cannabis

Importance: Approximately 27% of adults in the US and Canada report having ever used cannabis for medical purposes. An estimated 10.5% of the US population reports using cannabidiol (CBD), a chemical compound extracted from cannabis that does not have psychoactive effects, for therapeutic purposes.

Observations: Conditions for which cannabinoids have approval from the US Food and Drug Administration include HIV/AIDS-related anorexia, chemotherapy-induced nausea and vomiting, and certain pediatric seizure disorders. A meta-analysis of randomized clinical trials reported a small but significant reduction in nausea and vomiting from various causes (eg, chemotherapy, cancer) when comparing prescribed cannabinoids (eg, dronabinol, nabilone) with placebo or active comparators (eg, alizapride, chlorpromazine; standardized mean difference [SMD], -0.29 [95% CI, -0.39 to -0.18]). A meta-analysis of randomized clinical trials among patients with HIV/AIDS reported that cannabinoids had a moderate effect on increasing body weight compared with placebo (SMD, 0.57 [95% CI, 0.22 to 0.92]). Evidence-based guidelines do not recommend the use of inhaled or high-potency cannabis (≥10% or 10 mg Δ9-tetrahydrocannabinol [Δ9-THC]) for medical purposes. High-potency cannabis compared with low-potency cannabis use is associated with increased risk of psychotic symptoms (12.4% vs 7.1%) and generalized anxiety disorder (19.1% vs 11.6%). A meta-analysis of observational studies reported that 29% of individuals who used cannabis for medical purposes met criteria for cannabis use disorder. Daily inhaled cannabis use compared with nondaily use was associated with an increased risk of coronary heart disease (2.0% vs 0.9%), myocardial infarction (1.7% vs 1.3%), and stroke (2.6% vs 1.0%). Evidence from randomized clinical trials does not support the use of cannabis or cannabinoids for most conditions for which it is promoted, such as acute pain and insomnia. Before considering cannabis or cannabinoids for medical use, clinicians should consult applicable institutional, state, and national regulations; evaluate for drug-drug interactions; and assess for contraindications (eg, pregnancy) or conditions in which risks likely outweigh benefits (eg, schizophrenia or ischemic heart disease). For patients using cannabis or cannabinoids for treatment of medical conditions, clinicians should discuss harm reduction strategies, including avoiding concurrent use with alcohol or other central nervous system depressants such as benzodiazepines, using the lowest effective dose, and avoiding use when driving or operating machinery.

Conclusions and relevance: Evidence is insufficient for the use of cannabis or cannabinoids for most medical indications. Clear guidance from clinicians is essential to support safe, evidence-based decision-making. Clinicians should weigh benefits against risks when engaging patients in informed discussions about cannabis or cannabinoid use.

Author/s:

Michael Hsu, Arya Shah, Ayana Jordan, Mark S Gold, Kevin P Hill

Prenatal Cannabis Use and Neonatal Outcomes A Systematic Review and Meta-Analysis

Hope Smashey — Tue, 08 Jul 2025 16:15:44 +0000

Date Added:

July 8, 2025

Journal/Publication:

JAMA Pediatrics

Publication Date:

May 5, 2025

Issue:

179

Volume:

URL:

Prenatal Cannabis Use and Neonatal Outcomes A Systematic Review and Meta-Analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamapediatrics.2025.0689

Keywords

PMID (1):

40323610

MeSH

Evidence-Based Medicine

Maternal marijuana use during pregnancy is bad for babies. James W. Mold, MD, MPH.

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Importance: Prenatal cannabis use continues to increase, and cannabis remains the most commonly used illegal substance in pregnancy. Accumulating evidence suggests potential adverse effects on fetal and neonatal outcomes following cannabis use in pregnancy.

Objective: To update a living systematic review and meta-analysis to provide a timely understanding regarding cannabis use in pregnancy and fetal and neonatal outcomes.

Data sources: The previous review was updated by searching bibliographic databases MEDLINE, CINAHL, PsycInfo, Global Health, and Evidence-Based Medicine Reviews Cochrane Database of Systematic Reviews from November 1, 2021, through April 4, 2024.

Study selection: Cohort or case-control studies comparing pregnancies with and without prenatal cannabis use on prespecified fetal or neonatal outcomes with adjustment for confounders, such as co-use of tobacco products, were included. Two independent reviewers screened studies, with disagreements resolved through discussion.

Data extraction and synthesis: Included studies were extracted by 1 reviewer and confirmed by a second. Risk of bias was assessed with the Newcastle-Ottawa Scale. Random-effects meta-analyses of unadjusted and adjusted odds ratios (ORs) were performed for all primary outcomes. Results were synthesized using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Main outcomes and measures: Primary outcomes were preterm birth (PTB; <37 weeks of gestation), small for gestational age (SGA), low birth weight (LBW; <2500 g), and perinatal mortality.

Results: For this update, 8 new studies with 1 709 998 participants were added, for a total of 51 studies synthesized (N = 21 146 938). From meta-analyses of adjusted effect sizes, moderate-certainty evidence indicated that cannabis use in pregnancy was associated with increased odds of LBW (20 studies; OR, 1.75; 95% CI, 1.41-2.18), PTB (20 studies; OR, 1.52; 95% CI, 1.26-1.83), and SGA (12 studies; OR, 1.57; 95% CI, 1.36-1.81), and low-certainty evidence indicated that it was associated with greater odds of perinatal mortality (6 studies; OR, 1.29; 95% CI, 1.07-1.55). Previously, the evidence was rated as very low or low certainty.

Conclusions and relevance: Cannabis use in pregnancy was associated with greater odds of PTB, SGA, and LBW even after adjusting for co-use of tobacco products, and confidence in these findings increased from low in the prior review to moderate in the current meta-analysis. The findings of this study may help inform patient counseling and future public health policies.

Author/s:

Jamie O Lo, Chelsea K Ayers, Snehapriya Yeddala, Beth Shaw, Shannon Robalino, Rachel Ward, Devan Kansagara

What Are E-Cigarettes?

Alex Haga — Sun, 11 Aug 2024 18:14:35 +0000

Date Added:

August 11, 2024

Journal/Publication:

JAMA

Publication Date:

August 7, 2024

URL:

What Are E-Cigarettes?

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2024.14334

Keywords

PMID (1):

39110431

MeSH

electronic nicotine delivery systems

nicotine

Vaping

cannabis

Patient/parent information about e-cigarettes. James W. Mold, MD, MPH

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This JAMA Patient Page describes e-cigarettes and the potential health effects of vaping.

Author/s:

Preeti N Malani, Kristin L Walter

Cannabis-Based Products for Chronic Pain : A Systematic Review

Saige Blanchard — Tue, 14 Jun 2022 05:00:00 +0000

Date Added:

June 14, 2022

Journal/Publication:

Annals of Internal Medicine

Publisher:

American College of Physicians

Publication Date:

June 7, 2022

URL:

Cannabis-Based Products for Chronic Pain : A Systematic Review

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.7326/M21-4520

Keywords

PMID (1):

35667066

MeSH

A systematic review of cannabis-related compounds for chronic pain. James W. Mold, MD, MPH

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Background: Contemporary data are needed about the utility of cannabinoids in chronic pain.

Purpose: To evaluate the benefits and harms of cannabinoids for chronic pain.

Data sources: Ovid MEDLINE, PsycINFO, EMBASE, the Cochrane Library, and Scopus to January 2022.

Study selection: English-language, randomized, placebo-controlled trials and cohort studies (≥1 month duration) of cannabinoids for chronic pain.

Data extraction: Data abstraction, risk of bias, and strength of evidence assessments were dually reviewed. Cannabinoids were categorized by THC-to-CBD ratio (high, comparable, or low) and source (synthetic, extract or purified, or whole plant).

Data synthesis: Eighteen randomized, placebo-controlled trials (n = 1740) and 7 cohort studies (n = 13 095) assessed cannabinoids. Studies were primarily short term (1 to 6 months); 56% enrolled patients with neuropathic pain, with 3% to 89% female patients. Synthetic products with high THC-to-CBD ratios (>98% THC) may be associated with moderate improvement in pain severity and response (≥30% improvement) and an increased risk for sedation and are probably associated with a large increased risk for dizziness. Extracted products with high THC-to-CBD ratios (range, 3:1 to 47:1) may be associated with large increased risk for study withdrawal due to adverse events and dizziness. Sublingual spray with comparable THC-to-CBD ratio (1.1:1) probably is associated with small improvement in pain severity and overall function and may be associated with large increased risk for dizziness and sedation and moderate increased risk for nausea. Evidence for other products and outcomes, including longer-term harms, were not reported or were insufficient.

Limitation: Variation in interventions; lack of study details, including unclear availability in the United States; and inadequate evidence for some products.

Conclusion: Oral, synthetic cannabis products with high THC-to-CBD ratios and sublingual, extracted cannabis products with comparable THC-to-CBD ratios may be associated with short-term improvements in chronic pain and increased risk for dizziness and sedation. Studies are needed on long-term outcomes and further evaluation of product formulation effects.

Author/s:

McDonah, M. S., Morasco, B. J., Wagner, J., Ahmed, A. Y., Fu, R., Kansagara, D., Chou, R.

Nonopioid Pharmacologic Treatments for Chronic Pain. Comparative Effectiveness Review No. 228

John Bayhi — Fri, 17 Apr 2020 17:56:57 +0000

Date Added:

April 17, 2020

Journal/Publication:

AHRQ Publication No. 20-EHC010

Publisher:

Agency for Healthcare Research and Quality

Publication Date:

April 16, 2020

URL:

Nonopioid Pharmacologic Treatments for Chronic Pain. Comparative Effectiveness Review No. 228

Type:

Meta-analyses, Reviews, and Guidelines

Keywords

chronic pain

non-opioid treatment

anticonvulsants

serotonin-norepinephrine reuptake inhibitor

nonsteroidal anti-inflammatory drugs

MeSH

duloxetine hydrochloride

Diclofenac

Capsaicin

Celecoxib

Anti-Inflammatory Agents

AHRQ evidence review of non-opioids analgesics for relief of chronic pain. James W. Mold, MD, MPH

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Objectives. To evaluate the effectiveness and comparative effectiveness of nonopioid pharmacologic agents in patients with specific types of chronic pain, considering effects on pain, function, quality of life, and adverse events.

Data sources. Electronic databases (Ovid® MEDLINE®, Embase®, PsycINFO®, CINAHL®, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews) through September 10, 2019, reference lists, data requests, and previous reviews.

Review methods. Randomized controlled trials (RCTs) of nonopioid pharmacologic agents in patients with chronic pain were selected using predefined criteria and dual review. This review focused on seven common chronic pain conditions (neuropathic pain, fibromyalgia, osteoarthritis, inflammatory arthritis, low back pain, chronic headache, sickle cell disease), with effects analyzed at short term (1 to <6 months following treatment completion), intermediate term (≥6 to <12 months), and long term (≥12 months). Magnitude of effects were described as small, moderate, or large using previously defined criteria, and strength of evidence was assessed. Meta-analyses were conducted where data allowed, stratified by duration within each intervention type, using random effects models. We evaluated effect modification through subgroup and sensitivity analyses, including specific drug, dose, study quality, and pain type.

Results. We included 185 RCTs in 221 publications and 5 systematic reviews. In the short term, anticonvulsants (pregabalin, gabapentin, and oxcarbazepine for neuropathic pain, pregabalin/gabapentin for fibromyalgia), serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants (duloxetine for neuropathic pain, fibromyalgia, osteoarthritis, and low back pain, milnacipran for fibromyalgia), and nonsteroidal anti-inflammatory drugs (NSAIDs) (for osteoarthritis and inflammatory arthritis) were associated with mostly small improvements (e.g., 5 to 20 points on a 0 to 100 scale) in pain and function. Function was not found to be improved with duloxetine for low back pain or pregabalin/gabapentin for neuropathic pain. Moderate improvement in quality of life was seen with duloxetine in patients with neuropathic pain, and small improvements in patients with osteoarthritis, but evidence was insufficient to draw conclusions for other drugs and conditions. While most comparisons of drugs and doses did not identify differences, diclofenac improved pain and function moderately more than celecoxib. In the intermediate term, limited evidence (1 RCT) showed memantine moderately improved pain, function, and quality of life in patients with fibromyalgia; improvements in pain, but not function, were maintained in the intermediate term with duloxetine and milnacipran for fibromyalgia. Other drugs studied, including acetaminophen (osteoarthritis), capsaicin (neuropathic pain), cannabis (neuropathic pain), amitriptyline (fibromyalgia, neuropathic pain), and cyclobenzaprine (fibromyalgia) had no clear effects. Withdrawal from study due to adverse events was significantly increased with nonopioid drugs, with the greatest increase over placebo seen with cannabis. Large increases in risk of adverse events were seen with pregabalin (blurred vision, cognitive effects, dizziness, peripheral edema, sedation, and weight gain), gabapentin (blurred vision, cognitive effects, sedation, weight gain), and cannabis (nausea, dizziness). Dose viii reductions reduced the risk of some adverse events with SNRI antidepressants. In the short term small increases in risk of major coronary events and moderate increases in serious gastrointestinal events (both short and long term) were found with NSAIDs.

Conclusions. In the short term, small improvements in pain and/or function were seen with SNRI antidepressants for neuropathic pain, fibromyalgia, osteoarthritis, and low back pain; pregabalin/gabapentin for neuropathic pain and fibromyalgia; oxcarbazepine for neuropathic pain; and NSAIDs for osteoarthritis and inflammatory arthritis. Improvement in function was not found with duloxetine for low back pain and pregabalin/gabapentin for neuropathic pain. Intermediate- and long-term outcomes were mostly not assessed. Increased incidence of drug class–specific adverse events led to withdrawal from treatment in some patients, suggesting that careful consideration of patient characteristics is needed in selecting nonopioid drug treatments.

Author/s:

McDonagh, MS, Selph, SS, Buckley, DI, Holmes, RS, Mauer, K, Ramirez, S, Hsu, FC, Dana, T, Fu, R, Chou

Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis

Brian Desmarais — Sat, 11 Apr 2020 18:25:13 +0000

Date Added:

April 11, 2020

Journal/Publication:

JAMA Network Open

Publisher:

Journal of American Medical Association

Publication Date:

April 1, 2020

URL:

Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jamanetworkopen.2020.2370.

Keywords

MeSH

substance withdrawal syndrome

Health Behavior

A meta-analysis of the incidence (47%) and predictors (concomitant tobacco or other substance abuse) of cannabis withdrawal symptoms. James W. Mold, MD, MPH

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IMPORTANCE:

Cannabis withdrawal syndrome (CWS)-a diagnostic indicator of cannabis use disorder-commonly occurs on cessation of heavy and prolonged cannabis use. To date, the prevalence of CWS syndrome has not been well described, nor have the factors potentially associated with CWS.

OBJECTIVES:

To estimate the prevalence of CWS among individuals with regular or dependent use of cannabinoids and identify factors associated with CWS.

DATA SOURCES:

A search of literature from database inception to June 19, 2019, was performed using MEDLINE, Embase, PsycINFO, Web of Science, the Cumulative Index to Nursing and Allied Health Literature, ProQuest, Allied and Complementary Medicine, and Psychiatry online, supplemented by manual searches of reference lists of included articles.

STUDY SELECTION:

Articles were included if they (1) were published in English, (2) reported on individuals with regular use of cannabinoids or cannabis use disorder as a primary study group, (3) reported on the prevalence of CWS or CWS symptoms using a validated instrument, (4) reported the prevalence of CWS, and (5) used an observational study design (eg, cohort or cross-sectional).

DATA EXTRACTION AND SYNTHESIS:

All abstracts, full-text articles, and other sources were reviewed, with data extracted in duplicate. Cannabis withdrawal syndrome prevalence was estimated using a random-effects meta-analysis model, alongside stratification and meta-regression to characterize heterogeneity.

MAIN OUTCOMES AND MEASURES:

Cannabis withdrawal syndrome prevalence was reported as a percentage with 95% CIs.

RESULTS:

Of 3848 unique abstracts, 86 were selected for full-text review, and 47 studies, representing 23 518 participants, met all inclusion criteria. Of 23 518 participants included in the analysis, 16 839 were white (72%) and 14 387 were men (69%); median (SD) age was 29.9 (9.0) years. The overall pooled prevalence of CWS was 47% (6469 of 23 518) (95% CI, 41%-52%), with significant heterogeneity between estimates (I2 = 99.2%). When stratified by source, the prevalence of CWS was 17% (95% CI, 13%-21%) in population-based samples, 54% in outpatient samples (95% CI, 48%-59%), and 87% in inpatient samples (95% CI, 79%-94%), which were significantly different (P < .001). Concurrent cannabis (β = 0.005, P < .001), tobacco (β = 0.002, P = .02), and other substance use disorders (β = 0.003, P = .05) were associated with a higher CWS prevalence, as was daily cannabis use (β = 0.004, P < .001).

CONCLUSIONS AND RELEVANCE:

These findings suggest that cannabis withdrawal syndrome appears to be prevalent among regularusers of cannabis. Clinicians should be aware of the prevalence of CWS in order to counsel patients and support individuals who are reducing their use of cannabis.

Author/s:

Bahji, A., Stephenson, C., Tyo, R., Hawken, E.R., Seitz, D.P.

Therapeutic use of cannabis and cannabinoids: an evidence mapping and appraisal of systematic reviews

John Bayhi — Mon, 03 Feb 2020 19:39:52 +0000

Date Added:

February 3, 2020

Journal/Publication:

BMC Complementary Medicine and Therapies

Publisher:

Springer Nature

Publication Date:

January 15, 2020

Issue:

Volume:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1186/s12906-019-2803-2

Keywords

Another summary of what we know about the therapeutic effects of cannabinoids. The figures appear to be useful. James W. Mold, MD, MPH

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Background

Although cannabis and cannabinoids are widely used with therapeutic purposes, their claimed efficacy is highly controversial. For this reason, medical cannabis use is a broad field of research that is rapidly expanding. Our objectives are to identify, characterize, appraise, and organize the current available evidence surrounding therapeutic use of cannabis and cannabinoids, using evidence maps.

Methods

We searched PubMed, EMBASE, The Cochrane Library and CINAHL, to identify systematic reviews (SRs) published from their inception up to December 2017. Two authors assessed eligibility and extracted data independently. We assessed methodological quality of the included SRs using the AMSTAR tool. To illustrate the extent of use of medical cannabis, we organized the results according to identified PICO questions using bubble plots corresponding to different clinical scenarios.

Results

A total of 44 SRs published between 2001 and 2017 were included in this evidence mapping with data from 158 individual studies. We extracted 96 PICO questions in the following medical conditions: multiple sclerosis, movement disorders (e.g. Tourette Syndrome, Parkinson Disease), psychiatry conditions, Alzheimer disease, epilepsy, acute and chronic pain, cancer, neuropathic pain, symptoms related to cancer (e.g. emesis and anorexia related with chemotherapy), rheumatic disorders, HIV-related symptoms, glaucoma, and COPD. The evidence about these conditions is heterogeneous regarding the conclusions and the quality of the individual primary studies. The quality of the SRs was moderate to high according to AMSTAR scores.

Conclusions

Evidence on medical uses of cannabis is broad. However, due to methodological limitations, conclusions were weak in most of the assessed comparisons. Evidence mapping methodology is useful to perform an overview of available research, since it is possible to systematically describe the extent and distribution of evidence, and to organize scattered data.

Author/s:

Montero-Oleas, N, Arevalo-Rodriguez, I, Nunez-Gonzalez, S, Viteri-Garcia, A, Simancas-Racines, D

Severe Pulmonary Disease Associated with Electronic-Cigarette–Product Use — Interim Guidance

John Bayhi — Fri, 13 Sep 2019 12:52:13 +0000

Date Added:

September 13, 2019

Journal/Publication:

Morbidity and Mortality Weekly Report

Publisher:

U.S. Department of Health & Human Services / Centers for Disease Control and Prevention

Publication Date:

September 13, 2019

Issue:

Volume:

Pages:

787-790

URL:

Severe Pulmonary Disease Associated with Electronic-Cigarette–Product Use — Interim Guidance

Type:

Public Health Announcements

Format:

Article

DOI (1):

10.15585/mmwr.mm6836e2

Keywords

PMID (1):

31513561

MeSH

electronic nicotine delivery systems

volatile organic compounds

Neoplasms

Lung Diseases

centers for disease control and prevention (U.S.)

The latest information from the CDC on lung disease associated with vaping. James W. Mold, MD, MPH

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On September 6, 2019, this report was posted as an MMWR Early Release on the MMWR website (https://www.cdc.gov/mmwr). As of August 27, 2019, 215 possible cases of severe pulmonary disease associated with the use of electronic cigarette (e-cigarette) products (e.g., devices, liquids, refill pods, and cartridges) had been reported to CDC by 25 state health departments. E-cigarettes are devices that produce an aerosol by heating a liquid containing various chemicals, including nicotine, flavorings, and other additives (e.g., propellants, solvents, and oils). Users inhale the aerosol, including any additives, into their lungs. Aerosols produced by e-cigarettes can contain harmful or potentially harmful substances, including heavy metals such as lead, volatile organic compounds, ultrafine particles, cancer-causing chemicals, or other agents such as chemicals used for cleaning the device (1). E-cigarettes also can be used to deliver tetrahydrocannabinol (THC), the principal psychoactive component of cannabis, or other drugs; for example, "dabbing" involves superheating substances that contain high concentrations of THC and other plant compounds (e.g., cannabidiol) with the intent of inhaling the aerosol. E-cigarette users could potentially add other substances to the devices. This report summarizes available information and provides interim case definitions and guidance for reporting possible cases of severe pulmonary disease. The guidance in this report reflects data available as of September 6, 2019; guidance will be updated as additional information becomes available.

Author/s:

Schier, JG, Meiman, JG, Layden, J, Mikosz, CA, VanFrank, B, King, BA, Salvatore, PP, Weissman, DN, Thomas, J, Melstrom, PC, Baldwin, GT, Parker, EM, Courtney-Long, EA, Krishnasamy, VP, Pickens, CM, Evans, ME, Tsay, SV, Powell, KM, Kiernan, EA, Marynak, KL, Adjemian, J, Holton, K, Armour, BS, England, LJ, Briss, PA, Houry, D, Hacker, KA, Reagan-Steiner, S, Zaki, S, Meaney-Delman, D, CDC 2019 Lung Injury Response Group

Clinicians’ Guide to Cannabidiol and Hemp Oils

Brian Desmarais — Wed, 11 Sep 2019 21:41:17 +0000

Date Added:

September 18, 2019

Journal/Publication:

Mayo Clinic Proceedings

Publisher:

Mayo Foundation for Medical Education and Research

Publication Date:

September 1, 2019

Issue:

Volume:

Pages:

1840-1851

URL:

Clinicians’ Guide to Cannabidiol and Hemp Oils

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.mayocp.2019.01.003

Keywords

cannabidoil

cannabis

PMID (1):

31447137

MeSH

This is a review of what is known about cannabidiol and other hemp-related oils from the Mayo Clinic. James W. Mold, MD, MPH

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Cannabidiol (CBD) oils are low tetrahydrocannabinol products derived from Cannabis sativa that have become very popular over the past few years. Patients report relief for a variety of conditions, particularly pain, without the intoxicating adverse effects of medical marijuana. In June 2018, the first CBD-based drug, Epidiolex, was approved by the US Food and Drug Administration for treatment of rare, severe epilepsy, further putting the spotlight on CBD and hemp oils. There is a growing body of preclinical and clinical evidence to support use of CBD oils for many conditions, suggesting its potential role as another option for treating challenging chronic pain or opioid addiction. Care must be taken when directing patients toward CBD products because there is little regulation, and studies have found inaccurate labeling of CBD and tetrahydrocannabinol quantities. This article provides an overview of the scientific work on cannabinoids, CBD, and hemp oil and the distinction between marijuana, hemp, and the different components of CBD and hemp oil products. We summarize the current legal status of CBD and hemp oils in the United States and provide a guide to identifying higher-quality products so that clinicians can advise their patients on the safest and most evidence-based formulations. This review is based on a PubMed search using the terms CBD, cannabidiol, hemp oil, and medical marijuana. Articles were screened for relevance, and those with the most up-to-date information were selected for inclusion.

Author/s:

VanDolah H.J., Bauer, B.A., Mauck, K.F.

Medical Marijuana for Treatment of Chronic Pain and Other Problems

Brian Desmarais — Mon, 19 Aug 2019 14:41:38 +0000

Date Added:

August 19, 2019

Journal/Publication:

JN Learning

Publisher:

The American Medical Association

Publication Date:

August 23, 2015

URL:

Medical Marijuana for Treatment of Chronic Pain and Other Problems

Type:

Clinical Decision Aids

Format:

Web Page

Keywords

MeSH

This is a 27 ½ min. audiotaped interview with an expert on the medical uses and adverse effects of marijuana. James W. Mold, MD, MPH

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Interview with Kevin P. Hill, MD, MHS, author of Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems: A Clinical Review, and Deepak Cyril D'Souza, MBBS, MD, author of Medical Marijuana: Is the Cart Before the Horse?

Cannabidiol (CBD) - What we know and what we don't

Jeffrey Wilson — Wed, 24 Apr 2019 15:32:45 +0000

Date Added:

April 24, 2019

Journal/Publication:

Harvard Health Blog

Publisher:

Harvard University

Publication Date:

August 24, 2018

URL:

Cannabidiol (CBD) - What we know and what we don't

Type:

Patient Education Materials

Format:

Web Page

Keywords

MeSH

sleep initiation and maintenance disorders

chronic pain

This patient-friendly review of what we currently know about CBD includes a warning that CBD oil reduces the metabolism of warfarin and other drugs metabolized by the CYP450 enzyme system (the same system affected by grapefruit juice) causing elevation of the INR and increased risk of bleeding. James W. Mold, MD, MPH

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Cannabidiol (CBD) has been recently covered in the media, and you may have even seen it as an add-in booster to your post-workout smoothie or morning coffee. What exactly is CBD? Why is it suddenly so popular?

Author/s:

Grinspoon, Peter

Does CBD Actually Work?

Tracy Ashby — Wed, 17 Apr 2019 05:00:00 +0000

Date Added:

April 18, 2019

Journal/Publication:

Quartz

Publication Date:

April 17, 2019

URL:

Does CBD Actually Work?

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

MeSH

nebulizers and vaporizers

This lay press article attempts to summarize what is currently known about the efficacy of cannabidiol (CBD) for anxiety, pain, and sleep. James W. Mold, MD, MPH

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Perhaps you’ve heard a lot of people are using CBD.

The chemical compound, naturally occurring in cannabis plants, doesn’t get you high, but does have a wide swath of other purported effects making it very popular. Although clinical studies haven’t necessarily proven those results, many Americans are testing CBD (which stands for “cannabidiol”) for themselves. All over the US, people are rubbing CBD balm onto aching joints, dropping CBD tinctures under tired tongues, popping CBD gummies, and puffing on CBD oil-filled vaporizers in hopes of chilling out.

On Quartz’s behalf, Harris Poll recently surveyed more than 2,000 people in the US about their experience, knowledge, and opinions regarding CBD and found that more than 85% of Americans have heard of CBD, and of those, more than one in five have tried it.

Author/s:

Avins, Jenni

Lack of evidence for cannabis in adults with chronic neuropathic pain

Jeffrey Wilson — Tue, 04 Dec 2018 23:10:18 +0000

Date Added:

December 4, 2018

Journal/Publication:

Pearls

Issue:

597

Type:

Meta-analyses, Reviews, and Guidelines

Keywords

MeSH

There is so far no high quality evidence to support the use of cannabinoids for relief of chronic neuropathic pain.

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Bottom Line:

There was no high-quality evidence for the efficacy of any CBM (herbal cannabis, plant-derived tetrahydrocannabinol (THC) (dronabinol), synthetic THC (nabilone), plant-derived THC/cannabidiol (CBD) com bination) in any condition with chronic neuropathic pain. The studies were two to 26 weeks long and compared an oromucosal spray with a plant-derived combination of THC and CBD (10 studies), a synthetic cannabinoid mimicking THC (nabilone) (two studies), inhaled herbal cannabis (two studies) and plant-derived THC (dronabinol) (two studies) against placebo (15 studies) and an analgesic (dihydrocodeine) (one study). Herbal cannabis was not different from placebo in reducing pain and the number of people who dropped out due to side effects. Some adverse events (particularly somnolence or sedation, confusion, psychosis) might limit the clinical usefulness of cannabis-based medicines.

Author/s:

McAvoy, Brian R.

Oklahoma Medical Marijuana Authority: Rules, Risks, and Strategies

Jeffrey Wilson — Wed, 31 Oct 2018 15:11:34 +0000

Date Added:

October 31, 2018

Publisher:

Oklahoma Medical Marijuana Authority

Publication Date:

October 26, 2018

Type:

Meta-analyses, Reviews, and Guidelines, Public Health Announcements

Format:

Slides

Keywords

MeSH

Legislation, rules, and licensing pertaining to medical marijuana in Oklahoma.

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Overview

State Question 788
Oklahoma Medical Marijuana Authority
Emergency Rules Approved
Food Safety Standards Board
Contact Information

Author/s:

Bates, Tom

Don't Get Burned! Legal Issues Associated with Medical Marijuana

Jeffrey Wilson — Wed, 31 Oct 2018 14:57:07 +0000

Date Added:

October 31, 2018

Publisher:

Christensen Law Group

Type:

Meta-analyses, Reviews, and Guidelines, Public Health Announcements

Keywords

MeSH

Legal issues with prescription of medical marijuana.

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In Conclusion

Evaluate carefully whether recommending medical marijuana is something you want to do and the risks and requirements associated with it.
Prepare and use appropriate informed consent forms and treatment agreements.
Notify your medical liability insurance carrier.
Check with your employer or facilities at which you have privleges.

Author/s:

Loomis, Cori H.