Supplementary Material for: UK Medical Cannabis Registry: A Clinical Analysis of Patients with Substance Use Disorder

Background:
With a global rise in opioid-related mortality, comes a need to address this with novel therapies. Cannabinoid receptors are highly expressed and co-localised with opiate receptors of the mesolimbic system. Cannabis-based medicinal products (CBMPs) have been suggested as a measure to reduce harm as maintenance therapy for substance use disorder (SUD).

Aim:
To assess changes in patient-reported outcomes measures (PROMs) and opioid medications in individuals treated with CBMPs for SUD.

Methods:
Data from patients with SUD from the UK Medical Cannabis Registry was analysed. Outcomes included changes at 1, 3, and 6 months from baseline of the EQ-5D-DL, single-item sleep quality scale (SQS) and Generalised Anxiety Disorder-7 (GAD-7) questionnaire. Change in opioid medications was assessed as change in oral morphine equivalent (OME).

Results:
Thirty-four patients were included. Twenty-seven (79.41%) participants were male. Twenty-nine (85.29%) participants were illicit cannabis consumers at baseline. The most common SUD was opioid use disorder (n=18; 52.94%). Four (11.76%), 14 (41.18%), and 16 (47.05%), patients were prescribed oils, dried flower or a combination of dried flower and oils, respectively. Improvements in GAD-7, SQS, and EQ-5D-5L at 1, 3, and 6 months from baseline were observed (p<0.050). Median OME consumption at baseline was 274.95 [79.50-441.80] mg/day. This was reduced at 6 months (204.45 [61.88-354.85] mg/day; p=0.043), there was no significant difference at 1 or 3 months (p>0.050). Three (8.81%) participants reported 17 (50.00%) adverse events.

Conclusions:
There was an associated improvement in health-related quality of life PROMs and reduction in prescribed opioids in individuals with SUD treated with CBMPs. CBMPs were well tolerated by most individuals in this 6-month analysis. Further evaluation through randomised controlled trials is needed to determine causality.