The Health Benefits of Medical Marijuana As Reported by Users

Using cannabis for medical reasons has been linked in a study to outcomes including better sleep, less anxiety, and taking fewer prescription medications.

The paper, published in Cannabis and Cannabinoid Research, involved 1,276 people recruited from the registry and social media pages of the Realm of Caring Foundation, a non-profit that focuses on therapeutic cannabis research and education. Of the total respondents, 808 were defined as cannabis users, either being patients with a health condition who took the substance (524) or their carers (284). The remaining 468 who acted as the control group were made up of 271 people considering using medicinal cannabis, and 197 carers thinking of giving it to a dependent child or adult.

Between April 2016 and February 2018, the researchers invited participants to complete online surveys every three months, with 33 percent doing one or more follow-up. In the study, the researchers referred to all those who filled out the surveys as participants, and those who had health conditions as patients.

The most common health conditions among participants were neurological problems such as epilepsy or multiple sclerosis; chronic pain, like fibromyalgia, or back pain; and psychiatric issues such as anxiety, depression or post-traumatic stress disorders.

The respondents answered questions about variables including whether they or their dependent used medication or healthcare services, experienced pain, anxiety or depression, how they slept, and their quality of life. Most participants were white (79 percent), and female (63 percent).

Compared with the controls, cannabis users reported having a better quality of life and were more satisfied with their health. They also slept better, experienced less severe pain, used fewer prescription medications, and were less likely to have visited an emergency department in the past month. When it came to mental health, they had lower levels of anxiety, and depression.

When the team looked at controls who started using cannabis after they completed the first survey, they found these participants "showed significant health improvements at follow-up."

The study also revealed that only 27 percent of those who used cannabis had been explicitly told to do so by a doctor. The team called said this result was "somewhat concerning" as having a medical professional involved in a patient's treatment can help keep them safe. In contrast, 45 percent said a physician did not recommend it.

For 29 percent of respondents, using cannabis was a "last resort" treatment, while it was a first-line therapy for 11 percent, a second-line therapy for 18 percent, and a supplementary treatment for 39.

In terms of which products patients used, most (58 percent) took those largely containing the active cannabis ingredient cannabidiol (CBD), with an average dose of 79 mg per day. Those who used products mostly containing THC (13 percent) had 3 mg per day. These measures were lower than those used in past human lab studies and clinical trials, the researchers noted. Over a fifth (21 percent) didn't know or specify the type of cannabis product used.

More than 2.1 million people in the U.S. are registered with medicinal cannabis programs in their state for over 40 health problems, according to research cited by the authors.

"Of note, most participants in this study were using cannabis for health conditions other than the FDA-approved [U.S. Food and Drug Administration] uses of CBD or THC, and for which effective doses have not been determined in controlled clinical trials," the authors wrote. These include THC for weight loss in AIDS patients, and nausea and vomiting in cancer patients having chemotherapy; or CBD for the rare forms of epilepsy known as Dravet and Lennox/Gastaut syndromes.

Co-author Ryan Vandrey, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, said in a statement: "It wasn't surprising to me that people claim to feel better when using medical cannabis, but it was unexpected to see that these people utilized less health care resources.

"When we evaluated people before and after using medical cannabis, and then saw the exact same changes seen in the cross-sectional comparison between cannabis users and controls, that's when we knew we had a compelling validation showing actual medical benefit."

Vandrey said: "This study was a 30,000-foot view of the landscape and now we need to drill down to see what conditions are actually benefited from medical cannabis use."

Ian Hamilton, an expert in drug use and mental health at the Department of Health Sciences at the U.K.'s University of York, who did not work on the study, told Newsweek that those who used cannabis were less likely to use health services was "surprising and will clearly be a welcome aspect for most patients who would also want to reduce their reliance and need for hospital and out-patient services."

Hamilton said the main limitation of the findings was that the team reported statistically significant results in reductions in anxiety and pain of users "but it is questionable how much a few percentage points reduction in anxiety or pain would actually be noticed by a patient even if it is statistically significant."

In addition, a "significant" number of participants dropped out. "Although this isn't unusual it does raise the question of why they dropped out, perhaps their condition worsened or even improved, unfortunately we don't know," he said.

The results may also have been biased as participants either used cannabis or were considering it, meaning they may already believe it is effective—which could produce more positive findings, said Hamilton.

"Also the research was funded by the organization that some of the participants were drawn from and the researchers had received funding from the cannabis industry, although this is similar to research conducted in the pharmaceutical industry, it isn't clear how independent and objective the researchers and participants were," he said.

While the study has some encouraging results, Hamilton said, it's too early to recommend using cannabis for a range of health conditions such as pain or anxiety.

"This study does help provide more detail and indicates some potential benefits but it will be important for further research to explore whether these same results can be found with people who perhaps aren't already convinced of the benefits these products have," he said.

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