dosing behaviors, highlighting the necessity for personalized dosing strategies and emphasizing fluctuating dosing behaviors. •Our findings stress the...
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Cannabis Use and Head and Neck Cancer

Please use this link to access this publication. Key Points Question  Is cannabis use associated with increased risk of head and neck cancer (HNC)? Findings  In this cohort study of 116 076 individuals, people with cannabis use disorder had an increased risk of any HNC, as well as oral, oropharyngeal, nasopharyngeal, salivary gland, and laryngeal cancer, compared with a group of matched individuals. Meaning  The results of this study suggest that patients with cannabis-related disorder may be at an increased risk for HNC, and further studies are required to further explore the strength and potential mechanisms of this association. Abstract Importance  Cannabis is the most commonly used illicit substance...
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Use of Cannabis-Based Medical Products for Pediatric Health Conditions: A Systematic Review of the Recent Literature

Abstract Introduction: Cannabis policy is rapidly changing in the USA and across the globe, with 24 states legalizing cannabis for adult use and 38 states making medical cannabis available for those with qualified conditions. Building on prior evidence, we reviewed the recently published literature (from the past 5 years) focused on the treatment effects of naturally derived medical cannabis products within the pediatric population. Methods: We conducted a systematic literature review of three electronic databases using MeSH terms and free-text. A study was eligible for inclusion if it investigated the efficacy of medical cannabis for any condition, it was published in 2019 or later, and the mean...
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