ABSTRACT
Background: Over the past decade, there has been increased utilization of medical cannabis (MC) in the United States. Few studies have described sociodemographic and clinical factors associated with MC use after certification and more specifically, factors associated with use of MC products with different cannabinoid profiles. Methods: We conducted a longitudinal cohort study of adults (N=225) with chronic or severe pain on opioids who were newly certified for MC in New York State and enrolled in the study between November 2018 and January 2022. We collected data over participants' first 3 months in the study, from web-based assessment of MC use every 2 weeks (unit of analysis). We used generalized estimating equation models to examine associations of sociodemographic and clinical factors with (1) MC use (vs. no MC use) and (2) use of MC products with different cannabinoid profiles. Results: On average, 29% of the participants used predominantly high delta-9-tetrahydrocannabinol (THC) MC products within the first 3 months of follow-up, 30% used other MC products, and 41% did not use MC products. Non-Hispanic White race, pain at multiple sites, and past 30-day sedative use were associated with a higher likelihood of MC use (vs. no MC use). Current tobacco use, unregulated cannabis use, and enrollment in the study during the COVID-19 pandemic were associated with a lower likelihood of MC use (vs. no MC use). Among participants reporting MC use, female gender and older age were associated with a lower likelihood of using predominantly high-THC MC products (vs. other MC products). Conclusion: White individuals were more likely to use MC after certification, which may be owing to access and cost issues. The findings that sedative use was associated with greater MC use, but tobacco and unregulated cannabis were associated with less MC use, may imply synergism and substitution that warrant further research. From the policy perspective, additional measures are needed to ensure equitable availability of and access to MC. Health practitioners should check patients' history and current use of sedative, tobacco, and unregulated cannabis before providing an MC recommendation and counsel patients on safe cannabis use. clinicaltrials.gov (NCT03268551).
ABSTRACT
INTRODUCTION: The global COVID-19 pandemic has caused changes in the daily life of people, with a particularly relevant impact upon certain groups of individuals that have difficulties in facing stress. A study is made of the impact of the pandemic upon patients with burning mouth syndrome (BMS). MATERIAL AND METHODS: A total of 40 patients with BMS diagnosed in the Unit of Oral Medicine (University of Murcia, Spain) were included. In all cases the study comprised a standardized clinical interview by the same professional and an exploration of the oral cavity. The first visit took place before the pandemic and consisted of the evaluation of anxiety (Hospital and Anxiety Depression Scale [HADS]), the Pain Catastrophizing Scale (PCS), pain intensity (visual analog scale [VAS]) and sleep quality (Pittsburg Sleep Quality Index [PSQI]), while the second visit took place one and a half months after the start of lockdown due to the pandemic in Spain. RESULTS: The study sample consisted of 36 women (90%) and four men (10%) aged between 39 and s86 years. Statistically significant differences were recorded between the two visits in terms of anxiety (p < 0.001), sleep quality (p < 0.001) and pain intensity (p < 0.001). CONCLUSIONS: The appearance of the COVID-19 pandemic has triggered worsening of anxiety, sleep quality and pain intensity in patients with BMS.