A recent Australian study involving over 2,300 individuals with chronic health conditions has revealed interesting improvements in their overall quality of life within the initial three months of using medical cannabis. The study, published this week in the journal PLoS ONE, also found a reduction in fatigue. The research also highlighted improvements in anxiety, depression, and chronic pain among patients during this three-month period. “Patients experiencing anxiety, depression, or chronic pain also improved in those outcomes over 3 months,” the study found.
The study looked at responses from Australian patients eligible for the QUEST Initiative, which researchers describe as a “large prospective multicenter study of patients with any chronic health condition newly prescribed medicinal cannabis between November 2020 and December 2021.” These participants are between 18 and 97 years old (with a mean of 51). 62.8% were female.
Chronic pain was the prevailing condition reported by participants, constituting 69% of cases, followed by insomnia at 23%, anxiety at 22%, and a combination of anxiety and depression at 11%. Half of the patients reported experiencing more than one of these conditions concurrently.
Before initiating their medical marijuana, participants underwent baseline assessments, encompassing evaluations of health-related quality of life (HRQL), pain, sleep, fatigue, anxiety, and depression. Subsequently, they were administered follow-up surveys after two weeks of treatment, with additional surveys conducted once a month for a duration of three months.
Individuals prescribed medical cannabis in the preceding four weeks were not eligible to participate in the study.
All study participants were prescribed Little Green Pharma medical cannabis oil, a product that contains a combination of THC and CBD dissolved in a medium-chain triglyceride (MCT) oil. This product was available in four different formulations, each characterized by its THC-to-CBD ratio:
- A 1:20 THC-to-CBD ratio
- A balanced 10:10 ratio
- A THC-dominant 20:5 ratio
- A CBD-only formulation
In contrast to their health-related quality of life before treatment, participants who successfully completed three months of therapy reported significant enhancements in their overall well-being.
Only folks who solely completed the initial follow-up assessment showed less progress compared to those involved who continued their treatment.
Furthermore, pain eased up for participants as a whole. In contrast to those not undergoing pain treatment, those diagnosed with chronic pain experienced more considerable improvements.
Regarding depression, the study’s authors emphasized that “though scores shifted from moderate severity into the mild severity range, the difference didn’t quite meet the 5-point threshold for clinically significant improvement.” However, mirroring patterns seen in other areas, the improvement was more pronounced among individuals diagnosed with specific conditions. In particular, when focusing on 288 participants grappling with “depression health conditions, such as mixed depressive and anxiety, recurrent depressive disorder, and bipolar disorder,” the study highlights that “respondents transitioned from the severe category to moderate depression, with a difference of more than 5 points, indicating clinically meaningful improvement.”
As for anxiety scores, participants exhibited similar improvement trends over time but fell short of achieving “clinically meaningful improvement,” except among the 748 participants diagnosed with anxiety conditions. According to the study, “on average,” scores shifted from “moderate/severe down to mild anxiety.”
Regarding insomnia, the study suggests that: “Analysis of 534 participants with an insomnia diagnosis…did not reveal statistically significant, or clinically meaningful change in mean Sleep T-scores over time and did not differ from patients without insomnia.”
But energy levels seemingly improved, as fatigue did show a decrease, “indicating clinically meaningful improvement.
During the three-month observation period, 127 participants pulled out of the study. Their reasons included the treatment not working (52 people), changing treatment (31), undesirable side effects (30), and the cannabis products being too expensive (14).
However, most participants reported some relief. “Within the first three months of medicinal cannabis therapy, participants reported improvements in their health-related quality of life, fatigue, and health conditions associated with anxiety, depression, and pain,” the study’s authors said in a press release.
While the results were generally welcome, the researchers noted that some of the reported improvements could be due to the placebo effect.
“Our findings should be interpreted in the context of a single arm study without a control group. A systematic review of cannabis and HRQL studies revealed small effect sizes in [randomized controlled trials] and large effect sizes without control groups,” the study says. “There is a chance that observed improvements are partly due to placebo effect, with the widespread public public discussion (press and social media) on the benefits of medicinal cannabis and its interaction with the endocannabinoid system increasing patients’ expectations.”
As for the future, the authors say that their research “continues to follow patients over 12-months to determine whether improvements in [patient-reported outcomes] are maintained long-term,” the study reads. “In addition, further subgroup analysis will be undertaken to determine whether patients with specific conditions have better outcomes compared with others when using validated condition-specific questionnaires.”
So, the researchers aren’t done yet, and ideally will report back with more specific and detailed findings.