Cannabis based medicines and cannabis dependence : A critical review of issues and evidence
Journal article
Schlag, Anne K., Hindocha, Chandni, Zafar, Rayyan, Nutt, David J. and Curran, H. Valerie. (2021). Cannabis based medicines and cannabis dependence : A critical review of issues and evidence. Journal of Psychopharmacology. 35(7), pp. 773-785. https://doi.org/10.1177/0269881120986393
Authors | Schlag, Anne K., Hindocha, Chandni, Zafar, Rayyan, Nutt, David J. and Curran, H. Valerie |
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Abstract | Cannabis has been legalised for medical use in an ever-increasing number of countries. A growing body of scientific evidence supports the use of medical cannabis for a range of therapeutic indications. In parallel with these developments, concerns have been expressed by many prescribers that increased use will lead to patients developing cannabis use disorder. Cannabis use disorder has been widely studied in recreational users, and these findings have often been projected onto patients using medical cannabis. However, studies exploring medical cannabis dependence are scarce and the appropriate methodology to measure this construct is uncertain. This article provides a narrative review of the current research to discern if, how and to what extent, concerns about problems of dependence in recreational cannabis users apply to prescribed medical users. We focus on the main issues related to medical cannabis and dependence, including the importance of dose, potency, cannabinoid content, pharmacokinetics and route of administration, frequency of use, as well as set and setting. Medical and recreational cannabis use differs in significant ways, highlighting the challenges of extrapolating findings from the recreational cannabis literature. There are many questions about the potential for medical cannabis use to lead to dependence. It is therefore imperative to address these questions in order to be able to minimise harms of medical cannabis use. We draw out seven recommendations for increasing the safety of medical cannabis prescribing. We hope that the present review contributes to answering some of the key questions surrounding medical cannabis dependence. |
Keywords | medical cannabis; tetrahydrocannabinol; cannabidiol; dependence; cannabis use disorder |
Year | 2021 |
Journal | Journal of Psychopharmacology |
Journal citation | 35 (7), pp. 773-785 |
Publisher | SAGE Publications |
ISSN | 0269-8811 |
Digital Object Identifier (DOI) | https://doi.org/10.1177/0269881120986393 |
PubMed ID | 33593117 |
Scopus EID | 2-s2.0-85100964300 |
PubMed Central ID | PMC8278552 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 773-785 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 17 Feb 2021 |
Publication process dates | |
Deposited | 30 Mar 2022 |
https://acuresearchbank.acu.edu.au/item/8x9y2/cannabis-based-medicines-and-cannabis-dependence-a-critical-review-of-issues-and-evidence
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Publisher's version
OA_Schlag_2021_Cannibis_based_medicines_and_cannabis_dependence.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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