A Cross-Sectional Survey of Medical Cannabis Users : Patterns of Use and Perceived Efficacy
Michelle Sexton, Carrie Cuttler, John S. Finnell, and Laurie K. Mischley
Cannabis and Cannabinoid Research, 2016, Volume 1.1, 131-138
DOI: 10.1089/can.2016.0007
Abstract
Background: The political climate around Cannabis as a medicine is rapidly changing. Legislators are adopting policies regarding appropriate medical applications, while the paucity of research may make policy decisions around conditions for which Cannabis is an effective medicine difficult.
Methods: An anonymous online survey was developed to query medical Cannabis users about the conditions they use Cannabis to treat, their use patterns, perception of efficacy, and physical and mental health. Participants were recruited through social media and Cannabis dispensaries in Washington State.
Results: A total of 1429 participants identified as medical Cannabis users. The most frequently reported conditions for which they used Cannabis were pain (61.2%), anxiety (58.1%), depression (50.3%), headache/migraine (35.5%), nausea (27.4%), and muscle spasticity (18.4%). On average, participants reported an 86% reduction in symptoms as a result of Cannabis use; 59.8% of medical users reported using Cannabis as an alternative to pharmaceutical prescriptions. Global health scores were on par with the general population for mental health and physical health.
Conclusions: While patient-reported outcomes favor strong efficacy for a broad range of symptoms, many medical users are using Cannabis without physician supervision and for conditions for which there is no formal research to support the use of Cannabis (e.g., depression and anxiety). Future research and public policy should attempt to reduce the incongruence between approved and actual use.
Background
Cannabis has been used medicinally for a variety of ailments for millennia.1 The legalization of medical marijuana in the United States began in 1996, expanding to 25 States and the District of Columbia.2 Although medical use has become increasingly common, scholarly reports on locally accessed over-the-counter Cannabis are sparse.
Research on the therapeutic potential of Cannabis has been significantly hindered by Schedule 1 status and by the National Institute on Drug Abuse policy on the legal supply of Cannabis for research. Nevertheless, mounting evidence from controlled studies has provided evidence for the efficacy of Cannabis in the treatment of some medical conditions and symptoms. Specifically, controlled studies have revealed that cannabinoids demonstrate therapeutic potential as an analgesic, antiemtic and appetite stimulant; for Tourette’s syndrome, post-traumatic stress disorder, multiple sclerosis, epilepsy, movement disorders, glaucoma, and headaches.3–8 However, the external validity of these studies is limited by small sample size, oral administration of Cannabis extracts, administration of isolated cannabinoids, and lack of patient-reported outcomes (PROs). These studies may not represent outcomes for patients using locally accessed inhaled Cannabis or adequately address the potential for cannabis to simply improve quality of life (QOL).
States that have approved medical Cannabis typically define diagnoses for which doctors can recommend Cannabis. Commonly accepted conditions include pain, multiple sclerosis, nausea, spasms, seizures, or other chronic and debilitating conditions.9 Despite restrictions on which diagnoses are sanctioned for medical use, clinical experience demonstrates that patients often report relief from a wide variety of symptoms or diagnoses. These patients may also be using Cannabis alongside or in lieu of prescription drugs. It is largely unknown what is the perceived efficacy or effect on global functioning and well-being. The goal of this study was to collect epidemiologic data to inform medical practice, research, and policy, as well as to provoke discussion about the discrepancies between medico-legal recommendations and PROs.
can.2016.0007