Cannabinoid Profiles in Medical Cannabis Users: Effects of Age, Gender, Symptoms, and Duration of Use

Abstract

Introduction: Clinical trials remain the gold standard for evaluating efficacy, but there is increasing interest in using real-world evidence (RWE) to inform health care decision making. The aims of this observational study were to describe patterns of medical cannabis use, associated changes in symptom severity over time, and to evaluate change in cannabis dose over time for pain-related symptoms. Methods: Data were collected by Strainprint TM , an application that is HIPAA, PIPEDA, and PHIPA compliant. A total of 629 participants recorded data between May 2017 and August 2019. A total of 65 symptoms were grouped as Pain, Mental Health, Physical Symptoms, Seizures, Headaches/Migraines, and Other. Descriptive statistics and mixed-effects modeling were applied. Results: THC-dominant products were more frequently consumed for symptoms of pain and sleep, while CBDdominant products were more frequently consumed for anxiety and depression. Male and female participants demonstrated significant differences in the type of cannabis they consumed. Females more frequently consumed CBD-dominant products, and males more frequently consumed balanced (THC:CBD) products. Oil use was more prominent among females, while vaping was more common among males. Product use also varied by age tertiles ( < 31; 31-39; > 40 years). CBD-dominant products were more common among younger participants, < 31 years, THC-dominant products were more common among the 31-39 years category and balanced (THC:CBD) products were common among older participants > 41 years. Dosages of CBD-dominant and balanced (THC:CBD) products increased over time irrespective of symptom response. THC-dominant products demonstrated a significant relationship between dose and symptom reduction over time. Conclusions: Recognizing that RWE has important methodological limitations, we observed cannabis product preferences based on demographic characteristics, such as gender and age and the primary symptom treated such as pain and anxiety. Our study offers real-world insights into how participants use and respond to cannabis products and suggests important avenues and methodologies for future research.

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“…Recent and ongoing amendments to international laws have resulted in greater access to a range of cannabis products through legalisation for recreational and therapeutic purposes ( Ruheel et al, 2021 ). Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the two most well-known compounds found in the cannabis plant, with THC responsible for the psychoactive effects associated with cannabis use, while CBD is known for its potential therapeutic properties ( Kalaba and Ware, 2022 ). Products containing CBD and THC are increasingly utilised for their proposed medicinal properties and are commonly used in combination to manage chronic pain and conditions such as epilepsy, insomnia and anxiety ( Busse et al, 2021 ; Whiting et al, 2015 ).…”

Sex Differences in the Neuropsychiatric Effects and Pharmacokinetics of Cannabidiol: A Scoping Review

“…Dominant forms of masculinity are often associated with traits such as stubbornness, self-reliance, and victim-blaming that can lead to under-reporting of psychiatric disorders (especially mood and anxiety disorders) and lack of treatment seeking [ 99 ]. Since there are known gender influences on cannabis use patterns [ 100 ] and sex/gender differences in patterns of CBD use specifically [ 42 , 43 , 44 ], future human studies should consider whether specific gendered dimensions may impact willingness to use CBD and treatment adherence.…”

“…Further, human studies have identified sex/gender differences in patterns and motivations of cannabis use, including use for therapeutic purposes [ 40 ]. Of relevance to the present review, recent cross-sectional studies have found that women are more likely to use CBD-only or CBD-dominant cannabis products across a range of patient and non-patient samples [ 42 , 43 , 44 ]. Another recent cross-sectional study of patients with chronic non-cancer pain found that women were significantly more likely to experience adverse effects of medical cannabis (specifically, central nervous system, gastrointestinal, musculoskeletal, and psychological AEs), while also consuming significantly higher monthly doses of CBD than men [ 45 ].…”

Considerations for Cannabinoids in Perioperative Care by Anesthesiologists

“…There are also a significant number of claims in the media that are difficult to validate but influence patients' consumption of cannabinoid products [17,19,25,[35][36][37][38]. Patients often consume cannabinoids regardless of their efficacy [39,40]. Other confounding variables affecting the assessment of cannabinoid properties are the lack of compound standardization and the increasing variability in their strength and composition [17,19,35,36].…”