New data from the UK shows that medicinal cannabis improves quality of life in patients with a range of chronic conditions.
Real-world analysis of over 2,500 patients enrolled on the UK Medical Cannabis Registry, which is run by Sapphire Medical Clinics, explores the effects of prescription cannabis on a broad range of chronic conditions.
As the number of medicinal cannabis patients continues to rise in the UK, with somewhere between 25,000 – 30,000 people now thought to have a legal prescription, the new study highlights that just over 50% of patients are being prescribed the medication for chronic pain, whilst a quarter of patients receive the therapy for mental health conditions.
A picture of cannabis patients in the UK
Data was collected from patients attending Sapphire Clinics between December 2019- February 2022, who completed follow up questionnaires at one, three, six and 12 months after treatment.
In total, 2,833 patients were included in the analysis, 43% were female and 57% male, with an average age of 42.
There were 31 different diagnoses recorded. Chronic non-cancer pain was the most common indication prescribed for, reported by 32% of patients. This was followed by anxiety, for which 11% of patients were prescribed cannabis.
Other pain-related chronic conditions were among the top 10 most common, including fibromyalgia (11%), neuropathic pain (8%), migraine (3%) and Ehlers-danlos syndrome (3%).
Around 11% of patients were prescribed cannabis for post traumatic stress disorder (PTSD), and depression, with around 6% receiving a prescription for the neurodivergent conditions, autism spectrum disorder (ASD) and ADHD.
Primary, secondary, and tertiary indication for cannabis-based medicinal products. Data from the UK Medical Cannabis Registry. https://doi.org/10.1080/17512433.2023.2183841
As chronic conditions often present with a variety of symptoms, researchers also recorded comorbidities. Anxiety or depression was reported in just under half of patients, with arthritis, hypertension, endocrine dysfunction, epilepsy and venous thromboembolism also recorded, although less common.
Improvements to quality of life
According to the analysis, patients observed changes in their overall quality of life, as well as anxiety and sleep quality, suggesting that cannabis may have beneficial effects beyond those for which it is primarily prescribed in the individual.
In the UK, patients can only be prescribed medical cannabis if they have not had sufficient benefit from first line treatments. These patients, therefore, had limited options available for management of their conditions prior to assessment for medical cannabis.
Ahead of the study, up to 70% of patients reported prior illicit cannabis consumption. Interestingly these patients also showed the same changes in quality of life, anxiety, and sleep quality at each follow up as the study population as a whole.
This highlights a difference in outcomes between those patients who receive care through a medical model against those who self-medicate with cannabis.
Adverse events were reported by only 17% of patients with the majority being mild or moderate. The most common adverse events were fatigue, dry mouth, sleepiness, and feeling lethargic.
Understanding different responses in male and female patients
Additional analysis from the authors showed that women were the most likely to report changes in their quality of life and adverse events.
Some research in animals has shown that female sex hormones cause there to be a higher concentration of CB1 receptors (the main receptor which cannabis works upon) in the body.
This may mean that women respond to the effects of cannabis at lower doses than men.
Dr Simon Erridge, co-author of the study and head of research at Sapphire Medical Clinics, which runs the patient registry, says this data may be a case for a more gradual titration regimen.
“At Sapphire Clinics we want to play a defining role in helping clinicians and patients make the best decisions for their healthcare. This research is a really important step forward in helping us better understand the effects of medical cannabis on individuals,” he commented.
“Whilst it is important to consider condition-specific effects, as we have done in some of our other recent research it has been useful to take a step back and think about the holistic effects seen across all conditions we see at Sapphire.
“This has allowed us to further explore the changes seen in general health-related quality of life, anxiety, and sleep quality during the first 12 months of care. Beyond this it has allowed us to identify some interesting findings.
“In addition to the overarching findings, we observed different outcomes in both men and women, which will allow us to further personalise care for patients as we move forward.
“Furthermore, we saw that individuals who had previously been utilising illicit cannabis had similar outcomes to patients who had never tried cannabis before which we hope will give eligible patients who had previously been self-treating with illicitly-sourced cannabis the confidence to transition away from the illegal market.”
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