title: Therapeutic satisfaction and subjective effects of different strains of pharmaceutical-grade cannabis.
abstract: In The Netherlands, pharmaceutical-grade cultivated cannabis is distributed for medicinal purposes as commissioned by the Ministry of Health. Few studies have thus far described its therapeutic efficacy or subjective (adverse) effects in patients. The aims of this study are to assess the therapeutic satisfaction within a group of patients using prescribed pharmaceutical-grade cannabis and to compare the subjective effects among the available strains with special focus on their delta-9-tetrahydrocannabinol and cannabidiol content. In a cross-sectional and natural design, users of pharmaceutical-grade cannabis were investigated with questionnaires. Medical background of the patients was asked as well as experienced therapeutic effects and characteristics of cannabis use. Subjective effects were measured with psychometric scales and used to compare among the strains of cannabis used across this group of patients. One hundred two patients were included; their average age was 53 years and 76% used it for more than a year preceding this study. Chronic pain (53%; n = 54) was the most common medical indication for using cannabis followed by multiple sclerosis (23%; n = 23), and 86% (n = 88) of patients (almost) always experienced therapeutic satisfaction when using pharmaceutical cannabis. Dejection, anxiety, and appetite stimulation were found to differ among the 3 strains of cannabis. These results show that patients report therapeutic satisfaction with pharmaceutical cannabis, mainly pain alleviation. Some subjective effects were found to differ among the available strains of cannabis, which is discussed in relation to their different tetrahydrocannabinol/cannabidiol content. These results may aid in further research and critical appraisal for medicinally prescribed cannabis products.
authors.affiliation: From the *Drug Monitoring System, Netherlands Institute of Mental Health and Addiction, Utrecht; †Department of Psychiatry, University of Amsterdam, Amsterdam; ‡Department of Pharmacy, University of Utrecht, Utrecht; and §Office for Medicinal Cannabis, Ministry of Health, The Hague, The Netherlands.
authors.forename: Tibor M
authors.initials: TM
authors.lastname: Brunt
authors.forename: Marianne
authors.initials: M
authors.lastname: van Genugten
authors.forename: Kathrin
authors.initials: K
authors.lastname: Höner-Snoeken
authors.forename: Marco J
authors.initials: MJ
authors.lastname: van de Velde
authors.forename: Raymond J M
authors.initials: RJ
authors.lastname: Niesink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002185:Cannabidiol / Q000302:isolation & purification; D002188:Cannabis / Q000737:chemistry*; D059350:Chronic Pain / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D013759:Dronabinol / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy; D009426:Netherlands; D017060:Patient Satisfaction; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods*; D028321:Plant Preparations / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D011594:Psychometrics; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D028321:Plant Preparations; D002185:Cannabidiol; D013759:Dronabinol