Study: Post-Operative Cannabis Use Associated with Opioid-Sparing Effects
Denver, CO: Patients who self-report consuming cannabis following hip or knee surgery are less likely than non-users to engage in the long-term use of prescription opioids, according to data in the journal Arthroplasty Today.
A team of investigators affiliated with the University of Denver and with John Hopkins University in Baltimore assessed opioid use trends in a cohort of patients who had recently undergone either total hip or total knee arthroplasty.
Researchers reported that those patients who reported perioperative cannabis use were less likely to engage in the use of prescription opioids long-term than were matched controls. The findings are consistent with dozens of prior studies documenting reduced levels of opioid consumption in pain patients who initiate cannabis use.
Authors concluded: "This study helps to shed light on what role if any cannabis should play as a part of an opioid-sparing multimodal pain protocol after TJA [total joint arthroplasty]. Self-reported perioperative cannabis use appeared to significantly reduce the number of patients that persistently used opioids greater than 90 days after TJA from 9.5 percent to 1.4 percent. ... As cannabis becomes more widely available and patient interest in its use for pain management continues to increase, further research with higher quality, prospective studies are required to clarify its role in perioperative pain management, including the examination of different preparations (delta-9-tetrahydrocannabinol vs cannabidiol), dosages, routes of administration (edible, inhalation, topical), and frequency of use."
Full text of the study, "Self-reported cannabis use associated with a lower rate of persistent opioid use after total joint arthroplasty," appears in Arthroplasty Today.
Study: Cannabis Preparations Associated with Quality of Life Improvements in Adults with Autism
London, United Kingdom: The use of cannabis flowers and extracts is associated with symptom improvements in adults diagnosed with autism spectrum disorder (ASD), according to data published in the journal Therapeutic Advances in Psychopharmacology.
British investigators affiliated with Imperial College in London assessed the safety and efficacy of cannabis products in a cohort of autistic adults (mean age: 32) enrolled in the UK Medical Cannabis Registry. Subjects in the study either inhaled cannabis flowers or consumed sublingual extracts for a period of up to six months. Subjects primarily consumed cannabis preparations that were elevated in THC content and lower in CBD.
Consistent with prior studies, investigators reported that patients experienced symptomatic improvements following cannabis therapy. They also reduced their use of prescription medications. Specifically, there was "a 33.3 percent and 25.0 percent reduction in the concomitant prescribing of benzodiazepines and neuroleptics, respectively, within this cohort." Authors further acknowledged that cannabis preparations were "well tolerated" by over 80 percent of the participants.
"In this first published experience of clinical outcomes in adult patients with ASD treated with CBMPs [cannabis-based medicinal products], there were associated improvements in general health-related quality of life, in addition to sleep- and anxiety-specific outcomes," they concluded. "Moreover, there was a reduction in the administration of concomitant medications, some of which are associated with serious adverse events with long-term use. ... These results ... provide scientific justification for further evaluation within the context of randomized controlled trials while also providing guidance for clinical practice in the interim."
Numerous trials have previously identified clinical improvements in autistic children who consume plant-derived CBD extracts. Survey data published in 2021 by the publication Autism Parenting Magazine reported that 22 percent of US caregivers or parents have provided CBD to an autistic child.
Full text of the study, "Clinical outcome analysis of patients with autism spectrum disorder: Analysis from the UK Medical Cannabis Registry," appears in Therapeutic Advances in Psychopharmacology.
Clinical Trial: Plant-Derived CBD Extracts Reduce Agitation in Dementia Patients
Tel Aviv, Israel: The administration of plant-derived extracts containing high levels of CBD and low levels of THC reduces agitation in patients suffering from behavioral disturbances related to dementia, according to clinical trial data published in the journal Frontiers in Medicine.
Israeli researchers assessed the safety and efficacy of CBD-dominant extracts (30 to 1 ratio of CBD to THC) compared to placebo in a cohort of seniors (mean age: 79 years) with dementia. Subjects in the trial received sublingual drops of either cannabis extracts or a placebo (olive oil) three times daily for a period of 16 weeks.
"Patients in the investigational group experienced a significantly greater reduction in sleep disturbances, and in agitation and aggression sub-score using two different measurement tools. The improvements were accompanied with non-serious side-effects," authors reported. "We recommend conducting a large scale randomized controlled trial on behavioral disturbances related to dementia and to compare clinical sub-types of dementia."
The findings are consistent with those of other studies – such as those here, here, and here – reporting that the use of either cannabis flowers or extracts mitigates agitation in dementia patients.
Full text of the study, "Effects of rich cannabidiol oil on behavioral disturbances in patients with dementia: A placebo controlled randomized clinical trial," appears in Frontiers in Medicine.
Analysis: Medical Cannabis Products Safe and Effective for Older Adults
Ontario, Canada: Medical cannabis products are safe and effective for older adults with chronic pain conditions, according to data published in The Journal of Cannabis Research.
Researchers assessed the safety and efficacy of cannabis products in a cohort of medically authorized Canadian patients age 65 or older. Subjects in the study used cannabis for at least three months.
Consistent with other studies assessing the use of cannabis by seniors, investigators reported that marijuana treatments were safe, well-tolerated, and associated with meaningful reductions in pain. "No serious AEs (adverse events) were reported, and non-serious AEs were experienced in less than 12 percent of the cohort," they acknowledged.
Most patients in the study reported no prior experience with cannabis. Most initially purchased cannabis products either high in CBD or containing equal ratios of CBD and THC. Participants typically preferred cannabis oils over other formulations.
Authors concluded, "Our findings inform the underexplored area of medical cannabis use in this population and suggest that medical cannabis is associated with therapeutic effects on pain in older adults with an acceptable safety profile."
Full text of the study, "Medical cannabis authorization patterns, safety, and associated effects in older adults," appears in The Journal of Cannabis Research.
Review: Available Data Supports the Use of CBD for Treatment of Social Anxiety
New Haven, CT: Data indicates that CBD is "effective" for improving social anxiety and suggests that it may have "key benefits over existing pharmacotherapies" for social anxiety disorder (SAD), according to a systemic review of human studies published in the journal Psychiatry Research Communications.
A pair of researchers affiliated with Yale University reviewed data from seven studies involving 278 total participants.
Authors reported: "Overall, the literature reviewed supports the anxiolytic effect of CBD administration, both among healthy volunteers undergoing experimental social anxiety paradigms, as well as individuals with SAD. ... Additionally, CBD may have key advantages over existing treatments, including a rapid course of action, reduced abuse liability and potential for drug interactions with alcohol and opioids, as well as reduced sedative and cognitive side effects."
They concluded: "Existing data suggest that acute administration of CBD significantly attenuates social anxiety, without significant sedation or cognitive impairment. However, additional research is needed to determine optimal dosing among individuals with SAD, assess the time-course of CBD's acute effects, examine the efficacy and side effect profile of chronic CBD administration, assess sex differences in the use of CBD for social anxiety, as well as investigate CBD's mechanisms of action."
Open-label trial data published in June in The Journal of Clinical Psychiatry reported that the adjunctive use of CBD safely and effectively reduces severe anxiety in young people with treatment-resistant anxiety disorders.
Social anxiety disorder is characterized by clinical fear of one or more specific social situations. Some seven percent of US adults are estimated to have suffered from SAD within the past year.
Full text of the study, "Systemic literature review of human studies assessing the efficacy of cannabidiol for social anxiety," appears in Psychiatry Research Communications.
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