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Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia.

ABSTRACT: BACKGROUND:Cannabis-smoking patients with a psychotic disorder have poorer disease outcomes than non-cannabis-smoking patients with poorest outcomes in patients smoking high-potency cannabis (HPC) containing high ?9-tetrahydrocannabinol (THC) and low cannabidiol (CBD). Quitting cannabis smoking or substitution of HPC by cannabis variants containing less THC and/or more CBD may benefit these patients. The present study explores whether daily HPC-smoking patients with schizophrenia accept smoking such variants. METHODS:Twelve male patients were asked to smoke on six different occasions one joint: on two occasions, the cannabis they routinely smoke (HPC; not blind), and blind in random order; on two occasions, cannabis containing low THC and no CBD; and on two occasions, cannabis containing low THC and high CBD. RESULTS:Both substitute variants were appreciated, but patients preferred the HPC they usually smoked. The effect of the low THC/high CBD variant was reported by 32% to be too short and by 36% to be not strong enough, whereas this was reported by 5% and 64%, respectively, for the low THC cannabis variant. CONCLUSIONS:Based on these findings, a larger and longer study on the efficacy of cannabis substitution treatment in HPC-smoking patients with schizophrenia seems feasible and should be considered. TRIAL REGISTRATION:2014-005540-17NL . Registered 22 October 2014, 2014-005540-17NL 20141215 CTA.xml.

SUBMITTER: van Amsterdam J

PROVIDER: S-EPMC6149068 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia.

van Amsterdam Jan J Vervloet Jojanneke J de Weert Gerdien G Buwalda Victor J A VJA Goudriaan Anna E AE van den Brink Wim W

Harm reduction journal 20180920 1

<h4>Background</h4>Cannabis-smoking patients with a psychotic disorder have poorer disease outcomes than non-cannabis-smoking patients with poorest outcomes in patients smoking high-potency cannabis (HPC) containing high Δ9-tetrahydrocannabinol (THC) and low cannabidiol (CBD). Quitting cannabis smoking or substitution of HPC by cannabis variants containing less THC and/or more CBD may benefit these patients. The present study explores whether daily HPC-smoking patients with schizophrenia accept ...[more]

PMID: 30236118

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Project description:Medicinal cannabis registries typically report pain as the most common reason for use. It would be clinically useful to identify patterns of cannabis treatment in migraine and headache, as compared to arthritis and chronic pain, and to analyze preferred cannabis strains, biochemical profiles, and prescription medication substitutions with cannabis.Via electronic survey in medicinal cannabis patients with headache, arthritis, and chronic pain, demographics and patterns of cannabis use including methods, frequency, quantity, preferred strains, cannabinoid and terpene profiles, and prescription substitutions were recorded. Cannabis use for migraine among headache patients was assessed via the ID Migraine™ questionnaire, a validated screen used to predict the probability of migraine.Of 2032 patients, 21 illnesses were treated with cannabis. Pain syndromes accounted for 42.4% (n =?861) overall; chronic pain 29.4% (n =?598;), arthritis 9.3% (n =?188), and headache 3.7% (n =?75;). Across all 21 illnesses, headache was a symptom treated with cannabis in 24.9% (n =?505). These patients were given the ID Migraine™ questionnaire, with 68% (n =?343) giving 3 "Yes" responses, 20% (n =?102) giving 2 "Yes" responses (97% and 93% probability of migraine, respectively). Therefore, 88% (n =?445) of headache patients were treating probable migraine with cannabis. Hybrid strains were most preferred across all pain subtypes, with "OG Shark" the most preferred strain in the ID Migraine™ and headache groups. Many pain patients substituted prescription medications with cannabis (41.2-59.5%), most commonly opiates/opioids (40.5-72.8%). Prescription substitution in headache patients included opiates/opioids (43.4%), anti-depressant/anti-anxiety (39%), NSAIDs (21%), triptans (8.1%), anti-convulsants (7.7%), muscle relaxers (7%), ergots (0.4%).Chronic pain was the most common reason for cannabis use, consistent with most registries. The majority of headache patients treating with cannabis were positive for migraine. Hybrid strains were preferred in ID Migraine™, headache, and most pain groups, with "OG Shark", a high THC (?9-tetrahydrocannabinol)/THCA (tetrahydrocannabinolic acid), low CBD (cannabidiol)/CBDA (cannabidiolic acid), strain with predominant terpenes ?-caryophyllene and ?-myrcene, most preferred in the headache and ID Migraine™ groups. This could reflect the potent analgesic, anti-inflammatory, and anti-emetic properties of THC, with anti-inflammatory and analgesic properties of ?-caryophyllene and ?-myrcene. Opiates/opioids were most commonly substituted with cannabis. Prospective studies are needed, but results may provide early insight into optimizing crossbred cannabis strains, synergistic biochemical profiles, dosing, and patterns of use in the treatment of headache, migraine, and chronic pain syndromes.

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Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia.

Publications

Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia.

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