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Abstract
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Lorenzetti et al. propose a hierarchical framework of increasing complexity for assessing cannabis use in diverse populations and settings [1]. It is meant to address one of the challenges that many countries are now facing around cannabis: rapidly evolving laws and policies, as well as rapidly evolving products and use patterns. This important step towards harmonizing data collection on a global level will facilitate the ability of different countries (or States) to learn from each other as they implement distinct approaches towards cannabis decriminalization or legalization--with the caveat that cultural, geographic, socio-economic status and other factors also strongly influence outcomes even when policies are identical.
At the same time, there is an urgent need to develop or adapt standards to measure cannabis consumption for medical use. Medical use has been increasing in the United States and continues to garner strong public support [2], despite there being no US Food and Drug Administration (FDA)-approved whole-plant cannabis product for any medical condition. Regulation of cannabis for medical purposes in the United States is currently a patchwork, with widely varying State laws (at odds with those on the Federal level) and few clinical data to inform treatment recommendations. Some states have legalized cannabis products with low delta-9-tetrahydrocannabinol (THC) and high cannabidiol (CBD) content for limited medical uses, while others have broad policies allowing even high-THC cannabis to be used in a range of products and conditions. Most products available at medical dispensaries do not differ in their THC content from those available for adult recreational use [3]. A majority of medical cannabis users report using it to treat pain.
In the United States, physicians and other approved providers (which also vary by State) are not permitted to 'prescribe' cannabis to their patients; instead, they provide a recommendation and patients can purchase the products from dispensaries (or they may grow their own), often following the advice of 'budtenders' with no medical qualifications. As recently as a few years ago, many budtenders in Colorado recommended cannabis to pregnant women for nausea without appropriate cautions or even suggestions that the women consult with their physicians first...
Language: en |