Treatment-resistant patients say their quality of life improves with cannabinoid medicine

This original longitudinal investigation examined the effects of cannabis treatment on health-related quality of life (HRQoL) in more than 3,000 patients diagnosed with several chronic conditions. It was published in May 2023 on the Journal of the American Medical Association (JAMA) Network.

3,148 patients with an average age of 56 were tracked for up to 15 follow-up visits over a period of 675 days. Most were diagnosed with chronic non-cancer pain (69%), followed by cancer pain (6%), insomnia (5%) and anxiety (4%).

All patients were required to have exhausted other treatment options for their clinical indication before medical cannabis could be prescribed, so they all had treatment-resistant conditions. Patient data was collected through May 5, 2022.

They used the 36-Item Short Form Health Survey (SF-36) questionnaire to track changes in patients' perception of their health-related quality of life. Specifically, it tracks 36 items grouped in 8 dimensions:

  1. physical functoning
  2. physicial limitations
  3. emotional limitations
  4. social functioning
  5. bodily pain
  6. general health
  7. vitality
  8. mental health


Treatment regimes included 3 primary cannabinoid profiles (on average):

  • Balanced: 19mg CBD + 19mg THC
  • CBD dominant: 97mg CBD + 9mg THC
  • THC dominant: 5mg CBD + 36mg THC


The authors noted that after 90 days, the CBD dose stayed mostly stable for the next 500+ days. However, those also taking THC steadily increased their daily dose from about 7mg to 26mg (average) at follow-up 15.

The patients reported improvements in ALL 8 dimensions of HRQoL, and these improvements were maintained over time. Balanced CBD+THC products showed the most improvements in 6 of the measured 'domains'. Interestingly, THC dominant products showed the most improvements in the physical functioning domain.

In the authors' words:

After commencing treatment with medical cannabis, patients reported significant improvements relative to baseline on all 8 domains of the SF-36

For all domains except for physical functioning and role-physical, balanced products were associated with marginally greater improvements than either CBD-dominant or THC-dominant products.

CBD-dominant products were associated with largest improvements on the role-physical domain, while THC-dominant products were associated with largest improvements on the physical functioning domain.


The authors' general conclusion:

patients using medical cannabis reported improvements in health-related quality of life, which were mostly sustained over time.



The full text article is here at the JAMA Network.