PDF(Pubmed)
Abstract：
BACKGROUND: Cannabis was legalised for medical purposes in 2016. Uptake was initially slow, but since 2019 there has been a large increase in the number of Australians who have been prescribed cannabis for medical reasons. Yet a significant number of consumers continue to treat their medical conditions via illicitly-sourced cannabis. Little is known about how these two groups of medical cannabis consumers differ.
METHODS: The anonymous Cannabis-As-Medicine Survey 2022-2023 (CAMS-22) was available for completion online from December 2022 to April 2023 to adult Australians who had used cannabis to treat a medical condition in the previous year. Recruitment occurred through social media, consumer forums, and medical practices. Questions included demographic characteristics, patterns of cannabis use, conditions treated, and self-rated effectiveness.
RESULTS: Of the 3323 respondents included in these analyses, 2352 (73%) mainly used prescribed medical cannabis, 871 (27%) mainly used illicit. Prescribed users were significantly more likely than illicit users to have had their health condition diagnosed (OR = 1.7, 95% CI 1.3, 2.2), to consume their cannabis via oral (OR = 1.9; CI 1.5, 2.4) or vaporised (OR = 5.2; CI 4.0, 6.8) routes, and to be sure of the composition of their medical cannabis (OR = 25.0; CI 16.7, 50.0). Prescribed users were significantly less likely to have used cannabis non-medically before medical use (OR = 0.6, CI 0.5, 0.7), consume cannabis via smoked routes (OR = 0.2, CI 0.1, 0.2), and to report any side effects (OR = 0.1; CI 0.1, 0.2). The most common conditions among both prescribed and illicit users were pain (37%), mental health (36%), and sleep (15%) conditions. Prescribed users were significantly more likely to use cannabis to mainly treat a pain (OR = 1.3; CI 1.1, 1.5) or sleep condition (OR = 1.4; CI 1.1, 1.7) and less likely to treat a mental health condition (OR = 0.8; CI 0.7, 0.9). There were no between-group differences in effectiveness with 97% saying medical cannabis had improved their symptoms.
CONCLUSIONS: From a harm-reduction perspective there is much to recommend prescribed medical cannabis; it has fewer side-effects than illicit, is used more safely (oral or vaporised versus smoked routes), gives consumers greater certainty regarding the composition and quality of their medicine, and does not risk exposure to the criminal justice system. Of concern, however, is the apparent willingness of prescribers to prescribe for indications for which there is limited evidence of efficacy, such as mental health and sleep conditions.
METHODS: The anonymous Cannabis-As-Medicine Survey 2022-2023 (CAMS-22) was available for completion online from December 2022 to April 2023 to adult Australians who had used cannabis to treat a medical condition in the previous year. Recruitment occurred through social media, consumer forums, and medical practices. Questions included demographic characteristics, patterns of cannabis use, conditions treated, and self-rated effectiveness.
RESULTS: Of the 3323 respondents included in these analyses, 2352 (73%) mainly used prescribed medical cannabis, 871 (27%) mainly used illicit. Prescribed users were significantly more likely than illicit users to have had their health condition diagnosed (OR = 1.7, 95% CI 1.3, 2.2), to consume their cannabis via oral (OR = 1.9; CI 1.5, 2.4) or vaporised (OR = 5.2; CI 4.0, 6.8) routes, and to be sure of the composition of their medical cannabis (OR = 25.0; CI 16.7, 50.0). Prescribed users were significantly less likely to have used cannabis non-medically before medical use (OR = 0.6, CI 0.5, 0.7), consume cannabis via smoked routes (OR = 0.2, CI 0.1, 0.2), and to report any side effects (OR = 0.1; CI 0.1, 0.2). The most common conditions among both prescribed and illicit users were pain (37%), mental health (36%), and sleep (15%) conditions. Prescribed users were significantly more likely to use cannabis to mainly treat a pain (OR = 1.3; CI 1.1, 1.5) or sleep condition (OR = 1.4; CI 1.1, 1.7) and less likely to treat a mental health condition (OR = 0.8; CI 0.7, 0.9). There were no between-group differences in effectiveness with 97% saying medical cannabis had improved their symptoms.
CONCLUSIONS: From a harm-reduction perspective there is much to recommend prescribed medical cannabis; it has fewer side-effects than illicit, is used more safely (oral or vaporised versus smoked routes), gives consumers greater certainty regarding the composition and quality of their medicine, and does not risk exposure to the criminal justice system. Of concern, however, is the apparent willingness of prescribers to prescribe for indications for which there is limited evidence of efficacy, such as mental health and sleep conditions.
摘要：
背景：大麻在2016年被合法化用于医疗目的。最初的摄取很慢，但自2019年以来，出于医疗原因服用大麻的澳大利亚人数量大幅增加。然而，大量消费者继续通过非法来源的大麻治疗他们的医疗状况。关于这两组医用大麻消费者的区别知之甚少。
方法：2022-2023年匿名大麻医学调查（CAMS-22）于2022年12月至2023年4月在线完成，适用于使用大麻治疗疾病的成年澳大利亚人。招聘是通过社交媒体进行的，消费者论坛，和医疗实践。问题包括人口统计特征，大麻的使用模式，治疗条件,和自我评估的有效性。
结果：在这些分析中包括的3323名受访者中，2352(73%)主要使用处方医用大麻，871（27％）主要使用非法。处方使用者比非法使用者更有可能诊断出他们的健康状况(OR=1.7,95%CI1.3,2.2),通过口服（OR=1.9；CI1.5，2.4）或蒸发（OR=5.2；CI4.0，6.8）途径消耗大麻，并确定其医用大麻的成分（OR=25.0；CI16.7，50.0）。处方使用者在医疗使用前使用大麻的可能性大大降低（OR=0.6，CI0.5，0.7），通过烟熏路线消费大麻(OR=0.2，CI0.1，0.2)，并报告任何副作用（OR=0.1；CI0.1，0.2）。处方和非法使用者中最常见的疾病是疼痛（37％），心理健康（36%），和睡眠（15％）条件。处方使用者更有可能使用大麻主要治疗疼痛（OR=1.3；CI1.1，1.5）或睡眠状况（OR=1.4；CI1.1，1.7），而不太可能治疗精神健康状况（OR=0.8；CI0.7，0.9）。两组之间的有效性没有差异，97％的人说医用大麻改善了他们的症状。
结论：从减少伤害的角度来看，有很多值得推荐的处方医用大麻；它的副作用比非法的少，使用更安全(口服或蒸发与吸烟途径)，使消费者对其药物的成分和质量有更大的确定性，并且不会有暴露于刑事司法系统的风险。令人担忧的是，然而,是处方者对有效性证据有限的适应症开处方的明显意愿，如心理健康和睡眠条件。
方法：2022-2023年匿名大麻医学调查（CAMS-22）于2022年12月至2023年4月在线完成，适用于使用大麻治疗疾病的成年澳大利亚人。招聘是通过社交媒体进行的，消费者论坛，和医疗实践。问题包括人口统计特征，大麻的使用模式，治疗条件,和自我评估的有效性。
结果：在这些分析中包括的3323名受访者中，2352(73%)主要使用处方医用大麻，871（27％）主要使用非法。处方使用者比非法使用者更有可能诊断出他们的健康状况(OR=1.7,95%CI1.3,2.2),通过口服（OR=1.9；CI1.5，2.4）或蒸发（OR=5.2；CI4.0，6.8）途径消耗大麻，并确定其医用大麻的成分（OR=25.0；CI16.7，50.0）。处方使用者在医疗使用前使用大麻的可能性大大降低（OR=0.6，CI0.5，0.7），通过烟熏路线消费大麻(OR=0.2，CI0.1，0.2)，并报告任何副作用（OR=0.1；CI0.1，0.2）。处方和非法使用者中最常见的疾病是疼痛（37％），心理健康（36%），和睡眠（15％）条件。处方使用者更有可能使用大麻主要治疗疼痛（OR=1.3；CI1.1，1.5）或睡眠状况（OR=1.4；CI1.1，1.7），而不太可能治疗精神健康状况（OR=0.8；CI0.7，0.9）。两组之间的有效性没有差异，97％的人说医用大麻改善了他们的症状。
结论：从减少伤害的角度来看，有很多值得推荐的处方医用大麻；它的副作用比非法的少，使用更安全(口服或蒸发与吸烟途径)，使消费者对其药物的成分和质量有更大的确定性，并且不会有暴露于刑事司法系统的风险。令人担忧的是，然而,是处方者对有效性证据有限的适应症开处方的明显意愿，如心理健康和睡眠条件。
