In the article “Abstracts for the 2023 Cannabis Clinical Outcomes Research Conference (CCORC)” [Med Cannabis Cannabinoids 2023;6(1):102–124; https://doi.org/10.1159/000534044], five abstracts were omitted in error by the conference organizers. The organizers apologize for this omission and provide the five aforementioned abstracts below.
. 2024 Feb 22;7(1):31–33. doi: 10.1159/000537825
Med Cannabis Cannabinoids. 2024 Feb 22;7(1):31.
Background
Cannabis use has increased in prevalence among all age groups over the past decade in the United States. Concurrent to an increased prevalence of use is the increase in routes of cannabis use beyond traditional smoking. Studies have suggested a difference in respiratory disease outcomes based on whether a consumer smoked or vaped cannabis; however, little is known about the cardiovascular health impact of dabbing high concentrates of cannabis and vaping. The purpose of this review is to examine the past 10 years of studies to identify the physical health impact of cannabis vaping compared to cannabis dabbing among all age groups with emphasis on cardiovascular health.
Methods
In February of 2023, a PubMed search was conducted. Inclusion criteria was: (1) manuscripts published between 2010 to 2023; (2) human subjects; (3) manuscripts available in English; (4) manuscripts about cannabis vaping and dabbing. Exclusion criteria for the initial search was: (1) non-cannabis illicit drugs; (2) manuscripts published before 2010; (3) abstracts without a peer-reviewed manuscript. Initial articles yielded were filtered by date relevance, title relevance, abstract relevance, and full paper relevance. The presentation will focus on results from analyzing results individually and synthesizing key findings.
Results
The following number of articles were found based on search term: “cannabis dabbing AND vaping” = 16; “marijuana dabbing and vaping” = 21; “dab and vape” = 3; “cannabinoid dabbing and vape” = 8. Majority of articles examined prevalence estimates of cannabis use by routes of administration: smoking joint, smoking blunts, vaping, dabbing, edibles, butane hash oil use, water pipe use, etc. Adherent articles ranged in topics such as chemical pneumonitis, pulmonary disease, cancer risk, and inflammatory bowel disease. The presentation will summarize dabbing and vaping within respiratory disease, cancer, and inflammatory disease.
Conclusion
Vaping is the second most common route of cannabis use and dabbing is gaining popularity at an increased rate based on articles excluded. Despite the high prevalence, little is known about the physical health impact of these routes of cannabis administration that require a device and high heat. There were no studies published on cardiovascular disease effects.
Med Cannabis Cannabinoids. 2024 Feb 22;7(1):31–32.
Background
The National Academies of Sciences, Engineering, and Medicine (NAS) published a report in 2017 of conclusions on the therapeutic effects of cannabis for over 20 conditions based on the highest quality studies available [1]. Our objective was to compare each state's current qualifying conditions (QCs) with the NAS findings.
Methods
We collected the QCs of each of the 36 states where medical cannabis is legal in 2023 [2]. These conditions were divided into the NAS-established categories into which they fit: substantial evidence of effectiveness (chronic pain), moderate or limited evidence of effectiveness (PTSD), limited evidence of ineffectiveness (glaucoma), and no/insufficient evidence to support effectiveness (epilepsy).
Results
The number of QCs for medical cannabis varied widely between states, with South Dakota having the fewest (5) and Illinois the most (52). While 91.7% of states had at least one QC with substantial evidence, on average, only 9.3% of a state's QCs met this standard. In contrast, 88.9% of states had one or more QCs with limited evidence of ineffectiveness or no/insufficient evidence, and 41.7% of states had more than three of such conditions. Twelve states allowed physicians to recommend medical cannabis at their discretion – while three left the decision entirely up to the physician, requiring no specific QCs whatsoever. Of any state's list of QCs, South Dakota had the highest percentage (20.0%) with substantial evidence, while Massachusetts the lowest (0.0%). Illinois had the highest percentage (53.9%) of QCs not included in the NAS report, while Maryland, Oregon, and South Dakota tied for the lowest percentage (0.0%).
Conclusion
We found that most states are condoning medical cannabis use for conditions that have not been appropriately studied – ALS symptoms, Parkinson's, opioid dependence – or are known to some degree to be ineffective – dementia symptoms and depression. Thirty states listed one or more QCs that were not included in the NAS report. Overall, these data show: (1) a large gap between state-level recommendations for medical cannabis and the quality evidence to support them, and (2) the need for more randomized controlled trials using the products currently available in dispensaries.
Disclosures
B.J.P.'s research is supported by the Pennsylvania Academic Clinical Research Center. The other authors have no disclosures.
References
- [1].National Academies of Sciences, Engineering, and Medicine 2017 . Washington, DC: The National Academies Press; The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. [DOI] [PubMed] [Google Scholar]
- [2].“Medical Marijuana Laws.” NORML, The NORML Foundation, 2 Feb. 2023. https://norml. org/laws/medical-laws/
Med Cannabis Cannabinoids. 2024 Feb 22;7(1):32.
Marijuana and CBD are considered as a potential source to reduce symptoms of anxiety and depression. There are growing trends in anxiety and depression patients whether to use marijuana or CBD alone as a therapy or combine CBD with their prescription medications. This study is designed to understand the potential use of marijuana in older women which remains unknown. Additionally, this study aimed to determine whether marijuana or CBD was associated with improved mental health in women between 50 and 64 years old who substituted their prescription medications (e.g., anti-depressants, anxiety). This was an online crosssectional study evaluating a subset of 258 participants who used either marijuana or CBD in the past 12 months. To compare women who substituted their medication to those who did not we dichotomized the following question “substituted marijuana or CBD for anti-depressants or anxiety prescription drugs” (Yes/No). We used the continuous scores for PHQ8 scale to measure depression and the OASIS scale to measure anxiety symptoms. The t-test was used to measure group differences, and linear regression was used to identify associations between marijuana/CBD use and mental health symptoms. A total of 37% of participants reported moderate to moderately severe symptoms of depression and 46% reported moderate to severe symptoms of anxiety, and 22% substituted marijuana and/or CBD for prescription medication. The mean use for marijuana was 21 days (SD = 65), and CBD was 11 days (SD = 35) per month in the last 12 months. We found significant differences in depression (mean score 11.2 vs. 8.2, p = 0.001) and anxiety (mean score 8.9 vs. 12.3, p = 0.001) symptoms in women who substituted prescription drugs reporting worse mental health outcomes compared to women who did not substitute prescription drugs for marijuana or CBD. The linear regression analysis showed a significant positive association between marijuana/CBD use and anxiety and depression (β 0.32, 95% CI 2.1–4.4; β 0.19, 95% CI 1.3–4.1, respectively) among women who substituted their prescription medication. It is important to understand the potential effect of marijuana or CBD on mental health treatment and drug prescription substitution.
Med Cannabis Cannabinoids. 2024 Feb 22;7(1):32.
Introduction
Many states within the US have enacted medical marijuana laws (MML). However, how MML may impact the prevalence of marijuana, other substance use, and mental health conditions remains unclear. The purpose of this study was to examine differences in substance use, general health, and mental health outcomes in states with and without MML.
Method
This study was a secondary data analysis of the Behavioral Risk Factor Surveillance System (BRFSS) publicly available data collected in 2020 by the Centers for Disease Control and Prevention (CDC). Of 22 states that elected the marijuana use module, 14 states had passed MML (n = 143,151) and 8 states had not (n = 67,744). We used ordinary least squares (OLS) multiple regression analyses for continuous outcome variables and logistic regression analyses for the binary outcomes. For count data outcome variables (e.g., the number of days using marijuana), we used generalized linear modeling with zero-inflated negative binomial distribution in SAS.
Results
People living in states with MML were more likely to be marijuana users (p < 0.001) and have higher levels of marijuana use (p < 0.05), compared to those in non-MML states. Similarly, those living in MML states were more likely to be cigarette smokers and have used e-cigarettes (ps < 0.01). However, residents in MML states were more likely to be non-drinkers, non-binge drinkers, and less likely to drive under the influence (ps < 0.01), compared to those in non-MML states. Although those in MML states reported experiencing better general health (p < 0.001), they reported significantly worse mental health, including more days feeling stressed, depressed or having emotional problems, having depressive disorder, and having fewer hours of sleep (ps < 0.001).
Conclusions
Residents of MML states may be at increased risk to use marijuana and cigarettes as well as experience more mental health symptoms. Although it is unclear if MML influenced those health outcomes or if those with more negative health outcomes are more likely to live in MML states, the findings suggest that MML states should ensure adequate access to substance use and mental health treatment beyond medical marijuana.
Med Cannabis Cannabinoids. 2024 Feb 22;7(1):33.
Background
Endometriosis is a common, chronic inflammatory condition in women due to the presence of endometrial-like tissue found outside the uterus. Endometriosis can cause a myriad of symptoms such as chronic pelvic pain, fatigue, dyspnea, dyspareunia, dyschezia, and dysuria. The chronic health implications for women with endometriosis can lead to a decreased quality of life. Management of endometrial pain can include pain medications, oral contraceptives, laparoscopy, and even hysterectomy. The objective of this study was to determine what evidence exists for the use and effectiveness of medical marijuana (cannabis) for endometriosis related pain.
Methods
The literature for this review was collected from the following databases: PubMed, Web of Science, Cochrane Central Register of Controlled Trials, MEDLINE, and Embase. Cohort studies, case-control studies, cross-sectional surveys, and systematic reviews from 1996 to August 2022 assessing any relationship between marijuana/cannabis use and endometriosis were eligible for inclusion. Duplicate articles, non-accessible full text articles, and articles not published in English were excluded. Retrieved articles were independently reviewed by two reviewers and any discrepancies were resolved by consensus by a third reviewer.
Results
A total of 522 references were identified and retrieved. Following screening, eight articles were included for review: four cross-sectional surveys, two systematic reviews, one retrospective cohort study, and one review of literature. Total participants who used cannabis for endometriosis symptom management was N = 1,817 across five studies. All included studies were from high-income countries where marijuana is legalized medicinally or recreationally. Overall, results showed that cannabis consumption for symptom relief was common among women with endometriosis and some women even reported use of cannabis reduced their use of analgesics.
Discussion
We found no randomized controlled trials on the use of marijuana for endometriosis related pain indicating an important gap for future research given the recent findings that dysfunction in the endocannabinoid system (ECS) may play a role in endometriosis related pain. This study was limited by the lack of literature specifically analyzing the relationship between endometriosis and therapeutic marijuana use. Although, endometriosis is very common, it can often go undiagnosed which may attribute to the lack of literature.