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Study: Medical Cannabis Associated With Symptom Improvements In Patients With Major Depressive Disorder
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.
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Twin Study: Lifetime Cannabis Exposure Not Linked To Significant Changes In Mental Health Or Other Psychosocial Outcomes
Minneapolis, MN: The cumulative use of cannabis over several decades is not associated with a significantly elevated risk of either psychiatric disorders, cognitive decline, or other adverse psychosocial outcomes, according to longitudinal data published in the Journal of Psychopathology and Clinical Science.
Investigators affiliated with the University of Minnesota and the University of Colorado assessed the long-term impact of cannabis use on psychiatric and psychosocial outcomes in a sample of more than 4,000 adult twins. Subjects were assessed from 1994 to 2021.
“This study suggests that lifetime exposure to cannabis has few persistent effects on mental health and other psychosocial outcomes,” researchers reported. “We did not identify within-pair differences in cognitive ability. … Cannabis consumption did not predict within-pair differences in psychoticism.”
Researchers cautioned that heavy cannabis use could elevate the risk of so-called ‘cannabis use disorder,’ tobacco use, and experimentation with other controlled substances.
The study’s authors concluded: “Broadly speaking, our results do not support a causal relationship between lifetime average cannabis frequency and most of the substance use, psychiatric, and psychosocial outcomes assessed here. Rather, genetic and familial confounding most likely explain the relationships between cannabis use and the negative outcomes associated with it. ... The lack of within-pair effects, or small effects for those existing within-pair differences, in our primary outcome suggest that cumulative cannabis use does not have large, or lasting effects on many psychosocial outcomes.”
Full text of the study, “Limited psychological and social effects of lifetime cannabis use frequency: Evidence from a 30-year community study of 4,078 twins,” appears in the Journal of Psychopathology and Clinical Science.
Survey: Pain Patents Report That Cannabis Is “More Effective” Than Conventional Medications
Berlin, Germany: Patients with chronic pain and other conditions report that cannabis is often more effective than conventional treatments, according to survey data published in the journal Frontiers in Medicine.
German researchers surveyed patients’ experiences with cannabis products. (Plant cannabis and cannabinoid treatments, such as , were legalized by prescription use in Germany in 2017; however, such products are typically only authorized when patients are unresponsive to traditional therapies.) Over 200 patients participated in the survey. Most respondents suffered from chronic pain and over two-thirds of the survey’s participants consumed cannabis flowers or plant-derived extracts.
Consistent with numerous other studies, patients reported reductions in their daily pain following cannabis therapy. Patients also said that they were less likely to be either anxious or depressed while using cannabis. Participants reported “greater satisfaction” with cannabis and said that it was “more effective” than their prior therapies. Ninety-four percent of those surveyed reported holding more positive attitudes toward cannabis following treatment.
“The results of this cross-sectional survey suggest that most surveyed outpatients treated with prescription cannabinoids in Germany subjectively experience health benefits and symptom reduction associated with these therapies,” the study’s authors concluded.
Full text of the study, “Patients’ perspectives on prescription cannabinoid therapies: A cross-sectional, exploratory, anonymous, one-time web-based survey among German patients,” appears in Frontiers in Medicine.
Study: Cannabis/opioid Co-administration Effective For Hospice Patients
New Haven, CT: Hospice patients administered plant-derived CBD-dominant capsules experience significant pain relief and reduce their daily opioid intake, according to data published in the American Journal of Hospice & Palliative Care.
Researchers affiliated with Yale University assessed the efficacy of the adjunctive use of cannabis products in a cohort of 66 hospice patients. Subjects in the study were administered oral capsules containing either 40mg CBD/1.5mg THC or 80mg CBD/3mg THC. All patients enrolled in the study were taking opioids for pain management.
Investigators reported: “Combination therapy led to a statistically significant reduction in pain intensity over time, aligning with previous research suggesting that cannabinoids … can modulate pain pathways and enhance the analgesic effects of opioids.”
They further acknowledged, “The average opioid dose used in combination with medical cannabis in our study decreased over time – while patients simultaneously showed statistically significant improved pain scores. While the decrease in opioid dose did not reach statistical significance, this trend may support a stabilizing effect of combination therapy on opioid dose.”
The study’s authors concluded: “Our study highlights the potential benefit of medical cannabis co-administration with opioid therapy for pain management in hospice inpatients, demonstrating statistically significant pain reduction over time with minimal adverse events. These findings contribute to the growing body of evidence supporting the use of medical cannabis as an adjunctive treatment for pain management.”
The findings are consistent with those of other studies reporting that the co-administration of either smoked cannabis or oral cannabinoids augments the pain-relieving effects of opioids, even when both substances are administered at subtherapeutic doses.
Full text of the study, “Medical marijuana for pain management in hospice care as a complementary approach to scheduled opioids: A single arm study,” appears in the American Journal of Hospice & Palliative Care.
Survey: Some Physicians Endorse Cannabis-Based Treatments for Children with Cerebral Palsy
Bern, Switzerland: Physicians are recommending cannabis-based treatments for children suffering from cerebral palsy (CP), according to survey data published in the journal Children.
Swiss researchers surveyed 70 physicians with experience treating children with cerebral palsy. Physicians participating in the survey resided in Europe, North America, and Australia.
Forty-seven percent of respondents reported having authorized cannabis-based therapies (e.g., Dronabinol, Epidiolex, whole-plant cannabis extracts, or CBD) to their pediatric patients, typically as an adjunctive therapy. Doctors were most likely to recommend cannabinoids for treating seizures, spasticity, and pain. Sixty-nine percent of respondents reported that cannabis-based treatments provided either “strong” or “moderate” effects on CP symptoms.
The study’s authors concluded: “This international online survey assessed the prescribing practices of cannabinoids in children with CP by their treating physicians. The participating physicians acquired their knowledge about cannabinoids mainly outside their medical training. The physicians frequently prescribed differing formulas of cannabinoids for various indications in children with CP. The most common indications were epilepsy, spasticity, and pain, and treatment was initiated as co-medication or second-line treatment. Overall, physicians perceived a moderate efficacy of cannabinoids and no long-term side effects.”
Survey data published last year in the journal Orthopedics reported that 17 percent of US pediatric patients with CP are using CBD supplements to mitigate disease symptoms.
Full text of the study, “Prescription practices of cannabinoids in children with cerebral palsy worldwide -- A survey of the Swiss cerebral palsy registry,” appears in Children.
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Study: Cannabis Use Not Associated With Elevated Risk of Atrial Fibrillation
San Francisco, CA: Middle-aged adults with a history of cannabis consumption do not possess an increased risk of suffering from atrial fibrillation (AFib), according to longitudinal data published in the journal Heart Rhythm.
Investigators affiliated with the University of California, San Francisco assessed the relationship between cannabis and AFib (irregular heartbeat) in a cohort of more than 150,000 subjects between the ages of 40 and 69. The cohort included non-users, occasional users, and frequent users. Researchers tracked the study’s participants for six years.
Researchers found “no evidence” that subjects who used cannabis were more likely than non-users to suffer from atrial fibrillation.
“Among a large, prospective cohort, we were unable to find evidence that occasional cannabis use [defined as more than 100 times] was associated with a higher risk of incident AF,” the study’s authors concluded. “To our knowledge, this is the first longitudinal cohort study to assess such recreational use and the first to report an absence of a relationship between cannabis use and risk of AF.”
AFib is associated with an increased risk of stroke and other adverse cardiovascular events.
Data published in October reported that middle-aged cannabis consumers do not possess an elevated risk of atherosclerosis (hardening of the arteries) as compared to never users. 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 recently in the journal Addiction reported that adults engaged in problematic cannabis use possess an elevated risk of adverse cardiovascular outcomes.
Full text of the study, “Cannabis use and incident of atrial fibrillation in a longitudinal cohort,” appears in Heart Rhythm.
Analysis: Legalization Not Associated With Spikes in Incidences of Marijuana-Related Psychosis
London, Canada: The legalization of the Canadian marijuana market is not associated with increases in rates of cannabis-related psychosis, according to data published in the International Journal of Drug Policy.
A team of Canadian researchers examined regional changes in health services use and incidences of psychotic disorders during the months immediately following legalization. (Canada legalized marijuana possession and retail sales in October 2018.)
They reported, “We did not find evidence of increases in health service use or incident cases of psychotic disorders over the short-term (17 month) period following cannabis legalization.” They cautioned, however, that “a longer post-legalization observation period ... is needed to fully understand the population-level impacts of non-medical cannabis legalization.”
The finding is consistent with the conclusions of a 2022 study published in the Canadian Journal of Psychiatry. Its authors similarly determined that the “implementation of Canada’s cannabis legalization framework was not associated with evidence of significant changes in cannabis-induced psychosis or schizophrenia ED [emergency department] presentations.”
In the United States, state-level marijuana legalization laws have not been associated with a statistically significant increase in psychosis-related health outcomes. Specifically, a 2022 paper published in the Journal of the American Medical Association (JAMA) Network Open found no association between the adoption of marijuana legalization and overall rates of psychosis-related diagnoses or prescribed antipsychotics.
Although the use of cannabis and other controlled substances tends to be more common among those with psychotic illnesses, studies indicate that lifetime incidences of marijuana-induced psychosis are relatively rare among those who do not have a prior psychiatric diagnosis. According to one recently published study, fewer than one-half of one percent of cannabis consumers had ever reported experiencing psychotic symptoms requiring medical intervention – a percentage that is lower than the rate associated with alcohol.
Full text of the study, “Impact of non-medical cannabis legalization with market restrictions on health service use and incident cases of psychotic disorder in Ontario, Canada,” appears in the International Journal of Drug Policy.
Analysis: Legalization Not Associated With Spikes in Incidences of Marijuana-Related Psychosis
London, Canada: The legalization of the Canadian marijuana market is not associated with increases in rates of cannabis-related psychosis, according to data published in the International Journal of Drug Policy.
A team of Canadian researchers examined regional changes in health services use and incidences of psychotic disorders during the months immediately following legalization. (Canada legalized marijuana possession and retail sales in October 2018.)
They reported, “We did not find evidence of increases in health service use or incident cases of psychotic disorders over the short-term (17 month) period following cannabis legalization.” They cautioned, however, that “a longer post-legalization observation period … is needed to fully understand the population-level impacts of non-medical cannabis legalization.”
The finding is consistent with the conclusions of a 2022 study published in the Canadian Journal of Psychiatry. Its authors similarly determined that the “implementation of Canada’s cannabis legalization framework was not associated with evidence of significant changes in cannabis-induced psychosis or schizophrenia ED [emergency department] presentations.”
In the United States, state-level marijuana legalization laws have not been associated with a statistically significant increase in psychosis-related health outcomes. Specifically, a 2022 paper published in the Journal of the American Medical Association (JAMA) Network Open found no association between the adoption of marijuana legalization and overall rates of psychosis-related diagnoses or prescribed antipsychotics.
Although the use of cannabis and other controlled substances tends to be more common among those with psychotic illnesses, studies indicate that lifetime incidences of marijuana-induced psychosis are relatively rare among those who do not have a prior psychiatric diagnosis. According to one recently published study, fewer than one-half of one percent of cannabis consumers had ever reported experiencing psychotic symptoms requiring medical intervention – a percentage that is lower than the rate associated with alcohol.
Full text of the study, “Impact of non-medical cannabis legalization with market restrictions on health service use and incident cases of psychotic disorder in Ontario, Canada,” appears in the International Journal of Drug Policy.
Analysis: Few Serious Adverse Events Associated With Medical Cannabis Use
Montreal, Canada: Few patients authorized to consume medical cannabis products report experiencing serious side effects, according to data published in the journal Drug Safety.
McGill University researchers analyzed data from a cohort of nearly 3,000 authorized Canadian medical cannabis patients. Data regarding adverse events was collected by enrollees’ attending physicians over a period of several years.
A total of 108 patients (about four percent of the cohort) reported experiencing marijuana-related adverse events. The most frequently reported side effects were dizziness, somnolence, headache, nausea, and vomiting.
Patients with mental health disorders were no more likely than others to report side effects from cannabis treatment. The latter finding is consistent with data from a 2022 study, which found that authorized Canadian patients were at low risk for psychiatric hospitalizations resulting from their medical cannabis use.
The study’s authors concluded: “This is the first comprehensive, population-level prospective study to contribute evidence that MC [medical cannabis] is safe for a wide variety of symptoms. ... No new safety concerns were identified relative to the published literature, although notable differences in AE [adverse events] profile between modes of administration and cannabinoid content ratios should be considered by health professionals.”
Full text of the study, “A descriptive analysis of adverse event reports from the Quebec Cannabis Registry,” appears in Drug Safety.