Values and preferences towards medical cannabis
Chronic pain patients may benefit from the use of medicinal cannabis.
Patients exhibited varying degrees of desire to use medicinal cannabis, according to low confidence evidence, and the vast majority of those who did use medical cannabis had favourable sentiments regarding its usage in general. The majority of patients with severe life-limiting conditions were comfortable with the use of medicinal cannabis for pain management, although some other chronic pain patients were resistant or indifferent regarding the use of medical cannabis. 26. When compared to white patients with severe illness, non-white patients with advanced illness expressed more fear about medical cannabis, but they remained comfortable taking medicinal cannabis. 25. People who suffer from chronic pain and have taken medicinal cannabis have reported that it has been successful in alleviating their symptoms. The usage of prescription drugs was reduced by 25%, 25%, 30%, and 34%, respectively. 27. The findings of two qualitative investigations were almost identical.
In comparison to conventional pain relievers, medical cannabis has many advantages.
According to the study (low certainty), patients who had a history of drug abuse chose medicinal cannabis over prescribed opioids.
23. The notion that medicinal cannabis was safer than conventional analgesics was expressed by certain patients, and such attitudes were more widespread among non-Christians as well as patients with a college degree or above (very low certainty). 25
Medical cannabis is available in a variety of forms.
According to moderate confidence data, the majority of those who suffer from chronic pain chose to use a combination of indica and sativa to control their symptoms.
21. Between males and females, those who used cannabis for medicinal reasons alone and those who endorsed both medical and recreational usage, or between beginner and expert users, there was no difference in the strains they preferred to use. twenty-first.
The vast majority of patients preferred medical cannabis products with balanced THC: CBD ratios (37%) or high CBD formulations (46%), with only a minority (17%) preferring high THC products (Moderate certainty).
21/33 Women, novice users, and those who endorsed the use of cannabis for medical purposes only were more likely to choose products with low THC and high CBD ratios, whereas males, those who endorsed the use of cannabis for both medical and recreational purposes, and experienced users were more likely to choose products with equal ratios of THC and CBD, according to the findings.
The choice of a particular method of administration was impacted by factors such as gender, purpose for usage, and previous experience with cannabis (moderate certainty).
21:35 In contrast to male patients, female patients chose to employ tinctures and topical treatments rather than vaporize or smoke cannabis. 20. The majority of patients who used cannabis both for leisure and for medicinal purposes favored smoking, while the majority of patients who used cannabis just for medical purposes preferred vaporizing. 21. Expert cannabis users recommended several methods of administration, as opposed to rookie cannabis users, who preferred to vape their cannabis. 21. The majority of patients with advanced life-limiting illnesses favored oral forms of medicinal cannabis (as opposed to inhaled cannabis). 25
Factors that influence a person’s choice to use medicinal marijuana
According to evidence of high to moderate confidence, the majority of people who suffer from chronic pain utilize medicinal cannabis to alleviate their symptoms. If you want to know how to get a medical marijuana card baltimore follow the link.
Patients said that medicinal cannabis could help them control pain, sleep, hunger, and nausea, among other things. The use of cannabis has also been observed to enhance patients’ emotional and mental well-being by lowering their anxiety, depression, and stress levels (20, 35), as well as increasing their capacity to concentrate and perform. 28). The majority of patients indicated that cannabis helped them achieve a level of relaxation in which pain was still there but was easier to endure than before. 28
According to moderate certainty data, factors associated with patients’ reluctance to use medicinal cannabis include significant adverse effects (such as losing control or behaving strangely), addiction or tolerance, and unfavorable social implications (e.g., stigma).
Greater reticence to use medicinal cannabis was connected with older age, and worries about unfavorable attitudes from others, which might lead to relationship issues or arguments with loved ones, were also shown to be associated with older age. twenty-sixth, thirty-fourth, and forty-fifth. In other cases, patients stated that stigma made them feel uncomfortable approaching healthcare practitioners about cannabis as a therapeutic option, as well as making them reluctant to use medicinal cannabis in a public environment. 32. The cost, legal status, and accessibility of medicinal cannabis were all shown to have an impact on usage, according to evidence of moderate confidence. 20–23, 24–25, 31–34, and 35.
Consider the following considerations while selecting various medicinal cannabis preparations:
Some of the evidence was not very strong, but it seemed to show that most people who use medical cannabis choose products based on cannabinoid content, recommendations from dispensary workers and the effects they say they can help with (like pain relief).
21–23, 28–30, 31 Females were more likely than men to choose cannabis products based on the cannabinoid concentration, cannabis type, aesthetic features, and fragrance, whereas a greater percentage of males sought advice from a medical practitioner before making their selection (moderate certainty). twenty-first.
Patients who used cannabis both medically and recreationally were more likely to select cannabis products based on cannabinoid content, cannabis variety, described effects, visual properties, smell, recommendations from friends, and product name, whereas those who only used cannabis medically were more likely to prioritize recommendations from dispensary employees or medical professionals. Patients who only used cannabis for medical reasons were more likely to pay attention to recommendations from dispensary employees or doctors (some certainty).
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Discussion
Patients with chronic pain have a wide range of values and preferences when it comes to the use of medicinal cannabis, which is very diverse. Positive factors that influence patients’ decisions to use medical cannabis include improvement of symptoms and reduction of prescription medications, whereas negative factors that influence patients’ decisions to use medical cannabis include concerns about addiction, losing control of their lives, acting strangely, and negative social ramifications of using medical cannabis. Cost, legal standing, and accessibility are all significant considerations. Patients who approved the use of cannabis only for medicinal reasons preferred products with high CBD or equivalent ratios of THC:CBD, but those who accepted the use of cannabis for both medical and recreational purposes were more likely to choose products with high THC. Furthermore, patients with chronic pain who approved both medical and recreational cannabis use were more likely to prefer smoking cannabis than patients who recommended just medical cannabis use or who favored vaporizing cannabis. Our results were similar across a wide range of bodies of research (quantitative, qualitative, and mixed-method studies). Most of the conclusions had a moderate level of confidence in the evidence, mostly because of the risk of bias or inaccuracies in the data.
We reached out to three patient partners who serve on the BMJ fast recommendation panel for their thoughts on the results of this systematic study. We received three responses. (1) whether our findings were consistent with their personal experiences, and (2) if any of our findings were inconsistent with their personal experiences, what could have caused this discrepancy? The patient partners agreed that, with the exception of one result (table 2), our review findings were consistent with their own cannabis experiences. They said that people who use medicinal cannabis may not get the support they need from their families and friends because of the stigma and misinformation about the drug.
Our discovery that some patients choose medical cannabis based on the qualities that dispensers assign to strain type (indica or sativa) provides an opportunity for education on the subject of medicinal cannabis. When these strains were first studied, it was discovered that sativa strains of cannabis generated larger quantities of CBD than indica strains, which produced high levels of THC. At the current time, however, commercially accessible cannabis plants and products have undergone substantial interbreeding, resulting in a diverse array of distinct strains. 36. So the only valid method of determining the composition of any type of medicinal cannabis is through the correct reporting of its cannabinoid content (such as the amount of THC or CBD present).
We discovered significant variations in preferences for cannabis content and administration method between patients who use cannabis only for medicinal reasons and those who report dual usage (medical and recreational) in terms of cannabis content and administration route. Observational studies have shown that the majority of cannabis users support both medicinal and recreational use. 37, 38), which poses a hurdle to the therapeutic usage of the drug. Cannabis with high THC concentrations is often preferred by recreational users, but THC is a psychoactive cannabinoid that has been linked to more negative consequences than CBD,39Additionally, patients who use cannabis for both medical and recreational purposes are more likely to prefer inhaled forms of administration, which have a much faster onset and greater bioavailability than oral administration but also carry pulmonary risk factors due to the exposure to toxins and particulate matter in the air during the administration. 41). When it comes to the therapeutic use of cannabis, evidence-based formulations should be prioritized, and administration should be done in a way that prioritizes both safety and efficacy.
The review’s advantages and disadvantages are discussed below.
Explanatory eligibility criteria, a broad search method, and several assessments of eligibility and risk of bias are among the review’s many strengths. People could have more confidence in their interpretation of data because they used different kinds of evidence (qualitative, quantitative, and mixed-methods). They also used the GRADE method to figure out how certain the evidence was.
There were several drawbacks to this research as well. In this study, the vast majority of qualifying research (13 out of 15 investigations) was conducted in high-income nations, reflecting the values and preferences of patients who benefit from superior healthcare systems and health insurance coverage. The applicability of our results to other groups is still up in the air, as is their generalizability. Aside from that, our research synthesised and reported patients’ desire to use medical cannabis, despite the fact that most studies did not provide participants with appropriate information regarding the advantages and dangers of medical cannabis. Studies were not able to consistently describe the socioeconomic status, educational level, and religious views of the people who took part in them. This made it difficult to study the effects of these variables on values and preferences in a scientifically valid way.
Implications
Our results have immediate implications for clinicians who work with clients who suffer from chronic pain and are contemplating using medicinal cannabis to alleviate their symptoms. Patients’ decisions about medical cannabis appear to be influenced by the benefits (reduction in pain and reduction in prescription medications), harms (adverse effects), burdens (negative social consequences, cost), and accessibility (including legal status) of the drug, all of which appear to influence their decisions. However, we were unable to locate any research that looked at how patients ranked these criteria in terms of importance. This is something that should be addressed in further study. In addition, the impact of patient characteristics (e.g., medical problems, socioeconomic position, religious views) on their values and preferences is an important question that should be investigated further in future studies.
Conclusions
People who suffer from chronic pain have a wide range of values and preferences when it comes to medical cannabis, and this is especially true when it comes to their readiness to use medical cannabis, as shown in this study. These findings suggest that an individualized patient-centered approach, such as shared decision-making, should be emphasized in order to empower patients to make choices that are most consistent with their own values and preferences and that are appropriate for their specific situation and circumstances.
