Objective
Although cannabis is an
illegal drug, ‘medical marijuana programs’ (MMPs) have proliferated (e.g., in
Canada and several US states), allowing for legal cannabis use for therapeutic
purposes. While both health risks and potential therapeutic benefits for cannabis
use have been documented, potential public health impacts of MMPs — also
vis-à-vis other psychoactive substance use — remain under-explored.
Methods
We briefly reviewed the
emerging evidence on MMP participants' health status, and specifically other
psychoactive substance use behaviors and outcomes.
Results
While data are limited
in amount and quality, MMP participants report improvements in overall health
status, and specifically reductions in levels of risky alcohol, prescription
drug and — to some extent — tobacco or other illicit drug use; at the same
time, increases in cannabis use and risk/problem patterns may occur.
Conclusion
MMP participation may
positively impact — for example, by way of possible ‘substitution effects’ from
cannabis use — other psychoactive substance use and risk patterns at a scale
relevant for public health, also influenced by the increasing population
coverage of MMPs. Yet, net overall MMP-related population health effects need
to be more rigorously and comprehensively assessed, including potential
increases in cannabis use related risks and harms.
...Beyond the effects of MMP participation for an individual, an emerging body of evidence suggests that MMPs may have discernable — both positive and negative — impacts relevant on a population health level. Most MMP participants are individuals with severe/chronic, and often multiple — physical or mental — health problems (e.g., pain, psychiatric, sleep, gastro-intestinal, MS, arthritis, HIV/AIDS, neurological problems), many of whom report improved health status/outcomes which may result in reduced health care needs or utilization. For example, among n = 100 California MMP participants, 59% reported MMU for > 1 chronic condition; they reported significantly higher (average global rating 81 vs. 52; p < .01) effectiveness of MMU over other medication (Harris et al., 2000). Among n = 348 Michigan MMP participants, 87% reported multiple conditions (mostly pain); improved pain scores, and physical and mental health function scores, were reported by returning (n = 153) compared to first-time (n = 195) MMP patients (Ilgen et al., 2013). A Hawaii sample of returning MMP patients with mainly pain as the principal condition reported a 64% overall reduction in pain scores following MMP initiation; about half reported relief from anxiety/stress and insomnia problems (Webb and Webb, 2014). Among n = 130 San Francisco MMP patients with multiple conditions, 55% reported “better symptom management” from MMU compared to other prescription drugs (Reiman, 2007); similar data from UK-based MMP patients reported superior effects from MMU on their symptoms (Coomber, 2003, Ware et al., 2005). Among n = 628 Canadian MMP participants largely reporting multiple chronic conditions, 72% reported that MMU was “always helpful” and 24% reported that it was “often helpful” towards “effective symptom relief” (Walsh et al., 2013)...
...Beyond the effects of MMP participation for an individual, an emerging body of evidence suggests that MMPs may have discernable — both positive and negative — impacts relevant on a population health level. Most MMP participants are individuals with severe/chronic, and often multiple — physical or mental — health problems (e.g., pain, psychiatric, sleep, gastro-intestinal, MS, arthritis, HIV/AIDS, neurological problems), many of whom report improved health status/outcomes which may result in reduced health care needs or utilization. For example, among n = 100 California MMP participants, 59% reported MMU for > 1 chronic condition; they reported significantly higher (average global rating 81 vs. 52; p < .01) effectiveness of MMU over other medication (Harris et al., 2000). Among n = 348 Michigan MMP participants, 87% reported multiple conditions (mostly pain); improved pain scores, and physical and mental health function scores, were reported by returning (n = 153) compared to first-time (n = 195) MMP patients (Ilgen et al., 2013). A Hawaii sample of returning MMP patients with mainly pain as the principal condition reported a 64% overall reduction in pain scores following MMP initiation; about half reported relief from anxiety/stress and insomnia problems (Webb and Webb, 2014). Among n = 130 San Francisco MMP patients with multiple conditions, 55% reported “better symptom management” from MMU compared to other prescription drugs (Reiman, 2007); similar data from UK-based MMP patients reported superior effects from MMU on their symptoms (Coomber, 2003, Ware et al., 2005). Among n = 628 Canadian MMP participants largely reporting multiple chronic conditions, 72% reported that MMU was “always helpful” and 24% reported that it was “often helpful” towards “effective symptom relief” (Walsh et al., 2013)...
Full article at: http://goo.gl/PCo6Tq
By:
aCentre for Applied Research in Mental
Health and Addictions (CARMHA), Faculty of Health Sciences, Simon Fraser
University, Vancouver, British Columbia V6B 5K3, Canada
bSocial & Epidemiological Research,
Centre for Addiction & Mental Health (CAMH), Toronto, Ontario M5S 1S1,
Canada
cDepartment of Psychiatry, University of
Toronto, Toronto, Ontario M5T 1R8, Canada
dMental Health & Addiction Research
Program, Institute of Clinical Evaluative Sciences, Toronto, Ontario M4N 3M5,
Canada
eDalla Lana School of Public Health,
University of Toronto, Ontario M5T 3M7, Canada
Benedikt Fischer: ac.ufs@rehcsifb
⁎Corresponding author at:
Centre for Applied Research in Mental Health and Addictions (CARMHA), Faculty
of Health Sciences, Simon Fraser University, 2400 — 515 W Hastings St.,
Vancouver V6B 5K3, Canada. Fax: + 1 778 782 7768. Email: ac.ufs@rehcsifb
More at: https://twitter.com/hiv insight
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