An International Survey On Methods Of Intake

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Introduction: Only limited information is available on advantages and disadvantages of different methods of intake (oral, oro-mucosal, inhalation) of cannabis products and different cannabinoid-based medicines as well as preferences by patients. Few clinical studies have directly compared the effects of these medicines on patients (Abrams et al., Ann. Intern. Med. 2003;139(4):258-266; Zajicek et al., J. Neurol. Neurosurg. Psychiatry 2005;76(12):1664-1669) or healthy subjects (Hart et al., Psychopharmacology (Berl) 164(4):407-415; Wachtel et al., Psychopharmacology (Berl) 161(4):331-339). Therefore, a questionnaire was designed to determine how patients perceive possible advantages and disadvantages of different methods of intake and which methods or products they prefer over others. The study also intended to analyze whether perceived advantages and preferences depend on demographic parameters (gender, age and country), previous experience with recreational cannabis use, disease and/or symptoms, or involvement of a physician in the use of cannabinoids.

Methods: A cross-sectional survey was conducted by putting a questionnaire on the website of the IACM (International Association for Cannabinod Medicines, cannabis medicine) between 18 August 2009 and 31 January 2010. It was available in five languages (German, English, Spanish, French, Dutch). It consisted of 22 questions, each of which could be answered by binary (yes/no) response, a list from which to choose most-suited answers, or likert scale. Two open-ended questions were included to allow free comments. The collected information included demographics, diseases and symptoms, medical treatment, cannabis use pattern, dose, onset of effects and methods of former and current intake of cannabis or cannabinoids. Participants were asked on advantages of different methods of intake, including onset of effects, ease of dose finding, side-effects, amount of cannabis needed, etc.

Results: 953 patients (614 male, 339 female) with a mean age of 40.7 years from 32 countries completed the questionnaire. Most participants were from the USA, Germany, France, Canada, The Netherlands, Spain, and the UK. In 47.6% of all cases, cannabis products were prescribed or recommended by a physician, in 10.4% patients got their cannabinoid medication from a pharmacy, in 26.3% from a coffee shop or another unofficial or tolerated source. In 54.4% of cases the cannabis products were (also) home grown (legal or illegal). The highest percentage of prescribed or recommended cannabinoid medication was found in the USA, The Netherlands, Canada, and Germany. 76.5% of participants had experience with cannabis products before the onset of disease. Preferred modes of use were smoking of cannabis (62.9%), inhalation of cannabis with a vaporizer (23.6%), oral use of cannabis in baked goods (7.9%), oral use of cannabis as a tea (2.4%), and oral use of dronabinol/Marinol (1.8%). No significant differences in preferred modes of use were found in correlation to symptoms or diseases. Further results will be presented.

Conclusions: The IACM survey provides the largest database of information so far on patients' preferences with regard to the medical use of cannabinoids in correlation to a large number of variables (disease, symptoms, demographic parameters, etc.).

Source: Clinical Studies and Case Reports
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