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Essen, Germany: The use of medical cannabis products is associated with reduced levels of depression, according to data published in the journal Pharmacopsychiatry.

German investigators assessed medical cannabis use in a cohort of 59 outpatients suffering from major depressive disorder (MDD). (Plant cannabis and cannabinoid treatments, such as dronabinol, were legalized by prescription use in Germany in 2017; however, such products are typically only authorized when patients are unresponsive to traditional therapies.) Study participants used cannabis products for 18 weeks.

“Mean severity of depression decreased from 6.9 points at entry to 3.8 points at week 18,” they reported. “A treatment response (>50 percent reduction of the initial score) was seen in 50.8 percent [of study subjects] at week 18.”

The study’s authors concluded: “Medical cannabis was well-tolerated and [the] dropout rate was comparable to those in clinical trials of antidepressant medication. Patients reported a clinically significant reduction of depression severity. Further research on the effectiveness of medical cannabis for MDD seems warranted.”

The study’s findings are consistent with recently published data from the United Kingdom, which determined, “Medicinal cannabis was associated with improvements in depression and anxiety symptoms, as well as health-related quality of life, and sleep quality after 1, 3, and 6 months of treatment.”

Full text of the study, “Effectiveness of medical cannabis for the treatment of depression: A naturalistic outpatient study,” appears in Pharmacopsychiatry.

Analysis: Cannabis Use Plays Little Role In Cardiovascular Deaths Related To Substance Use

Jackson, MS: The use of alcohol is implicated in the majority of substance use-related cardiovascular deaths, according to data published in the Journal of the American Heart Association.

Researchers affiliated with the University of Mississippi Medical Center analyzed substance use-related mortality trends from 1999 to 2019.

They reported that alcohol likely played a role in 65 percent of all cardiovascular deaths related to substance use. Opioids were implicated in 14 percent of deaths and cocaine was linked to just under ten percent of deaths. Cannabis was associated with fewer than one percent of all substance use-related cardiovascular deaths.

“Substances evaluated in our analysis, including alcohol, cannabis, cocaine, opioids, and stimulants, have multiple cardiovascular effects and are associated with the development of cardiomyopathy, arrhythmias, microvascular disease, and coronary artery disease, particularly in the case of cocaine and stimulants,” the study’s authors concluded. “Among the substances evaluated in our study, alcohol was the most common to be associated with SU [substance use] + CVD [cardiovascular disease]‐related death, more than four times opioids, the second‐highest substance. … [C]annabis had the lowest SU + CVD-related absolute AAMR [age adjusted mortality rate].”

Data assessing cannabis’ potential role in adverse cardiovascular events, such as heart attack and stroke, has yielded inconsistent results. For instance, the findings of a meta-analysis published in May concluded, “Cannabis use insignificantly predicts all major cardiovascular adverse events,” including myocardial infarction and stroke. By contrast, data published more recently in the journal Addiction reported that adults engaged in problematic cannabis use possess an elevated risk of adverse cardiovascular outcomes.

Similarly, data published this month in the European Heart Journal reported that pain patients using medical cannabis products possessed a slightly increased risk of atrial fibrillation (AFib), whereas longitudinal data reported just days earlier in the journal Heart Rhythm identified no elevated risk.

Full text of the study, “Temporal trends in substance use and cardiovascular disease-related mortality in the United States,” appears in the Journal of the American Heart Association.

Analysis: Cannabis Products Provide Sustained Improvements In Patients With Generalized Anxiety Disorder

London, United Kingdom: Patients with generalized anxiety disorder (GAD) exhibit sustained improvements in their symptoms following the use of cannabis products, according to data published in the journal Neuropsychopharmacology Reports.

British investigators assessed the safety and efficacy of plant-derived cannabis products (either oils, flower, or a combination of both) in over 300 patients enrolled in the UK Medical Cannabis Registry. Cohort participants possessed a doctor’s authorization to access cannabis products. (Since 2018, specialists have been permitted to prescribe cannabis-based medicinal products to patients unresponsive to conventional medications.) Authors assessed the efficacy of cannabis at one, three, six, and 12 months.

Consistent with prior studies, cannabis treatment was associated with persistent improvements in patients’ anxiety, sleep, and health-related quality of life. Patients presenting with severe baseline anxiety were most likely to experience a clinically significant improvement in anxiety symptoms at 12 months.

Researchers concluded: “The findings from this cohort study demonstrate that treatment with CBMPs [cannabis-based medicinal products] is associated with statistically significant improvements across anxiety-, sleep-, and HRQoL-specific PROMs [patients-reported outcome measures] after 12 months in patients with GAD. … Results also indicated CBMPs were well tolerated throughout the study. … Patients were prescribed either oils, dried flower, or a combination of both, and this study identified no difference in outcomes at 12 months between treatment groups.”

Other studies assessing the use of cannabis products in patients enrolled in the UK Cannabis Registry have reported them to be effective for those suffering from chronic pain, post-traumatic stress, depression, migraine, inflammatory bowel disease, and other afflictions.
Full text of the study, “A cohort study comparing the effects of medical cannabis for anxiety patients with and without comorbid sleep disturbance,” appears in Neuropsychopharmacology Reports.

Survey: Cannabis Use Is “Widespread” Among Cancer Survivors

Houston, Texas: Nearly half of US cancer survivors report having used cannabis, according to survey data published in the journal Cancers.

Investigators affiliated with the University of Texas, Anderson Cancer Center and John Hopkins University surveyed 1,886 cancer survivors from 41 states.

Just under half (48 percent) of respondents acknowledged having experience with cannabis. Approximately one-third of them reported using cannabis following their cancer diagnosis. Patients were most likely to report inhaling cannabis flower or consuming oil extracts.

“Many cancer survivors use cannabis as a palliative while undergoing cancer treatment, and this usage tends to rise following cancer diagnosis,” the study’s authors reported. “This suggests that cancer survivors often turn to cannabis to cope with their diagnosis or manage treatment-related symptoms.”

They concluded: “Cannabis use is widespread among cancer patients; therefore, regulatory guidance is even more critical at this time. As cannabis becomes more accessible for medicinal and recreational use, it is important to strengthen the regulatory framework for its use to minimize the untoward effects of cannabis use in cancer management.”

Prior surveys find that cancer patients commonly report consuming cannabis to aid with sleep and to “improve their ability to cope with their illness.” Nonetheless, many healthcare providers acknowledge that they are unprepared to discuss cannabis therapy with cancer patients.

Full text of the study, “Cannabis use among cancer survivors: Use pattern, product type, and timing of use,” appears in Cancers.