“Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Drugs
2.3. CBPM Administration Protocol
- Fill the Mighty Medic dosing capsules with grounded cannabis flos (Figure 1B). Although the maximum capacity per capsule is 250 mg, dosing is based in both the number and frequency of inhalations rather than the absolute amount of herbal material loaded into the device. This allows an experienced patient to have more control over administration and dosing while, at the same time, adjust and standardize the amount of cannabis flos used to optimize cost–benefit.
- Turn on the device and set the temperature to 180 °C (Figure 1A). At this temperature, vapor will be composed mainly of steam, most volatile terpenes (e.g., limonene, pinene), and small amounts of THC (boiling point 157 °C) which will start decarboxylating.
- Once the target temperature is reached, patients are instructed to inhale and exhale naturally. Vapor should not be held in the lungs longer than during regular breathing. The first inhalation is typically less effective since it serves to “prime” the device and warm up the herbal material.
- After inhaling the indicated number of times (see Figure 1C), patients are advised to wait for 15–20 min and observe for side effects (such as dizziness, tachycardia, nausea, disorientation, euphoria, etc.). After this period, and in absence of side effects, patients can repeat the cycle if symptomatic control has not been achieved, increasing the temperature by 10 °C (Figure 1C).
- At 190 °C and 200 °C the vapor may feel dryer and less fragrant but will be more concentrated in cannabinoids [30]. Vaporization of cannabinoids continues at high temperatures even if vapor is not visible when exhaling, due to the exhaustion of water in the herbal material.
- The goal for this 5-day initiation protocol is to provide the prescribing doctor with clear administration instructions to share with patients so that they can experiment with the device and familiarize themselves safely with cannabis inhalation.
2.4. Patient-Reported Outcome Measures (PROMS)
2.4.1. Health-Related Quality of Life
- The visual analog score (VAS) of general health (0–100) was interpreted as a patient-reported measure of general health.
- The sum of ratings for the five dimensions of the EuroQol (5–25) was interpreted as patient-reported measure of HRQoL.
2.4.2. Mood/Depression
2.4.3. Sleep Disturbances
2.4.4. Chronic Pain
2.4.5. Anxiety
2.5. Statistical Analysis
3. Results
3.1. Participants
3.2. General Health Outcome Measures
3.2.1. Health Related Quality of Life (HRQoL)
3.2.2. General Mood/Depression
3.2.3. Sleep Quality
3.3. Indication-Specific Outcome Measures
3.3.1. Pain Severity
3.3.2. Pain Interference
3.3.3. Generalized Anxiety Disorder
3.4. Adverse Effects
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Gender | Total | |||
---|---|---|---|---|
Male | Female | Non-Binary | ||
Participants | ||||
Sample: N (%) | 267 (77.6) | 76 (22.1) | 1 (0.3) | 344 (100) |
Age: Mean ± SD | 38.3 ± 10.6 | 38.6 ± 9.89 | 42 ± 0.0 | 38.4 ± 10.4 |
Previous Experience with Cannabis: N (%) | 259 (97.0) | 69 (90.8) | 1 (100) | 329 (95.6) |
Intention of treating their primary condition with cannabis: N (%) | 205 (76.8) | 56 (73.7) | 1 (100) | 262 (76.1) |
Frequency of cannabis use: N (%) | ||||
Weekly | 2 (0.75) | 1 (1.32) | 0 | 3 (0.87) |
A few times a week | 29 (10.9) | 12 (15.8) | 0 | 41 (11.9) |
Once a day | 160 (59.9) | 41 (53.9) | 1 (100) | 202 (58.7) |
Multiple times a day | 15 (5.62) | 3 (3.95) | 0 | 18 (5.23) |
Did not answer the question | 61 (22.8) | 19 (25.0) | 0 | 80 (23.2) |
Primary Condition: N (%) | ||||
Chronic painful conditions | 134 (50.2) | 40 (52.6) | 1 (100) | 175 (50.8) |
Anxiety-related disorders | 74 (27.7) | 13 (17.1) | 0 | 87 (25.3) |
ADHD | 19 (7.12) | 5 (6.58) | 0 | 24 (6.98) |
PTSD | 12 (4.49) | 9 (11.8) | 0 | 21 (6.10) |
Other Mental Health | 14 (5.24) | 4 (5.26) | 0 | 18 (5.23) |
Insomnia | 8 (3.00) | 2 (2.63) | 0 | 10 (2.91) |
Autism Spectrum Disorder | 2 (0.75) | 0 | 0 | 2 (0.58) |
Epilepsy | 0 | 1 (2.33) | 0 | 1 (0.52) |
Other | 4 (1.50) | 1 (1.32) | 0 | 5 (1.45) |
General Health EQ5D VAS Score | Health-Related QoL EQ5D 5-Dimensions SUM | Mood/Depression PHQ-9 Score | Quality of Sleep PSQI Score | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean T = 0 | Mean T = 3 | Mean Diff | Mean T = 0 | Mean T = 3 | Mean Diff | Mean T = 0 | Mean T = 3 | Diff Mean | Mean T = 0 | Mean T = 3 | Mean Diff | |
Anxiety (N = 107) | 57.10 | 69.55 | 12.4 | 10.07 | 8.31 | 1.76 | 13.72 | 6.58 | 7.14 | 12.31 | 9.16 | 3.15 |
Chronic Pain (N = 174) | 47.35 | 54.33 | 6.98 * | 14.24 | 12.94 | 1.30 | 12.78 | 9.42 | 3.36 ** | 13.51 | 10.79 | 2.72 |
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Moreno-Sanz, G.; Madiedo, A.; Lynskey, M.; Brown, M.R.D. “Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients. Biomedicines 2022, 10, 2576. https://doi.org/10.3390/biomedicines10102576
Moreno-Sanz G, Madiedo A, Lynskey M, Brown MRD. “Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients. Biomedicines. 2022; 10(10):2576. https://doi.org/10.3390/biomedicines10102576
Chicago/Turabian StyleMoreno-Sanz, Guillermo, Alvaro Madiedo, Michael Lynskey, and Matthew R. D. Brown. 2022. "“Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients" Biomedicines 10, no. 10: 2576. https://doi.org/10.3390/biomedicines10102576
APA StyleMoreno-Sanz, G., Madiedo, A., Lynskey, M., & Brown, M. R. D. (2022). “Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients. Biomedicines, 10(10), 2576. https://doi.org/10.3390/biomedicines10102576