Medical Marijuana
October 24, 2023 - Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial.
Objective: Despite the staggering consequences of the opioid epidemic, limited nonopioid medication options have been developed to treat this medical and public health crisis. This study investigated the potential of cannabidiol (CBD), a nonintoxicating phytocannabinoid, to reduce cue-induced craving and anxiety, two critical features of addiction that often contribute to relapse and continued drug use, in drug abstinent individuals with heroin use disorder.
Methods: This exploratory double-blind randomized placebo controlled trial assessed the acute (1hour, 2hours, and24 hours), short-term (3 consecutive days), and protracted (7 days after the last of three consecutive daily administrations) effects of CBD administration (400 or 800mg, once daily for 3 consecutive days) on drug cue–induced craving and anxiety in drug-abstinent individuals with heroin use disorder. Secondary measures assessed participants positive and negative affect, cognition, and physiological status.
Results: Acute CBD administration, in contrast to placebo, significantly reduced both craving and anxiety induced by the presentation of salient drug cues compared with neutral cues. CBD also showed significant protracted effects on the measures 7days after the final short-term (3-day) CBD exposure. In addition, CBD reduced the drug cue–induced physiological measures of heart rate and salivary cortisol levels. There were no significant effects on cognition, and there were no serious adverse effects.
Conclusions: CBD’s potential to reduce cue-induced craving and anxiety provides a strong basis for further investigation of this phytocannabinoid as a treatment option for opioid use disorder.
December 4, 2022 - Placebo Response and Media Attention in Randomized Clinical Trials Assessing Cannabis-Based Therapies for Pain: A Systematic Review and Meta-Analysis (Gedin et al., 2022). There is an increasing interest in medicinal cannabis for treatment of persistent pain, an ailment that is common and often difficult to treat. The possible impact of patients’ expectations that cannabis will prove to be effective for pain may contribute to an elevated placebo effect, which may bias results when cannabis-based medications are tested in trials and inflate personal testimonials.
To evaluate the size of placebo responses in randomized clinical trials in which cannabinoids were compared with placebo in the treatment of pain, the authors conducted a systematic literature search within the MEDLINE and Embase databases. Studies published until September 2021 were considered. Only studies with a double-blind, placebo-controlled design with participants 18 years or older with clinical pain of any duration were included. This led to 20 studies, including 1,459 individuals.. Meta-analytic statistics were applied to these studies.
The main result was that pain intensity was associated with a significant reduction in response to placebo, in the range of a moderate to large effect size.
The authors conclude the following: “Placebo contributes significantly to pain reduction seen in cannabinoid clinical trials. The positive media attention and wide dissemination may uphold high expectations and shape placebo responses in future trials, which has the potential to affect the outcome of clinical trials, regulatory decisions, clinical practice, and ultimately patient access to cannabinoids for pain relief.”
December 10, 2021 - Cannabis and Medicine: The authors of this article searched PubMed and PsycInfo to locate published manuscripts that pertained to cannabis as medicine for medical and psychiatric conditions; 841 articles that met criteria for inclusion were reviewed by two or more authors. Two main conclusions from this review: (1) There are currently no psychiatric indications approved by the U.S. Food and Drug Administration (FDA) for cannabinoids, and there is limited evidence supporting the therapeutic use of cannabinoids for treatment of psychiatric disorders. (2) Evidence supporting cannabinoid prescription beyond the FDA indications is strongest for the management of pain and spasticity.
March 26, 2020: Mapping cannabis potency in medical and recreational programs in the United States.The current lack of knowledge surrounding advertised potencies in the legal cannabis market limits the ability to generate clear policies regarding online advertising to protect patients that are willing to use cannabis for their condition.
August 9, 2019: Medical Use of Cannabis in 2019. Insufficient evidence exists for the use of medical cannabis for most conditions for which its use is advocated.
July 27, 2019: Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use. Results suggest marijuana, especially for military personnel experiencing elevated PTSD symptoms may negatively impact suicidal thoughts and behavior.
February 1, 2019: Should Physicians Recommend Replacing Opioids With Cannabis? Recent state regulations (eg, in New York, Illinois) allow medical cannabis as a substitute for opioids for chronic pain and for addiction. Yet the evidence regarding safety, efficacy, and comparative effectiveness is at best equivocal for the former recommendation and strongly suggests the latter—substituting cannabis for opioid addiction treatments is potentially harmful. Neither recommendation meets the standards.
January 23, 2019: New Congressional Bill Requires VA To Study Medical Marijuana For Veterans. SAMMn supports a new bill introduced by US. House lawmakers. The VA Medicinal Cannabis Research Act would require the U.S. Department of VA to conduct studies on the potential therapeutic use of cannabis for conditions that commonly afflict veterans, including chronic pain and post-traumatic stress disorder.
December 3, 2018: Alzheimer’s added to Minnesota’s medical marijuana list. State adding disease to list eligible for treatment with cannabis, despite some reservations.
2018: Cannabis Use for Medicinal Purposes among Canadian University Students. A piece from SAMMn’s Research Advisor, Dr. Ken Winters. Medicinal cannabis use occurs among university students. None of the ailments listed by medicinal users meet the Canadian Family Physicians prescribing guidelines, and most are not among those viewed by the National Academies of Science, Engineering, and Medicine as having strong evidence for therapeutic value. The results raise concerns for health care providers who are authorizing or counseling patients’ considering medicinal cannabis.