Chronic Disease Symptoms Self-Managed by Cannabis During the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study

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“Background: The COVID-19 pandemic has impacted billions of people worldwide, particularly those with chronic health conditions, and has been associated with increases in substance use, including cannabis. The purpose of this study was to estimate the prevalence of cannabis use for symptom management of chronic health conditions during the COVID-19 pandemic. 

Methods: The COVID-19 Cannabis Health Study is an ongoing study among adults ≥18 who self-report cannabis use. Analyses included 1,466 responses received between March 21, 2020, and March 23, 2022, from participants who self-reported cannabis use and a chronic health condition. We examined comorbidities, symptoms managed with cannabis during the COVID-19 pandemic, and fear regarding COVID-19 diagnosis and transmission using the COVID-19 Cannabis Health Questionnaire. Descriptive statistics, Chi-squared, and T-tests were conducted. Results were stratified by those who reported using cannabis to manage a chronic health condition (medicinal cannabis user, n = 1,333) and those who did not use cannabis to manage chronic health condition (non-medicinal cannabis user, n = 133). 

Results: Most (90.9%, n = 1,333) of the total sample (mean age: 47.1 years [standard deviations {SD} = 15.0]) reported using cannabis to manage a chronic health condition, of which 46.1% (n = 615) reported having a medical card/recommendation, and 4.6% received recommendations to use cannabis to manage COVID-19 from health professionals. There were significant differences in age, gender, race/ethnicity, and education by medicinal cannabis use status. Comorbidities prevalent among medicinal cannabis consumers were mental health-related (66.1%), pain (58.5%), cardiometabolic-related (30.5%), immune-related (21.9%), and respiratory-related (20.8%). The most reported symptoms self-managed with cannabis during the pandemic were sleep (69.2%), chronic noncancer pain (49.7%), acute pain (46.5%), headaches/migraines (39.0%), muscle spasms (33.6%), nausea/vomiting (30.6%), and appetite stimulant (29.9%). There were no statistical differences in COVID-19 testing, fear of diagnosis, fear of transmission, or isolation due to COVID-19 between medicinal and nonmedicinal cannabis consumers in this sample. 

Conclusions: The perceived therapeutic benefit of cannabis during the COVID-19 pandemic is evident by the high prevalence of adults who reported using cannabis for medicinal reasons despite no recommendation from their health provider. Research is necessary to understand the prospective impact of cannabis use for self-management of chronic disease, especially within the context of COVID-19.”

https://pubmed.ncbi.nlm.nih.gov/40008990/

https://www.liebertpub.com/doi/10.1089/can.2023.0234

Cannabis use and illicit opioid cessation among people who use drugs living with chronic pain

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“Introduction: Amidst the opioid overdose crisis, there is interest in cannabis use for pain management and harm reduction. We investigated the relationship between cannabis use and cessation of unregulated opioid use among people who use drugs (PWUD) living with chronic pain.

Method: Data for analyses were collected from three prospective cohort studies in Vancouver, Canada. All cohort participants who completed at least two study visits and reported both pain and unregulated opioid use in the past 6 months were included in the present study. We analysed the association between cannabis use frequency and opioid cessation rates using extended Cox regression models with time-updated covariates.

Results: Between June 2014 and May 2022, 2340 PWUD were initially recruited and of those 1242 PWUD reported chronic pain, use of unregulated opioids and completed at least two follow-up visits. Of these 1242 participants, 764 experienced a cessation event over 1038.2 person-years resulting in a cessation rate of 28.5 per 100 person-years (95% confidence interval [CI] 25.4-31.9). Daily cannabis use was positively associated with opioid cessation (adjusted hazard ratio 1.40, 95% CI 1.08-1.81; p = 0.011). In the sex-stratified sub-analyses, daily cannabis use was significantly associated with increased rates of opioid cessation among males (adjusted hazard ratio 1.50, 95% CI 1.09-2.08; p = 0.014).

Discussion and conclusions: Participants reporting daily cannabis use exhibited higher rates of cessation compared to less frequent users or non-users. Observed sex-specific differences in cannabis use and opioid cessation suggest potential differences in cannabis use behaviours and effects. Our findings add to the growing evidence supporting the potential benefits of cannabis use among PWUD, underlining the need for further research.”

https://pubmed.ncbi.nlm.nih.gov/40011075/

Pain Predicts Cannabis Initiation Among Emerging Adults: Results from the Population Assessment of Tobacco and Health (PATH) Study

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“Pain is highly prevalent among emerging adults (18-25 years old), and rates of cannabis use are increasing among this population. Research indicates pain is a unique risk factor and motivator for substance use. However, evidence for pain-cannabis use relations among emerging adults is largely cross-sectional, and the only prospective evidence focuses on the frequency, quantity, and consequences of cannabis use, not initiation.

Accordingly, this is the first study to examine pain as a prospective predictor of cannabis initiation among emerging adults.

Data were drawn from five annual waves of the Population Assessment of Tobacco and Health Study. Emerging adults who denied cannabis use at baseline (n = 4,185) were included in the analysis. At baseline, a tenth of emerging adults reported moderate/severe pain (≥4/10). Adjusted Cox regression analysis revealed that emerging adults with moderate/severe baseline pain were more likely to initiate cannabis use, and did so earlier over the subsequent 4 years, than those with no/low baseline pain.

These findings provide initial evidence for pain as a risk factor for cannabis initiation during emerging adulthood. Future research is needed to identify mechanisms by which pain motivates cannabis initiation and to examine the utility of pain-targeted content in cannabis use prevention and intervention efforts among emerging adults.”

https://pubmed.ncbi.nlm.nih.gov/40009033/

https://www.tandfonline.com/doi/full/10.1080/08964289.2025.2465525

Inhibitory Potential of Cannabis Biomass Extracts on Livestock-Associated Staphylococcal and Streptococcal Pathogens

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“Diseases caused by staphylococci and streptococci are a serious burden on livestock production, causing significant losses. In addition, the associated antibiotic resistance of these pathogens often makes treatment impossible or prolonged.

Cannabis sativa L. contains many compounds with antibacterial properties and shows great potential as a natural antimicrobial agent for agricultural use against both of these bacterial species.

The aim of this study was to compare the in vitro antibacterial activity of ethanol extracts from five cultivars of hemp, namely, Bialobrzeskie, Felina 32, Futura 75, mixed and Santhica 27, against Staphylococcus aureusStreptococcus agalactiae and Streptococcus dysgalactiae.

All five cultivars exhibited a certain degree of inhibitory effect against all the pathogens tested with minimum inhibitory concentrations (MICs) ranging from 128 to 2048 μg/mL. The extract from the Santhica 27 cultivar was the most effective antibacterial agent with the lowest MIC value of 128 μg/mL against Str. agalactiae and two clinical isolates of S. aureus, followed by Bialobrzeskie and mixed cultivars with the same growth-inhibitory potential against Str. agalactiae.

The extracts from the Felina 32 and Futura 75 cultivars presented only weak activity with MIC values ranging from 256 to 2048 μg/mL. The extract from the Santhica 27 cultivar appears to be a promising product for future use in the treatment of staphylococcal and streptococcal infections in livestock.”

https://pubmed.ncbi.nlm.nih.gov/40005797/

“In this study, the antibacterial activity of ethanol extracts obtained from five different hemp cultivars (Felina 32, Futura 75, mixed, Santhica 27 and Bialobrzeskie) against various strains of S. aureusStr. agalactiae and Str. dysgalactiae, including their antibiotic-resistant and antibiotic-sensitive forms, was investigated.

All five ethanol cannabis extracts possessed specific growth-inhibitory potential against the bacteria tested, while Santhica 27 was identified as the most effective cultivar followed by the mixed and Bialobrzeskie cultivars. In the case of the Felina 32 and Futura 75 cultivars, only weak antibacterial activity was observed.

In the context of ever-increasing bacterial resistance to antibiotics, it is necessary to find alternatives to antibiotic treatment, and cannabis has great potential in this area.”

https://www.mdpi.com/2076-2607/13/2/432

Extraction, GC-MS analysis, cytotoxic, anti-inflammatory and anticancer potential of Cannabis sativa female flower; in vitro, in vivo and in silico

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“This work examines the anticancer activity, the anti-inflammatory nature, and the cytotoxicity of the ethanol extract obtained from the female flowers of Cannabis sativa L using molecular methods in vitro, animal testing in vivo, as well as computational methods and simulations in silico.

From the GC-MS analysis, the following bioactive compounds were found: cannabidiol (CBD), tetrahydrocannabinol (THC), and humulene. The antiproliferative activities of the extract were determined on HeLa cells by using MTT, Crystal Violet, and Trypan Blue assays with an IC50 value suggesting 51%-77.6% lethality.

The bioinformatics analysis of molecular docking proved significant ligand-protein interactions of CBD, THC, and humulene with cancer-associated proteins such as PD-1/PD-L1, TNF-α, and MMP-9. In vivo, breast cancer was first established in female Sprague-Dawley rats with 7,12-dimethylbenz(a)anthracene (DMBA) then treated with cannabinoids either singularly or in combination.

Detailed treatment demonstrated that the use of the three cannabinoids simultaneously yielded the best anticancer and anti-inflammatory outcomes together with the best tumor reduction. The concentration of serum biomarkers of inflammation and tumor progression was substantially reduced in treated groups compared to the control group, which proves the synergistic effects of these cannabinoids in breast cancer therapy.

This study emphasizes the importance of medical Cannabis sativa derivatives in cancer treatment.”

https://pubmed.ncbi.nlm.nih.gov/40008130/

“Cancer still has no known treatment, and research is being conducted to create lead compounds and precursors that could be used as anticancer medications for 1 day. The goal of this study was to identify natural compounds with anticancer properties.

The MTT assay showed that cannabinoids retain anti-proliferative, anti-invasion, and apoptotic effects. IC50 upregulates 51%–77.6% of carcinoma cell death. The synergistic effects of cannabidiol, tetrahydrocannabinol, and humulene significantly suppressed PD-1/PD-L1 expression and oxidative stress, suggesting a possible approach for targeting breast cancer resistance. The greatest effect was obtained when all three compounds were combined, suggesting that the immunosuppressive and oxidative stress-modulatory effects of the compounds occurred synergistically.

Herein, we report comprehensive findings that may be helpful in designing new combinatory therapeutic strategies for breast cancer via the PD-1/PD-L1 pathway and oxidative stress markers. Further studies and trials are needed to identify more cannabinoid-based treatments and to combine pharmacological and cannabinoid drugs to gain remarkable effects against various cancer treatments.”

“Cannabis sativa is the oldest cultivated plant and contains a lot of naturally useful components used by humans. It is used as a source of fuel, food, herbal body care products, and medicines to cure different diseases. It is a plant of the Cannabaceae family. “

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1546062/full

Enhancing Tetrahydrocannabinol’s Therapeutic Efficacy in Inflammatory Bowel Disease: The Roles of Cannabidiol and the Cannabinoid 1 Receptor Allosteric Modulator ZCZ011

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“Background/Objectives: Current inflammatory bowel disease (IBD) treatments focus on symptomatic relief, highlighting the need for innovative approaches. Dysregulation of the cannabinoid 1 (CB1) receptor, part of the endocannabinoid system, is linked to colitis. While tetrahydrocannabinol (THC) alleviates colitis via CB1 activation, its psychotropic effects limit clinical use. ZCZ011, a CB1R allosteric modulator, and cannabidiol (CBD), a non-psychoactive cannabinoid, offer alternatives. This study investigated combining sub-therapeutic THC doses with ZCZ011 or CBD in a murine model of dextran sodium sulphate (DSS)-induced colitis. 

Methods: Acute colitis was induced with 4% DSS for 7 days, followed by 3 days of water. Chronic colitis was modelled over 24 days with alternating DSS concentrations. The combination of 2.5 mg/kg THC with 20 mg/kg ZCZ011 or 10 mg/kg CBD was evaluated. Key markers were assessed to determine efficacy and safety, including disease activity index (DAI), inflammation, cytokine levels, GLP-1, and organ health. 

Results: DSS-induced colitis resulted in increased DAI scores, cytokines, organ inflammation and dysregulation of GLP-1 and ammonia. THC at 10 mg/kg significantly improved colitis markers but was ineffective at 2.5 and 5 mg/kg. ZCZ011 alone showed transient effects. However, combining 2.5 mg/kg THC with either 20 mg/kg ZCZ011 or 10 mg/kg CBD significantly alleviated colitis markers, restored colon integrity and reestablished GLP-1 homeostasis. This combination also maintained favourable haematological and biochemical profiles, including a notable reduction in colitis-induced elevated ammonia levels. 

Conclusions: This study demonstrates the synergistic potential of low-dose THC combined with CBD or ZCZ011 as a novel, effective and safer therapeutic strategy for ulcerative colitis.”

https://pubmed.ncbi.nlm.nih.gov/40005963/

“This study provides compelling evidence that sub-therapeutic doses of THC combined with ZCZ011 or CBD offer a safe and effective strategy for managing both the inflammatory and metabolic components of IBD. Notably, the normalisation of GLP-1 and ammonia levels underscores the dual benefits of these treatments in alleviating colitis while addressing associated metabolic dysregulation and extraintestinal complications. This dual-action approach addresses key limitations of current therapies and emphasizes ECS modulation as a promising avenue for IBD treatment.”

https://www.mdpi.com/1424-8247/18/2/148

Modulation of the endocannabinoid system in chronic conditions: a potential therapeutic intervention yet to be explored in sickle cell disease

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“Introduction: Individuals living with Sickle Cell Disease (SCD) are subject to numerous chronic complications, including disabling chronic pain, often dependent on opioids and with important repercussions on quality of life. The use of Medicinal Cannabis in this scenario may be a promising strategy for mitigating this impact.

Areas covered: This work compiled current knowledge regarding the endocannabinoid system in humans and the role of this system in various organic functions. Articles were retrieved through a comprehensive search of the PubMed NCBI database, covering relevant studies up to 2024. These data bring important speculations on the potential role of the use of medicinal cannabis in modulating SCD chronic complications, and the preliminary results of clinical trials carried out in this condition are discussed.

Expert opinion: The search for understanding the role of cannabis-derived products in the management of chronic complications of sickle cell disease could add resources to the serious challenge of dealing with the multiple aspects of the disease faced by patients. They range from the management of chronic pain itself, the risks of opioid dependence, in addition to other difficult scenarios, such as leg ulcers and chronic inflammation and its consequences.”

https://pubmed.ncbi.nlm.nih.gov/39992131/

https://www.tandfonline.com/doi/full/10.1080/17474086.2025.2471864

Combined effects of cannabidiol and Δ9-tetrahydrocannabinol alleviate migraine-like symptoms in mice

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“Background: The therapeutic use of cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) to treat migraine has been understudied. Using three mouse models, we examined the impact of CBD and THC on migraine-relevant behaviors triggered by: 1) calcitonin gene-related peptide (CGRP), 2) sodium nitroprusside (SNP), and 3) cortical spreading depolarization (CSD).

Methods: Both male and female CD1 mice were treated with CBD (100 mg/kg) or THC (1 mg/kg) alone or in combinations of CBD (1, 30 or 100 mg/kg) and THC (1 mg/kg) prior to injection of CGRP or SNP. The mice were assessed for light aversion (photophobia), squint (non-evoked pain), and periorbital tactile hypersensitivity, as well as possible adverse effects. In a separate set of experiments, CSD events were optogenetically induced in familial hemiplegic migraine 1 (FHM1) mutant and wildtype littermates (WT) mice (C57BL/6 background), followed by grimace and motor assessments with and without combinations of CBD (30 or 100 mg/kg) and THC (1 mg/kg).

Results: In CD1 mice, a 100:1 CBD:THC combination mitigated light aversion induced by CGRP and SNP in males and females. Rescue of CGRP- and SNP-induced squint was observed only in male mice with 100:1 CBD:THC. None of the treatments rescued periorbital tactile hypersensitivity in either sex. In FHM1 mutant and WT mice, the 100:1 CBD:THC ratio did not affect CSD characteristics but did reduce CSD-induced grimace features (i.e., head pain mimic). No adverse effects of any of the cannabinoid treatments were observed using cognitive, emotional, or motor tests.

Conclusions: A 100:1 ratio of CBD:THC has a beneficial effect on some of the most bothersome migraine-related symptoms in three mouse models. Our findings support a potential therapeutic efficacy of combined CBD and THC treatments.”

https://pubmed.ncbi.nlm.nih.gov/39988876/

“Our preclinical findings suggest that cannabinoids may have therapeutic potential for treating migraine symptoms without causing adverse effects. These findings are in line with previous studies that have suggested that cannabinoids may be effective in treating pain and migraine.”

https://journals.sagepub.com/doi/10.1177/03331024251314487

Cannabis Use in HIV: Impact on Inflammation, Immunity and the Microbiome

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“Purpose of review: This review explores how cannabis impacts the gut microbiome, immune system, and ART outcomes in people with HIV (PWH). Given the increasing prevalence of cannabis use among PWH, we investigated its potential to reduce chronic inflammation and enhance gut health, both of which can influence HIV pathogenesis.

Recent findings: Cannabis has immunomodulatory and anti-inflammatory effects, including reducing systemic inflammatory biomarkers (such as MCP-1 and IP-10) and improving gut barrier integrity through increased short-chain fatty acid (SCFA) production.

Studies have shown that cannabis use is associated with increased gut mucosal immunity, decreased immune activation, and a unique microbiome composition. Preliminary evidence indicates that cannabis may influence HIV reservoirs, although the results remain inconclusive.

Cannabis shows promise in managing inflammation, gut dysbiosis, and immune dysfunction in PWH. However, its effects on HIV reservoirs, adherence to antiretroviral therapy, and long-term outcomes need further investigation through rigorous clinical trials using standardized formulations.”

https://pubmed.ncbi.nlm.nih.gov/39984806/

https://link.springer.com/article/10.1007/s11904-025-00729-0

Impacts of vaping and marijuana use on airway health as determined by exhaled breath condensate (EBC)

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“Across the United States, there is increased use of cannabis products and electronic delivery systems for cannabis products and nicotine, yet little is known about their impacts on lung health.

We analyzed exhaled breath condensate of 254 participants who were non-users and users who used cannabis and tobacco products. The 132 participants reported using a product (“users”) were distributed into cohorts of tobacco products and cannabis products, with some participants following into multiple cohorts.

Targeted analysis of inflammatory oxylipins found up-regulation among persons using tobacco products, while cannabis users had concentrations closer to nonusers, and often down-regulated.

Untargeted screening of 403 significant metabolites found tobacco users had similar breath profiles, and that cannabis users had a similar profile that was closer to the profile of nonusers.

Metabolites were significantly higher in breath of people using combustion products (tobacco and cannabis) relative to nonusers, and significantly lower in e-device users (nicotine and THC). Our work demonstrates the relative impact of e-delivery systems and cannabis products compared to traditional cigarette smoking on lung metabolic profiles.”

https://pubmed.ncbi.nlm.nih.gov/39984952/

“Analysis of exhaled breath condensate was used to compare human metabolomic information of persons using tobacco and cannabis related products. Targeted measurements of oxylipin inflammatory markers found significant up-regulation among those using tobacco products relative to nonusers.

Cannabis users exhibited oxylipin levels closer to and often downregulated compared to nonusers. However, direct links to clinical outcomes such as lung disease or respiratory dysfunction were not established, limiting conclusions about the clinical impact of these biomarkers.

Untargeted screening of breath metabolites found that users of cigarettes, nicotine vapes, and any tobacco product had similar metabolite profiles, whereas cannabis smokers, vapers, and product users had a profile that was more similar to nonusers.”

https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-025-03147-3