Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Mar:132:105987.
doi: 10.1016/j.ypmed.2020.105987. Epub 2020 Jan 15.

Online patient-provider cannabis consultations

Kathleen Gali  1 , Ruth Narode  1 , Kelly C Young-Wolff  2 , Mark L Rubinstein  3 , Geoffrey Rutledge  4 , Judith J Prochaska  5
Affiliations

Online patient-provider cannabis consultations

Kathleen Gali et al. Prev Med. 2020 Mar.

Abstract

Cannabis has been legalized, decriminalized, or medicalized in over half the U.S. states. With restrictions on cannabis research, accepted standards to guide clinical practice are lacking. Analyzing online communications through a digital health platform, we characterized patient questions about cannabis use and provider responses. Coded for content were 4579 questions posted anonymously online between March 2011 through January 2017, and the responses from 1439 U.S. licensed clinicians. Provider responses to medical cannabis use questions were coded for sentiment: "negative", "positive", and "mixed." Responses could be "thanked" by patients and receive "agrees" from providers. The most frequent themes were detection of cannabis use (25.3%), health harms (19.9%), co-use with other substances (9.1%), and medical use (8.2%). The 425 medical cannabis use questions most frequently related to treatment of mental illness (20.3%), pain (20.0%), and cancer care (6.7%). The 762 provider responses regarding medical cannabis use were coded for sentiment as 59.6% negative, 28.6% mixed, and 11.8% positive. Provider sentiment was most positive regarding cannabis use for palliative care and most negative for treating respiratory conditions, poor appetite, and mental illness. The proportion of positive sentiment responses increased from 17.6% to 32.4%. Provider responses coded as negative sentiment received more provider "Agrees" (mean rank = 280) than those coded as positive (mean rank = 215), beta coefficient = 0.33; 95% CI: 0.05, 0.62; p = .02. Cannabis use is a health topic of public interest. Variability in provider responses reflects the need for more research and consensus building to inform evidence-based clinical guidelines for cannabis use in medicine.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare that there are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Volume of Questions Over Time (N=4579 questions), 2011 to 2017
See this image and copyright information in PMC

References

    1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health 2018;HHS Publication No. SMA 18–5068, NSDUH Series H-53. https://www.samhsa.gov/data/
    1. National Conference of State Legislatures. State medical marijuana laws. 2019. http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx. Accessed July 1, 2019.
    1. WHO Expert Committee on Drug Dependence Fortieth Meeting. Cannabidiol (CBD) Critical Review Report. 2018. https://www.who.int/medicines/access/controlled-substances/CannabidiolCr.... Accessed June 26, 2019.
    1. U.S. Food and Drug Administration. Marijuana Research with Human Subjects. 2019. https://www.fda.gov/news-events/public-health-focus/marijuana-research-h.... Published April 9, 2019 Accessed May 14, 2019.
    1. Joseph A. Want to test a marijuana-based drug? Expect a visit from the ‘men in black’. 2016. https://www.statnews.com/2016/05/16/marijuana-research/. Accessed May 14, 2019.

Publication types

Substances