A recent study conducted by a group of UK-based researchers found that medical cannabis was associated with improvements in health-related quality of life, anxiety, and sleep quality. This research adds to the growing body of literature suggesting that medical cannabis can help patients with chronic health conditions improve their well-being. The study also observed a reduced use of opioid medications among cannabis patients, and found that patients prescribed dried cannabis flower (versus tinctures and lozenges) were most likely to show clinical improvement.
The complex and nuanced task of studying cannabis
The cannabis plant is an incredibly complex and variable medicine. It contains over 400 chemical compounds, more than 100 of which have known medical effects. These chemicals are present in different amounts and combinations in cannabis, depending on numerous factors: The particular strain, the way it was grown, the way it was processed, and the way it is consumed.
When observational studies investigate cannabis use, they often capture results from a wide variety of different substances, not just cannabis. More controlled studies—there aren’t many—tend to focus on one or two isolated components of cannabis. While these studies provide more specific results, they don’t tell us much about how the various compounds interact with each other. This makes cannabis extremely challenging to study.
The authors of this study, however, decided to take a different route: They studied the effects of specific regimens of medical cannabis and their effects on patients’ well-being. By keeping track of the particulars of the medical cannabis in question, they hoped to gather data that could give us more specific information about cannabis’ effects.
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Can cannabis improve quality of life?
In this study, the researchers analyzed data from a cohort of 1,378 medical cannabis patients in the UK. About 40% of the patients were already consumers when the study began; the rest were not.
These patients had been prescribed a variety of specific cannabis options, including inhaled dried flower, sublingual oils, or a combination of the two (based on the medical needs of the patient).
At the start of the study, researchers collected information about patients’ demographics, conditions, medications, and occupations, as well as their history with cannabis, other drugs, and alcohol. Patients’ primary reasons for using cannabis varied, but the most common reasons were chronic pain, neuropathic pain, fibromyalgia, and anxiety.
Once the study began, patients were given a variety of self-reporting assessments they could use to describe their health-related quality of life, anxiety, and sleep quality. The first assessment was given before patients began their cannabis regimen. Patients were given additional assessments 1, 3, 6, and 12 months into the program.
After analyzing the data from the year-long study, the authors found statistically significant improvements from baseline on all measures—anxiety, sleep quality and health-related quality of life—at each benchmark. The data suggested that cannabis was benefiting these patients.
Patients in the study who used opioid medications also reported reducing their opioid use during the study. The greatest reduction (5.66%) occurred after one year of cannabis use.
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Dried cannabis flower showed the biggest improvements
In an interesting twist, the study also found that patients prescribed dried cannabis flowers—rather than sublingual cannabis options, like tinctures or lozenges, alone—experienced more substantial improvements. Dried flowers are the raw form of cannabis, usually consumed by smoking or vaporizing. Sublinguals, on the other hand, are a more processed form of cannabis which can be absorbed through the mucosal membranes in the mouth.
While patients who used both cannabis flowers and sublingual cannabis saw similar results to those using cannabis flowers alone, patients using solely sublinguals had less significant improvements. Those patients nonetheless saw improvements from baseline at each check-in.
While roughly one-fifth of the patients did experience negative side effects from cannabis, the majority of those side effects were moderate or mild. Researchers observed that the most common side effects were fatigue, somnolence (excessive sleepiness), dry mouth, lethargy, and headache. One of the 1,378 patients experienced a single episode of psychosis. Lastly, the patients who were already using cannabis at the onset of the study demonstrated less negative side effects than those who had been abstinent.
We need more cannabis research
While this study provides valuable insight—and supports the idea that cannabis can improve our quality of life—it does have some limitations. As an observational study, it cannot prove that cannabis caused the improvements, only that a correlation exists. Additionally, since many patients were already cannabis consumers, the study may be biased towards them, since cannabis is evidently effective for them. Future research should include randomized and controlled double-blind studies.