scholarly journals Medical cannabis use in the Australian community following introduction of legal access: The 2018-2019 Online Cross-Sectional Cannabis as Medicine Survey (CAMS-18)

2020 ◽  
Author(s):  
Nicholas Lintzeris ◽  
Llewellyn Mills ◽  
Anastasia Suraev ◽  
Maria Bravo ◽  
Thomas Arkell ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Online Survey ◽  
Medical Profession ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Plant Matter

Abstract Background: In 2016 the Australian federal government passed legislation enabling a range of cannabis-based products to be prescribed to patients by registered healthcare professionals. An online survey conducted immediately prior to these legislative changes found that the vast majority of respondents at the time were illicitly sourcing cannabis plant matter, smoking was the preferred route of administration, and mental health, chronic pain, and sleep conditions were the most frequently cited reasons for medical cannabis use. This manuscript reports the results of a follow-up survey conducted in 2018-2019, the Cannabis As Medicine Survey (CAMS-18). The goal of this second questionnaire was to examine patterns of use and consumer perspectives regarding medical cannabis use in Australia, two years after the introduction of legal access pathways. Methods: Anonymous online cross-sectional survey with convenience sample, recruited mainly through online media between September 2018 and March 2019. Participants were adults (18 years or over) residing in Australia who reported using a cannabis product for self-identified therapeutic reasons during the preceding 12 months. The survey measured consumer characteristics; indications and patterns of medical cannabis use; routes and frequency of administration; perceived benefits and harms; experiences and preferred models of access to medical cannabis. Results: Data were available for 1388 respondents. The main categories of condition being treated with medical cannabis were pain (36.4%), mental health (32.8%), sleep (9.2%), neurological (5.2%) and cancer (3.8%). Respondents reported using medical cannabis on 15.8 (11.2) days in the past 28, by inhaled (71.4%) or oral (26.5%) routes and spending AUD$82.27 ($101.27) per week. There were high levels of self-reported effectiveness, but also high rates of side effects. There was uncertainty regarding the composition of illicit cannabinoid products and concerns regarding their possible contamination. Few respondents (2.7%) had accessed legally prescribed medical cannabis, with the main perceived barriers being cost, disinterest from the medical profession, and stigma regarding cannabis use. Conclusions: Chronic pain, mental health and sleep remain the main clinical conditions for which consumers report using medical cannabis. Despite two years of legal availability, most consumers in Australia reported accessing illicit cannabis products, with uncertainty regarding the quality or composition of cannabis products.

scholarly journals Medical cannabis use in the Australian community following introduction of legal access: The 2018-2019 Online Cross-Sectional Cannabis as Medicine Survey (CAMS-18)

2020 ◽  
Author(s):  
Nicholas Lintzeris ◽  
Llewellyn Mills ◽  
Anastasia Suraev ◽  
Maria Bravo ◽  
Thomas Arkell ◽  
...  
Keyword(s):  
Mental Health ◽  
Chronic Pain ◽  
Online Survey ◽  
Medical Profession ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Plant Matter

Abstract Background : In 2016 the Australian federal government passed legislation enabling a range of cannabis-based products to be prescribed to patients by registered healthcare professionals. An online survey conducted immediately prior to these legislative changes found that the vast majority of respondents at the time were illicitly sourcing cannabis plant matter, smoking was the preferred route of administration, and mental health, chronic pain, and sleep conditions were the most frequently cited reasons for medical cannabis use. This manuscript reports the results of a follow-up survey conducted in 2018-2019, the Cannabis As Medicine Survey (CAMS-18). The goal of this second questionnaire was to examine patterns of use and consumer perspectives regarding medical cannabis use in Australia, two years after the introduction of legal access pathways. Methods : Anonymous online cross-sectional survey with convenience sample, recruited mainly through online media between September 2018 and March 2019. Participants were adults (18 years or over) residing in Australia who reported using a cannabis product for self-identified therapeutic reasons during the preceding 12 months. The survey measured consumer characteristics; indications and patterns of medical cannabis use; routes and frequency of administration; perceived benefits and harms; experiences and preferred models of access to medical cannabis. Results : Data were available for 1388 respondents. The main categories of condition being treated with medical cannabis were pain (36.4%), mental health (32.8%), sleep (9.2%), neurological (5.2%) and cancer (3.8%). Respondents reported using medical cannabis on 15.8 (11.2) days in the past 28, by inhaled (71.4%) or oral (26.5%) routes and spending AUD$82.27 ($101.27) per week. There were high levels of self-reported effectiveness, but also high rates of side effects. There was uncertainty regarding the composition of illicit cannabinoid products and concerns regarding their possible contamination. Few respondents (2.7%) had accessed legally prescribed medical cannabis, with the main perceived barriers being cost, dis-interest from the medical profession, and stigma regarding cannabis use. Conclusions : Chronic pain, mental health and sleep remain the main clinical conditions for which consumers report using medical cannabis. Despite two years of legal availability, most consumers in Australia reported accessing illicit cannabis products, with uncertainty regarding the quality or composition of cannabis products.

scholarly journals A mixed methods analysis of cannabis use routines for chronic pain management

2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Kevin F. Boehnke ◽  
Laura Yakas ◽  
J. Ryan Scott ◽  
Melissa DeJonckheere ◽  
Evangelos Litinas ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mixed Methods ◽  
Mean Difference ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Administration Routes ◽  
The Usa ◽  
Inhalation Administration

Abstract Background The wide heterogeneity of available cannabis products makes it difficult for physicians to appropriately guide patients. In the current study, our objective was to characterize naturalistic cannabis use routines and explore associations between routines and reported benefits from consuming cannabis. Methods We performed a mixed methods analysis of n=1087 cross-sectional survey responses from adults with self-reported chronic pain using cannabis for symptom management in the USA and Canada. First, we qualitatively analyzed responses to an open-ended question that assessed typical cannabis use routines, including administration routes, cannabinoid content, and timing. We then sub-grouped responses into categories based on inhalation (smoking, vaporizing) vs. non-inhalation (e.g., edibles). Finally, we investigated subgroups perceptions of how cannabis affected pain, overall health, and use of medications (e.g., substituting for opioids, benzodiazepines). Substitutions were treated as a count of medication classes, while responses for both pain and health were analyzed continuously, with − 2 indicating health declining a lot or pain increasing a lot and 2 indicating that health improved a lot or pain decreased a lot. Results Routines varied widely in terms of administration routes, cannabinoid content, and use timing. Overall, 18.8%, 36.2%, and 45% used non-inhalation, inhalation, and non-inhalation + inhalation routes, respectively. Those who used inhalation routes were younger (mean age 46.5 [inhalation] and 49.2 [non-inhalation + inhalation] vs. 56.3 [inhalation], F=36.1, p<0.001), while a higher proportion of those who used non-inhalation routes were female (72.5% non-inhalation vs. 48.3% inhalation and 65.3% non-inhalation + inhalation, X2=59.6, p<0.001). THC-rich products were typically used at night, while CBD-rich products were more often used during the day. While all participants reported similarly decreased pain, participants using non-inhalation + inhalation administration routes reported larger improvements in health than the non-inhalation (mean difference = 0.32, 95% CI: 0.07–0.37, p<0.001) and inhalation subgroups (mean difference = 0.22, 95% CI: 0.07–0.37, p=0.001). Similarly, the non-inhalation + inhalation group had significantly more medication substitutions than those using non-inhalation (mean difference = 0.62, 95% CI: 0.33–0.90, p<0.001) and inhalation administration routes (mean difference = 0.45, 95% CI: 0.22–0.69, p<0.001), respectively. Conclusions Subgrouping medical cannabis patients based on administration route profile may provide useful categories for future studies examining the risks and benefits of medical cannabis.

scholarly journals Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine

2021 ◽  
pp. 145507252098596
Author(s):  
Sinikka L. Kvamme ◽  
Michael M. Pedersen ◽  
Sagi Alagem-Iversen ◽  
Birgitte Thylstrup
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Cannabis Use ◽  
Health Conditions ◽  
Convenience Sample ◽  
Mental Health Conditions ◽  
Patient Organisations ◽  
Patterns Of Use

Background: In Denmark the boundaries between cannabis as an illicit drug and licit medicine have shifted rapidly in recent years, affecting also policy. However, the vast majority of Danes, who use cannabis as medicine (CaM) continue to rely on the unregulated market for supply. This study explores patterns of use and motives for use of CaM in Denmark. Methods: An anonymous online survey was made available to a convenience sample of users of CaM from July 14, 2018 to November 1, 2018. Participants were recruited through patient organisations, social and public media, and the illegal open cannabis market. Results: Of the final sample ( n = 3,021), a majority were women (62.6%) and the mean age was 49 years. Most had no prescription for CaM (90.9%), a majority had no or limited previous experience with recreational cannabis use (63.9%), and had used CaM for two years or less (65.0%). The most common form of intake was oil (56.8%) followed by smoke (24.0%). CBD oil (65.0%) was used more than hash, pot or skunk (36.2%). Most frequent conditions treated were chronic pain (32.0%), sleep disturbances (27.5%), stress (23.7%), osteoarthritis (22.7%), anxiety (19.6%), and depression (19.6%). Overall, users experienced CaM to be effective in managing somatic and mental health conditions and reported relatively few side-effects. CBD oil only users were more likely to be women, older, have limited recreational experience and have initiated use recently. Conclusions: A new user group has emerged in Denmark that, for the most part, use illegally sourced CaM to treat a broad range of somatic and mental health conditions, often with experienced effect and relatively low level of side-effects. The prevalent use of low-potency CBD oil indicates an interest in effects beyond the high normally associated with cannabis use. More clinical research into the effects and side-effects of CaM is needed to draw the boundaries of the medical utility of cannabis.

Cannabis and End-of-Life Care: A Snapshot of Hospice Planning and Experiences Among Illinois Medical Cannabis Patients With A Terminal Diagnosis

2021 ◽  
pp. 104990912110186
Author(s):  
James Alton Croker ◽  
Julie Bobitt ◽  
Sara Sanders ◽  
Kanika Arora ◽  
Keith Mueller ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Fast Track ◽  
Hospice Care ◽  
Cannabis Use ◽  
Care Plan ◽  
Medical Cannabis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Eol Care

Introduction: Between 2013 and 2019, Illinois limited cannabis access to certified patients enrolled in the Illinois Medical Cannabis Program (IMCP). In 2016, the state instituted a fast-track pathway for terminal patients. The benefits of medicinal cannabis (MC) have clear implications for patients near end-of-life (EOL). However, little is known about how terminal patients engage medical cannabis relative to supportive care. Methods: Anonymous cross-sectional survey data were collected from 342 terminal patients who were already enrolled in ( n = 19) or planning to enroll ( n = 323) in hospice for EOL care. Logistic regression models compare patients in the sample on hospice planning vs. hospice enrollment, use of palliative care vs. hospice care, and use standard care vs non-hospice palliative care. Results: In our sample, cancer patients ( OR = 0.21 (0.11), p < .01), and those who used the fast-track application into the IMCP ( OR = 0.11 (0.06), p < .001) were less likely to be enrolled in hospice. Compared to patients in palliative care, hospice patients were less likely to report cancer as their qualifying condition ( OR = 0.16 (0.11), p < .01), or entered the IMCP via the fast-track ( OR = 0.23 (0.15), p < .05). Discussion: Given low hospice enrollment in a fairly large EOL sample, cannabis use may operate as an alternative to supportive forms of care like hospice and palliation. Clinicians should initiate conversations about cannabis use with their patients while also engaging EOL Care planning discussions as an essential part of the general care plan.

scholarly journals Psycho-social factors associated with mental resilience in the Corona lockdown

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ilya M. Veer ◽  
Antje Riepenhausen ◽  
Matthias Zerban ◽  
Carolin Wackerhagen ◽  
Lara M. C. Puhlmann ◽  
...  
Keyword(s):  
Mental Health ◽  
Protective Factors ◽  
Internalizing Symptoms ◽  
Online Survey ◽  
Positive Association ◽  
Social Resilience ◽  
Current Crisis ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Resilience Factors

AbstractThe SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.

scholarly journals Resilience, well-being, depression symptoms and concussion levels in equestrian athletes

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Annika McGivern ◽  
Stephen Shannon ◽  
Gavin Breslin
Keyword(s):  
Mental Health ◽  
Online Survey ◽  
Well Being ◽  
Depression Symptoms ◽  
Physical And Mental Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Content Type ◽  
Mental Health Support ◽  
History Of

Purpose This paper aims to conduct the first cross-sectional survey on depression, Resilience, well-being, depression symptoms and concussion levels in equestrian athletes and to assess whether past concussion rates were associated with depression, resilience and well-being. Design/methodology/approach In total, 511 participants from Canada, Republic of Ireland, UK, Australia and USA took part in an international cross-sectional, online survey evaluating concussion history, depression symptoms, resilience and well-being. Findings In total, 27.1% of athletes met clinically relevant symptoms of major depressive disorder. Significant differences were shown in the well-being and resilience scores between countries. Significant relationships were observed between reported history of concussion and both high depression scores and low well-being scores. Practical implications Findings highlight the need for mental health promotion and support in equestrian sport. Social implications Results support previous research suggesting a need for enhanced mental health support for equestrians. There is reason to believe that mental illness could still be present in riders with normal levels of resilience and well-being. Originality/value This study examined an understudied athlete group: equestrian athletes and presents important findings with implications for the physical and mental health of this population.

scholarly journals Online paediatric chronic pain management: assessing the needs of UK adolescents and parents, using a cross-sectional survey

2020 ◽  
pp. 204946372094034
Author(s):  
Anna Hurley-Wallace ◽  
Daniel E Schoth ◽  
Suzanne Lilley ◽  
Glyn Williams ◽  
Christina Liossi
Keyword(s):  
Social Media ◽  
Chronic Pain ◽  
Pain Management ◽  
Online Survey ◽  
Interdisciplinary Treatment ◽  
Future Research ◽  
Chronic Pain Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Social Media Platforms

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.

scholarly journals ASSESSING HEALTH-RELATED OUTCOMES OF MEDICAL CANNABIS USE AMONG OLDER PERSONS IN COLORADO AND ILLINOIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S204-S204 ◽  
Author(s):  
J Alton Croker ◽  
Julie Bobitt ◽  
Kanika Arora ◽  
Brian Kaskie
Keyword(s):  
Older Persons ◽  
Sleep Disturbances ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Treatment Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Specific Patient ◽  
Patient Reported ◽  
Health Related

Abstract The use of cannabis is increasing among older Americans. A growing body of evidence shows cannabis and cannabinoids effective for treating chronic pain, spasticity, nausea, and sleep disturbances. States seeking to respond to the treatment needs of specific patient populations have legalized the use of cannabis for medical purposes. Few instruments offer standard outcomes for understanding the use of medial cannabis from the patient perspective, particularly focusing on older persons. Using cross-sectional survey data from a sample of older persons in Colorado and Illinois, we validate two scales to consistently measure patient-reported health related outcomes of medical cannabis use. We confirmed the validity of two separate, reliable outcome scales: a three-factor scale for measuring global health outcomes and a single-factor scale for capturing adverse health events. The COPS questionnaire revealed strong construct validity and internal consistency, and a lack of meaningful factor variance.

scholarly journals Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers’ infection and psychological distress during the COVID-19 pandemic in the USA

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e042752 ◽  
Author(s):  
Tsion Firew ◽  
Ellen D Sano ◽  
Jonathan W Lee ◽  
Stefan Flores ◽  
Kendrick Lang ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Healthcare Workers ◽  
Anxiety Symptoms ◽  
Front Line ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Burn Out ◽  
The Usa

ObjectiveThe COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA.DesignWe conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out).SettingThe questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey.ParticipantsUsing a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey.Primary outcomePrevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms.ResultsParticipants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71).ConclusionHCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being.

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