Clinical management

Health benefits and risks of cannabis use

A review of 101 meta-analyses of randomised controlled trials and observational studies, looked at the risks and benefits of cannabis use.

Evidence particularly supports avoidance of cannabis in early adulthood, people with mental health disorders, pregnancy (linked to low birth weight) and before driving (increased risk of accidents).

In the general healthy population, use of cannabis-based medicines/ cannabinoids has been linked to psychotic symptoms, suicide attempt, depression, mania and impaired cognition.

Cannabis-based medicines can provide benefits, but can also cause adverse effects in various conditions;

• Epilepsy (reduced seizures but increased gastrointestinal side-effects and somnolence)

• Multiple sclerosis (improved spasticity and pain, but increased risk of dizziness, dry mouth, nausea and somnolence)

• Chronic pain (reduced pain, but adverse psychological effects - see separate GEM)

• Inflammatory bowel disease (improved quality of life)

• Palliative medicine (reduced sleep disruption, but increased gastrointestinal side-effects)

WiseGP Actions:

• When patients inform you they are taking cannabis-based medicines/cannabinoids, do you know how to advise them?

• Do you enquire about and record data on cannabis use, for instance, when people tell you they take CBD oil or vape cannabis? It could inform the advice you offer for other presenting problems such as mental health concerns, somnolence or gastrointestinal symptoms.

Read more about the research informing this GEM here: https://www.bmj.com/content/382/bmj-2022-072348