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. 2019 Jan 28;16(1):9.
doi: 10.1186/s12954-019-0278-6.

Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients

Philippe Lucas  1   2   3 , Eric P Baron  4 , Nick Jikomes  5
Affiliations

Medical cannabis patterns of use and substitution for opioids & other pharmaceutical drugs, alcohol, tobacco, and illicit substances; results from a cross-sectional survey of authorized patients

Philippe Lucas et al. Harm Reduct J. .

Abstract

Background: A 239-question cross-sectional survey was sent out via email in January 2017 to gather comprehensive information on cannabis use from Canadian medical cannabis patients registered with a federally authorized licensed cannabis producer, resulting in 2032 complete surveys.

Methods: The survey gathered detailed demographic data and comprehensive information on patient patterns of medical cannabis use, including questions assessing the self-reported impact of cannabis on the use of prescription drugs, illicit substances, alcohol, and tobacco.

Results: Participants were 62.6% male (n = 1271) and 91% Caucasian (n = 1839). The mean age was 40 years old, and pain and mental health conditions accounted for 83.7% of all respondents (n = 1700). Then, 74.6% of respondents reported daily cannabis use (n = 1515) and mean amount used per day was 1.5 g. The most commonly cited substitution was for prescription drugs (69.1%, n = 953), followed by alcohol (44.5%, n = 515), tobacco (31.1%, n = 406), and illicit substances (26.6%, n = 136). Opioid medications accounted for 35.3% of all prescription drug substitution (n = 610), followed by antidepressants (21.5%, n = 371). Of the 610 mentions of specific opioid medications, patients report total cessation of use of 59.3% (n = 362).

Conclusions: This study offers a unique perspective by focusing on the use of a standardized, government-regulated source of medical cannabis by patients registered in Canada's federal medical cannabis program. The findings provide a granular view of patient patterns of medical cannabis use, and the subsequent self-reported impacts on the use of opioids, alcohol, and other substances, adding to a growing body of academic research suggesting that increased regulated access to medical and recreational cannabis can result in a reduction in the use of and subsequent harms associated with opioids, alcohol, tobacco, and other substances.

Keywords: Addiction; Cannabis; Harm reduction; Marijuana; Opioids; Substitution.

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Conflict of interest statement

Ethics approval and consent to participate

This survey was ethics reviewed and approved by Advarra (formerly Institutional Review Board Services; reference # Pro00018492), and the University of Victoria subsequently approved a post-survey sub-analysis of the substitution data (reference # 17-188). A password-protected link to an online survey available in French and English was sent out to 16,675 Tilray patients in January 2017. Clicking on the link in the email invitation took patients to the IRB approved Informed Consent Form (ICF), and consent was gathered electronically.

Consent for publication

Not applicable.

Competing interests

This research was supported by Tilray, a federally authorized Canadian medical cannabis production and research company. PL is Global Vice-President, Patient Research and Access for Tilray (www.tilray.ca), and he designed the survey. Formal analysis was conducted by EB, who has no conflict to disclose. Preliminary data analysis was conducted by NJ, Senior Science Advisor, Data & Analytics, at Leafly, an online cannabis website.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Russo EB. History of cannabis and its preparations in saga, science, and sobriquet. Chem Biodivers. 2007;4(8):1614–1648. doi: 10.1002/cbdv.200790144. - DOI - PubMed
    1. Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, et al. Lower-risk cannabis use guidelines: a comprehensive update of evidence and recommendations. Am J Public Health. 2017;107(8):e1–e12. doi: 10.2105/AJPH.2017.303818. - DOI - PMC - PubMed
    1. Grinspoon L. On the future of cannabis as medicine. Clin Trials. 2007;2(2):13–15.
    1. Ware MA, Wang T, Shapiro S, Collet J-P. Cannabis for the management of pain: assessment of safety study (COMPASS) J Pain. 2015;16(12):1233–1242. doi: 10.1016/j.jpain.2015.07.014. - DOI - PubMed
    1. Ware MA, Wang T, Shapiro S, Robinson A, Ducruet T, Huynh T, et al. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ. 2010;182(14):1–8. doi: 10.1503/cmaj.091414. - DOI - PMC - PubMed

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