A recent publication in Frontiers in Pharmacology (November 2024) provides a comprehensive overview of medical cannabis research and an evidence map for medical outcomes.
Cannabis Research For Health Conditions: Positive Effects
Montagner and her colleagues analyzed 194 systematic reviews, offering valuable insights into how cannabis affects various health conditions. The research team evaluated evidence for 71 health outcomes, with particularly strong findings in several key areas. Among high-quality studies, researchers found positive or potentially positive effects for
pain management
sleep disorders
seizures
anxiety
muscle spasticity
This is especially encouraging as it confirms what many healthcare practitioners have observed in clinical practice.
Interestingly, the study revealed that most evidence points to beneficial effects - 278 out of 489 treatment effect descriptions were either "positive" or "potentially positive." This suggests that medical cannabis may have broader therapeutic potential than previously acknowledged in mainstream medicine.
One of the study's most significant strengths is its thorough evaluation of research quality. Using the AMSTAR 2 tool, which requires 16 different review aspects and helps to determine that the review’s conclusions are trustworthy, researchers carefully assessed each systematic review, separating robust evidence from weaker studies. This attention to quality gives us confidence in the findings.
Although not all studies provided specificity for the type of cannabis product that was being investigated, limiting a fuller understanding of which products work best for different conditions, here are the interventions that were specified.
CBD (Cannabidiol) was the most studied identified compound, appearing in 100 reviews.
CBD is a non-intoxicating compound found in cannabis. Unlike THC, it doesn't cause a "high". CBD can be derived from either marijuana or hemp plants.
Δ9-THC followed with 62 reviews
THC is the primary intoxicating compound in cannabis. THC interacts directly with the body's endocannabinoid system, particularly CB1 receptors.
Dronabinol/Marinol® were included in 49 reviews
These FDA-approved synthetic versions of THC are prescribed primarily for nausea and vomiting in persons undergoing chemotherapy and for appetite stimulation in persons with AIDS-related weight loss.
Nabilone® was also well-represented, with 42 reviews
Nabilone® is another synthetic cannabinoid medication, structurally similar to THC but not identical. It's primarily prescribed for chemotherapy-induced nausea and vomiting.
Sativex® (nabiximols) appeared in 39 reviews
This product is a mouth spray containing both THC and CBD in a roughly 1:1 ratio, along with other minor cannabinoids and terpenes from the cannabis plant. It's approved in many countries (though not yet in the U.S.) for treating muscle spasticity in multiple sclerosis, neuropathic pain, and intractable cancer pain.
Various ratios of THC:CBD were studied, with balanced ratios appearing in 15 reviews and high-THC to CBD ratios in 14 reviews
Montagner et al.’s (2024) comprehensive evidence map represents a significant milestone in cannabis research and illuminates important gaps in our current knowledge.
Cannabis Research For Health Conditions: The Future
While we now have strong evidence supporting cannabis's therapeutic potential across multiple conditions, we still need more precise information about which specific cannabis formulations work best for particular health conditions. This specificity is especially crucial in areas like cancer-related applications, where high-quality systematic reviews are notably absent.
Healthcare providers need detailed, product-specific evidence to make informed patient recommendations. AND, with the expansion of legalized adult-use cannabis, many consumers want evidence-based information about the potential of cannabis to help them manage their chronic health conditions.
Despite these limitations, this evidence map provides an encouraging foundation for clinical practice and future research. It validates many therapeutic applications of cannabis while establishing a clear roadmap for the focused, high-quality research needed to advance the field of cannabis medicine.
Stay connected with PTCannabisInfo for updates on emerging cannabis research and evidence-based insights that can help inform your clinical practice and understanding of medical cannabis applications.
Reference
Montagner, P., Ferreira, A. S., Marinho, B., Ruppelt, B. M., Schlechta Portella, C. F., Abdala, C. V., Tabach, R., Ghelman, R., Blesching, U., Perfeito, J. P., & Schveitzer, M. C. (2024). Charting the therapeutic landscape: A comprehensive evidence map on medical cannabis for health outcomes. Frontiers in Pharmacology, 15, 1494492. https://doi.org/10.3389/fphar.2024.1494492
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