Medical cannabis use in Australian patients with chronic health issues linked to significant improvements in overall health-related quality of life and fatigue levels
Cannabis therapy also linked to improvements in anxiety, depression, and pain levels—though no changes in sleep disturbance levels reported
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Australian patients with chronic health issues prescribed medical cannabis showed significant improvements in overall health-related quality of life and fatigue in the first three months of use, along with improvements in anxiety, depression, and pain. Interestingly, cannabis therapy did not seem to improve reported sleep disturbances, according to a study published September 6, 2023 in the open-access journal PLOS ONE by Margaret-Ann Tait from the University of Sydney, Australia, and colleagues.
Since 2016 in Australia, medical cannabis has been approved for prescription to patients with health conditions unresponsive to other treatment. Tait and colleagues surveyed a group of Australians with chronic health conditions prescribed medical cannabis to better understand any changes in patient-reported outcomes following cannabis treatment in this population.
The authors used survey responses from 2327 Australian patients with chronic health issues prescribed medical cannabis (THC and CBD dissolved in a medium-chain triglyceride (MCT) carrier oil) between November 2020 and December 2021. Patients were surveyed about their self-reported health-related quality of life, pain, sleep, anxiety, and depression prior to beginning cannabis therapy, after two weeks of treatment, then once a month for three months.
63 percent of the surveyed patients were female, with an average age of 51 years (range 18-97 years). The most-reported conditions being treated were chronic pain (69 percent); insomnia (23 percent); anxiety (22 percent); and anxiety/depression (11 percent); half of patients were being treated for more than one condition. Patients reported significant, clinically-meaningful improvements in health-related quality of life and fatigue measurements across the three months surveyed. Patients also reported clinically meaningful reductions in pain and significant improvements for moderate-severe anxiety and depression. However, though many patients were prescribed cannabis for insomnia, there were no overall improvements in patient-reported sleep disturbance.
The authors did not measure adverse effects as part of the study, though 30 patients formally withdrew from the study due to “unwanted side effects”. Regardless, these results suggest medical cannabis may be effective in helping manage previously-untreatable chronic conditions. The authors also note that more research and development of the cannabis oil products used in this study may be needed in order to successfully treat patients with insomnia and sleep disorders.
The authors add: “Within the first three months of medicinal cannabis therapy, participants reported improvements in their health-related quality of life, fatigue, and health conditions associated with anxiety, depression, and pain.”
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In your coverage please use this URL to provide access to the freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0290549
Citation: Tait M-A, Costa DS, Campbell R, Norman R, Warne LN, Schug S, et al. (2023) Health-related quality of life in patients accessing medicinal cannabis in Australia: The QUEST initiative results of a 3-month follow-up observational study. PLoS ONE 18(9): e0290549. https://doi.org/10.1371/journal.pone.0290549
Author Countries: Australia
Funding: The University of Sydney received funding from Little Green Pharma Ltd. to support CR and MT to conduct this study. The funder played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; nor in the decision to submit the article for publication. The study was independently investigator-led and all authors had full access to all data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
JOURNAL
PLoS ONE
METHOD OF RESEARCH
Survey
SUBJECT OF RESEARCH
Not applicable
ARTICLE TITLE
Health-related quality of life in patients accessing medicinal cannabis in Australia: The QUEST initiative results of a 3-month follow-up observational study
ARTICLE PUBLICATION DATE
6-Sep-2023
COI STATEMENT
The University of Sydney received funding from Little Green Pharma Pty Ltd. to support MT and CR to conduct the submitted work; LW is a paid employee of Little Green Pharma Pty Ltd.; no other relationships or activities that could appear to have influenced the submitted work. All authors have completed the ICMJE uniform disclosure form. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Cannabis-involved traffic injury emergency department visits after cannabis legalization and commercialization
JAMA Network Open
Peer-Reviewed PublicationAbout The Study: This study found large increases in cannabis involvement in emergency department visits for traffic injury over time in Ontario, Canada, which may have accelerated following nonmedical cannabis commercialization. Although the frequency of visits was rare, they may reflect broader changes in cannabis-impaired driving. Greater prevention efforts, including targeted education and policy measures, in regions with legal cannabis are indicated.
Authors: Daniel T. Myran, M.D., M.P.H., of the University of Ottawa in Ottawa, Ontario, Canada, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2023.31551)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
JOURNAL
JAMA Network Open
Commercialization of cannabis linked to increased traffic injuries
Ottawa, ON, September 5, 2023 – Annual rates of emergency department visits for cannabis-involved traffic injury increased by 475 percent over 13 years, according to a new study from The Ottawa Hospital, Bruyère Research Institute, and ICES.
The study examined cannabis-involvement in emergency department (ED) visits for traffic injuries between 2010 and 2021 and looked for changes after the legalization of cannabis in October 2018 and following the commercialization of the legal market (expanded cannabis products and retail stores), which overlapped with the COVID-19 pandemic.
“Our findings highlight a concerning increase in cannabis-involvement in traffic-injury emergency visits over time, with even sharper spikes following the phases of legalization and commercialization,” says lead author and ICES post-doctoral trainee Dr. Daniel Myran, who is also a family physician and fellow at the Bruyère Research Institute and The Ottawa Hospital. “Conversely, alcohol-involvement in traffic injury ED visits did not increase over the study period, which suggests that legalization of cannabis has played an important role in rising rates.”
While documented cannabis-involvement in traffic injuries ED visits were very rare, the data raise concern about potential broader increases in cannabis-impaired driving which may have accelerated after legal market expansion.
Published in JAMA Network Open, the researchers examined medical record data of 947,604 ED visits for traffic in in Ontario, Canada. They included records from January 2010 and December 2021, but excluded ED visits from individuals who were younger than 16 (minimum legal age of driving) at the time of the ED visit.
Key findings include:
- The number of cannabis-involved traffic injury ED visits increased significantly. Annual rates of visits surged by 475 percent, from 0.18 visits per 1,000 total motor vehicle collisions in 2010 to 1.01 in 2021.
- Legalization of non-medical cannabis with restrictions was associated with a 94 percent increase in the rate of cannabis-involved traffic injury ED visits compared to the pre-legalization period. The subsequent phase of commercialization, which overlapped with the COVID-19 pandemic, saw an even greater increase of 223 percent in rates compared to the pre-legalization period.
- Male sex (assigned at birth), living in lower-income neighborhoods, being aged 19-21, and having a prior cannabis-related ED visit were associated with higher rates of ED visits.
“The observed increase in cannabis-involved traffic injuries might reflect broader trends in cannabis-impaired driving,” says Dr. Myran. “The study highlights the need for enhanced prevention efforts, including targeted education and policy measures.”
One limitation of the study is that ED staff may have been more aware of the potential for cannabis-related traffic injuries after legalization, leading to higher levels of testing for cannabis. The researchers believe that this would not have explained all the observed increase due to the severity of traffic injuries, which would be thoroughly investigated despite policy or testing procedure changes.
The authors caution that it is too soon to understand the impact of cannabis legalization on road safety particularly because of the enormous decline in driving and mobility during the pandemic, which overlapped with much of the legalization period.
The study, “Cannabis-involvement in traffic injury emergency department visits after the legalization and subsequent commercialization of non-medical cannabis” was published in JAMA Network Open.
Author block: Myran DT, Gaudreault A, Pugliese M, Manuel D, Tanuseputro P.
ICES is an independent, non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario
The Bruyère Research Institute supports investigators who contribute to a better, more responsive health care system that delivers the best care to patients, residents, and families. The Institute provides solutions to improve the health and health care of aging and vulnerable Canadians. To learn more, visit http://www.bruyere.org.
The Ottawa Hospital (TOH) is one of Canada’s top learning and research hospitals where we are guided by our vision to provide the world-class and compassionate care we would all want for our loved ones. Our multi-campus hospital, affiliated with the University of Ottawa, is home to the Regional Trauma Centre and Cancer Centre, and to discoveries that are adopted globally. Backed by generous support from the community, we are focused on reshaping the future of health care to improve the health of our diverse population of patients from Eastern Ontario, Western Quebec, and Nunavut. For more information about The Ottawa Hospital, visit OttawaHospital.on.ca.
The University of Ottawa is home to over 50,000 students, faculty and staff, who live, work and study in both French and English. Our campus is a crossroads of cultures and ideas, where bold minds come together to inspire game-changing ideas. We are one of Canada’s top 10 research universities—our professors and researchers explore new approaches to today’s challenges. One of a handful of Canadian universities ranked among the top 200 in the world, we attract exceptional thinkers and welcome diverse perspectives from across the globe. www.uottawa.ca
JOURNAL
JAMA Network Open
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Cannabis-Involved Traffic Injury Emergency Department Visits After Cannabis Legalization and Commercialization
ARTICLE PUBLICATION DATE
6-Sep-2023
COI STATEMENT
Dr Myran reported grants from Canadian Institutes of Health Research during the conduct of the study. No other disclosures were reported.
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