Higher Learning LV Staff
May 5, 20235 min
Welcome to homework assignment CAS 1.6 in the Cannabis for Anxiety seminar from Higher Learning LV. This assignment focuses on the therapeutic application of cannabis for anxiety and, specifically, a 2023 study about how registered patients in the United Kingdom medical cannabis program who feature anxiety have responded to medical cannabis.
After you complete this assignment, use the button at the bottom to return to the Cannabis for Anxiety Seminar master page.
A 2023 study entitled "An Observational Study of Safety and Clinical Outcome Measures Across Patient Groups in the United Kingdom Medical Cannabis Registry" that was published in the journal Expert Review of Clinical Pharmacology explored the potential efficacy of medical cannabis for anxiety. All participants were enrolled in the United Kingdom Medical Cannabis Registry.
Participants were measured for anxiety level and sleep quality. Their baseline metrics, gathered at the launch of the study, were compared to follow-up sessions after one, three, six, and 12 months.
The study reported that it has been legal since 2018 for cannabis-based medicinal products (CBMPs) to be prescribed in the United Kingdom by "specialist doctors for chronic illnesses where there has been insufficient response to licensed medications."
NICE justifies this self-admittedly "narrow" list of conditions based on both limited and low quality current scientific evidence.
Not known for its progressive stance on medical cannabis, the United Kingdom's National Institute for Health and Care Excellence (NICE) currently recommends medical cannabis for only a few qualifying conditions, including the nausea and vomiting resulting from chemotherapy, multiple sclerosis resulting in spasticity, and severe treatment-resistant epilepsy in the form of Dravet syndrome and Lennox Gastaut syndrome.
NICE justifies this self-admittedly "narrow" list of conditions based on both limited and low quality current scientific evidence. "In particular, there is a paucity of randomized controlled trials due to the challenges of investigating CBMPs in this setting," reported the study's authors.
The study reported that cannabidiol (CBD) and delta-9 tetrahydrocannabinol (THC) are the two most studied phytocannabinoids (the variety of cannabinoids derived from the cannabis plant as opposed to the endocannabinoids made by the bodies of humans and mammals).
The scientists reported that both CBD and delta-9 THC are being recognized "for a wide variety of pharmacological effects," including analgesic (pain reducing), anti-inflammatory, antiemetic (relieving nausea or vomiting), antispasticity, antipsychotic, anticonvulsant, anxiolytic (anxiety reducing), appetite-stimulating, and neuroprotective abilities.
"Delta-9 THC achieves its biochemical efficacy by binding with the CB1 and CB2 receptors in the ECS, but CBD features a low affinity for CB1 and CB2."
The study reported that delta-9 THC achieves its biochemical efficacy mainly by binding with the microscopic CB1 and CB2 cellular receptors in the endocannabinoid system, but that CBD features a "low affinity for CB1 and CB2" receptors, although it features a diverse range of biochemical targets outside of these two major ECS receptors.
CB1 receptors are most concentrated and dense in the brain and central nervous system (CNS), while CB2 receptors are most abundant in what scientists call "the periphery," or the area of the body outside of the brain and CNS. CB2 receptors are most dense in the tissues, glands, and organs associated with immune function. This said, it should be noted that CB2 receptors can be found in the brain (they are simply outnumbered by CB1 in a big way) and CB1 receptors appear outside of the brain and CNS.
The design of this research was that of an uncontrolled observational study of patients prospectively enrolled in the U.K. Medical Cannabis Registry (MCR) and included patients participating for any condition. Participants were prescribed individualized formulations that included consumption avenues such as oil, capsules, lozenges, and dried loose-leaf flower and that the exact form and consumption avenue was determined as a joint decision between the clinician and the patient.
The study reported that the medical cannabis prescribed could take on a variety of chemical compositions, including isolated cannabinoids or broad- and full-spectrum extracts. The study was conducted between December 1, 2019 and February 15, 2022. Data was gathered from participants at the launch of the study (called baseline) and after one, three, and six months and then every six months thereafter (until completion).
"Of these nearly three thousand registered medical cannabis patients, 43 percent were female and 57 percent were male and the mean age was 42."
The study reported that of 3,546 patients enrolled in the U.K. MCR on February 15, 2022, 2,833 were included in the current analysis. Of these nearly three thousand registered medical cannabis patients, 43 percent were female and 57 percent were male. The mean age of the group was 42.
This group encompassed a total of 31 diagnoses, with 40 percent of the patients featuring secondary indications and comorbid conditions. Half of the study participants (50 percent) featured anxiety or depression, while 20 percent had arthritis, seven percent featured endocrine dysfunction, and about five percent had epilepsy.
The study found that medical cannabis resulted in improvements in health-related quality of life and related symptoms for a number of conditions. It found that improvements were noted at the first follow-up visit at one month and, importantly, were maintained until the end of the study.
Female participants were found to feature a "higher likelihood of having a positive improvement after six months," reported the scientists. The research found no difference in health-related quality of life with respect to prior cannabis use.
"The study found that medical cannabis resulted in improvements in health-related quality-of-life and related symptoms for a number of conditions."
This study reported several cases of adverse effects, some of which were categorized as severe. Despite this, it concluded that CBMPs were "generally well tolerated" and reported that 83 percent of participants experienced no adverse effects. It found that females were at increased risk of adverse events and that prior cannabis consumption was a protective factor for negative side effects.
The study reported that its data confirm a previous analysis from the U.K. MCR that found "an association between initiating CBMP treatment and improved health-related quality of life in chronically ill patients." The scientists noted that their data and conclusions are "in line with findings from several other studies" that have observed improvements in pain, anxiety, depression, and overall well being after use of CBD-rich products. However, it should be noted that improvements were found only in those featuring moderate or severe symptoms; participants featuring mild symptoms failed to show benefit.
The study's authors concluded that their data and analysis suggest that treatment with CBMPs "is associated with an improvement in general health-related quality of life" and that this improvement includes decreases in anxiety symptoms and sleep problems and that these benefits persisted for up to 12 months.
The study's authors concluded that treatment with CBMPs "is associated with an improvement in general health-related quality-of-life."
The study noted that cannabis-naive (those who had never or rarely before consumed cannabis) patients and female patients are at the greatest risk of having adverse events. It expressed its hope that its findings "may help to inform current clinical practice, but most importantly, highlight the need for further clinical trials to determine causality and generate guidelines to optimize therapy with CBMPs."
View the original study.