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Research Article

Exploring medicinal use of low-THC cannabis products - Comparing experienced effects and side-effects between CBD-oil-only users to users of high-THC cannabis products

, , &
Received 08 Jul 2023, Accepted 23 Jan 2024, Published online: 14 Feb 2024

References

  • Althubaiti, A. (2016). Information bias in health research: Definition, pitfalls, and adjustment methods. Journal of Multidisciplinary Healthcare, 9, 211–217. https://doi.org/10.2147/JMDH.S104807
  • Andersen, M. (2022). Cannabis is legally sold as potpourri, but is it actually smoked? (Cannabis bliver lovligt solgt som potpourri, men bliver det faktisk røget?). Retrieved 13.12 2022 from https://www.tv2lorry.dk/koebenhavn/cannabis-bliver-lovligt-solgt-som-potpourri-men-bliver-det-faktisk-roeget?fbclid=IwAR2wSTscv6Fh3NxnL4p6-NCUQGZBnmovsjbswSgxx5rr3vH7OPXnpdttLrg
  • Arnold, J. C., McCartney, D., Suraev, A., & McGregor, I. S. (2022). The safety and efficacy of low oral doses of cannabidiol: An evaluation of the evidence. Clinical and Translational Science, 16(1), 10–30. https://doi.org/10.1111/cts.13425
  • Avisen, D. (2017, 16 juni). Søs Egelind om pot: ingen medicin kunne lindre paa den måde. https://www.avisen.dk/soes-egelind-om-pot-ingen-medicin-kunne-lindre-paa-d_449459.aspx
  • Banerjee, R., Erridge, S., Salazar, O., Mangal, N., Couch, D., Pacchetti, B., & Sodergren, M. H. (2022). Real world evidence in medical cannabis research. Therapeutic Innovation & Regulatory Science, 56(1), 8–14. https://doi.org/10.1007/s43441-021-00346-0
  • Barratt, M. J., Ferris, J. A., Zahnow, R., Palamar, J. J., Maier, L. J., & Winstock, A. R. (2017). Moving on from representativeness: Testing the utility of the Global Drug Survey. Substance Abuse, 11, 1178221817716391. https://doi.org/10.1177/1178221817716391
  • Barratt, M. J., Potter, G. R., Wouters, M., Wilkins, C., Werse, B., Perälä, J., Pedersen, M. M., Nguyen, H., Malm, A., Lenton, S., Korf, D., Klein, A., Heyde, J., Hakkarainen, P., Frank, V. A., Decorte, T., Bouchard, M., & Blok, T. (2015). Lessons from conducting trans-national Internet-mediated participatory research with hidden populations of cannabis cultivators. The International Journal on Drug Policy, 26(3), 238–249. https://doi.org/10.1016/j.drugpo.2014.12.004
  • Barrus, D. G., Capogrossi, K. L., Cates, S. C., Gourdet, C. K., Peiper, N. C., Novak, S. P., Lefever, T. W., & Wiley, J. L. (2016). Tasty THC: Promises and challenges of cannabis edibles. Methods Report, 2016, 1611. https://doi.org/10.3768/rtipress.2016.op.0035.1611
  • Bechgaard, A. T. (2014, 24 feb). Patients seek advice on Facebook on the use of illegal cannabis (Syge søger råd på Facebook om brugen af ulovlig cannabis). Dr.dk. https://www.dr.dk/nyheder/indland/syge-soeger-raad-paa-facebook-om-brugen-af-ulovlig-cannabis
  • Bharat, C., Webb, P., Wilkinson, Z., McKetin, R., Grebely, J., Farrell, M., Holland, A., Hickman, M., Tran, L. T., Clark, B., Peacock, A., Darke, S., Li, J.-H., & Degenhardt, L. (2023). Agreement between self-reported illicit drug use and biological samples: A systematic review and meta-analysis. Addiction, 118(9), 1624–1648. https://doi.org/10.1111/add.16200
  • Bilbao, A., & Spanagel, R. (2022). Medical cannabinoids: A pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Medicine, 20(1), 259. https://doi.org/10.1186/s12916-022-02459-1
  • Black, N., Stockings, E., Campbell, G., Tran, L. T., Zagic, D., Hall, W. D., Farrell, M., & Degenhardt, L. (2019). Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: A systematic review and meta-analysis. The Lancet. Psychiatry, 6(12), 995–1010. https://doi.org/10.1016/S2215-0366(19)30401-8
  • Blaskovich, M. A. T., Kavanagh, A. M., Elliott, A. G., Zhang, B., Ramu, S., Amado, M., Lowe, G. J., Hinton, A. O., Pham, D. M. T., Zuegg, J., Beare, N., Quach, D., Sharp, M. D., Pogliano, J., Rogers, A. P., Lyras, D., Tan, L., West, N. P., Crawford, D. W., … Thurn, M. (2021). The antimicrobial potential of cannabidiol. Communications Biology, 4(1), 7. https://doi.org/10.1038/s42003-020-01530-y
  • Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1
  • Boehnke, K. F., Häuser, W., & Fitzcharles, M.-A. (2022). Cannabidiol (CBD) in Rheumatic Diseases (Musculoskeletal Pain). Current Rheumatology Reports, 24(7), 238–246. https://doi.org/10.1007/s11926-022-01077-3
  • Bonaccorso, S., Ricciardi, A., Zangani, C., Chiappini, S., & Schifano, F. (2019). Cannabidiol (CBD) use in psychiatric disorders: A systematic review. Neurotoxicology, 74, 282–298. https://doi.org/10.1016/j.neuro.2019.08.002
  • Bonn-Miller, M. O., Loflin, M. J., Thomas, B. F., Marcu, J. P., Hyke, T., & Vandrey, R. (2017). Labeling accuracy of cannabidiol extracts sold online. JAMA, 318(17), 1708–1709. https://doi.org/10.1001/jama.2017.11909
  • Britch, S. C., Babalonis, S., & Walsh, S. L. (2021). Cannabidiol: Pharmacology and therapeutic targets. Psychopharmacology, 238(1), 9–28. https://doi.org/10.1007/s00213-020-05712-8
  • Brix, L. (2020, 24 November). Chaos in the content of cannabis oils (Kaos i indholdet af cannabisolier). Videnskab.dk. https://videnskab.dk/krop-sundhed/kaos-i-indholdet-af-cannabisolier
  • CBD-Helten. (2022). Retrieved December 13, from https://www.cbd-helten.dk/
  • Chesney, E., Oliver, D., Green, A., Sovi, S., Wilson, J., Englund, A., Freeman, T. P., & McGuire, P. (2020). Adverse effects of cannabidiol: A systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology, 45(11), 1799–1806. https://doi.org/10.1038/s41386-020-0667-2
  • Chesney, E., Oliver, D., & McGuire, P. (2021). Cannabidiol (CBD) as a novel treatment in the early phases of psychosis. Psychopharmacology, 239(5), 1179–1190. https://doi.org/10.1007/s00213-021-05905-9
  • Citti, C., Linciano, P., Russo, F., Luongo, L., Iannotta, M., Maione, S., Laganà, A., Capriotti, A. L., Forni, F., Vandelli, M. A., Gigli, G., & Cannazza, G. (2019). A novel phytocannabinoid isolated from Cannabis sativa L. with an in vivo cannabimimetic activity higher than Δ9-tetrahydrocannabinol: Δ9-Tetrahydrocannabiphorol. Scientific Reports, 9(1), 20335. https://doi.org/10.1038/s41598-019-56785-1
  • Colizzi, M., & Bhattacharyya, S. (2017). Does Cannabis Composition Matter? Differential Effects of Delta-9-tetrahydrocannabinol and Cannabidiol on Human Cognition. Current Addiction Reports, 4(2), 62–74. https://doi.org/10.1007/s40429-017-0142-2
  • Corroon, J., & Phillips, J. A. (2018). A Cross-Sectional Study of Cannabidiol Users. Cannabis and Cannabinoid Research, 3(1), 152–161. https://doi.org/10.1089/can.2018.0006
  • Cuculiza, M. (2019, January 19). Cannabisassociation sounds the alarm: The CBD-marked is a pure wild west (Cannabisforening slår alarm: CBD-markedet er et rent wild west.). Sundhedspolitisk tidsskrift. https://sundhedspolitisktidsskrift.dk/nyheder/1706-cannabis-forening-slar-alarm-cbd-markedet-er-et-rent-wild-west.html
  • Curran, H. V., Freeman, T. P., Mokrysz, C., Lewis, D. A., Morgan, C. J., & Parsons, L. H. (2016). Keep off the grass? Cannabis, cognition and addiction. Nature Reviews. Neuroscience, 17(5), 293–306. https://doi.org/10.1038/nrn.2016.28
  • Curran, H. V., Hindocha, C., Morgan, C. J., Shaban, N., Das, R. K., & Freeman, T. P. (2019). Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? Psychological Medicine, 49(9), 1574–1580. https://doi.org/10.1017/S003329171800226X
  • Damløv, L. (2016, October 11). Cannabis sellers on the internet mislead sick people (Cannabis-sælgere på nettet vildleder syge mennesker). Danmarks Radio https://www.dr.dk/nyheder/indland/cannabis-saelgere-paa-nettet-vildleder-syge-mennesker
  • Danish Medicines Agency. (2021, May 11). List of products determined to be medicines. https://laegemiddelstyrelsen.dk/en/licensing/medicine-or-not/list-of-products-determined-to-be-medicines/
  • Danish Medicines Agency, L. (2018, October 11). Change of the THC limit as of 1 July 2018. Retrieved 24.03.2020 from https://laegemiddelstyrelsen.dk/en/special/medicinal-cannabis/citizens/change-of-the-thc-limit-as-of-1-july-2018/
  • Danske Patienter. (2020, February 25). Patients opinions on and experiences with cannabis as medicine (Patienters holdninger til og erfaringer med cannabis Som Medicin) Retrieved 19.10.2021 from https://danskepatienter.dk/sites/danskepatienter.dk/files/media/Publikationer%20-%20Eksterne/A_Danske%20Patienter%20%28eksterne%29/rapport_cannabis_som_medicin.pdf
  • Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., Bianconi, F., Gardner-Sood, P., O’Connor, J., Russo, M., Stilo, S. A., Marques, T. R., Mondelli, V., Dazzan, P., Pariante, C., David, A. S., Gaughran, F., Atakan, Z., Iyegbe, C., … Murray, R. M. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: A case-control study. The Lancet. Psychiatry, 2(3), 233–238. https://doi.org/10.1016/S2215-0366(14)00117-5
  • Di Forti, M., Quattrone, D., Freeman, T. P., Tripoli, G., Gayer-Anderson, C., Quigley, H., Rodriguez, V., Jongsma, H. E., Ferraro, L., La Cascia, C., La Barbera, D., Tarricone, I., Berardi, D., Szöke, A., Arango, C., Tortelli, A., Velthorst, E., Bernardo, M., Del-Ben, C. M., … Murray, R. M. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicentre case-control study. The Lancet. Psychiatry, 6(5), 427–436. https://doi.org/10.1016/S2215-0366(19)30048-3
  • Dr1. (2017, January 24). Søs and the fight for cannabis (Søs og kampen om cannabis) Retrieved March 20, 2019, from https://www.dr.dk/drtv/serie/soes-og-kampen-om-cannabis_19010
  • Dr2. (2014, February 24). Dr2 undersøger: Syge danskere på hashmedicin (Dr2 Explores: Sick Danes on hash medicine). https://www.dr.dk/tv/se/dr2-undersoeger/dr2-undersoeger-syge-danskere-pa-hashmedicin?app_mode=true&platform=undefined
  • Drennan, M., Karoly, H., Bryan, A., Hutchison, K., & Bidwell, L. (2021). Acute objective and subjective intoxication effects of legal-market high potency THC-dominant versus CBD-dominant cannabis concentrates. Scientific Reports, 11(1), 21744. https://doi.org/10.1038/s41598-021-01128-2
  • Dunlap, E., & Johnson, B. D. (1998). Gaining access to hidden populations: Strategies for gaining cooperation of drug sellers/dealers and their families in ethnographic research. Drugs & Society, 14(1–2), 127–149. https://doi.org/10.1300/J023v14n01_11
  • Englund, A., Freeman, T. P., Murray, R. M., & McGuire, P. (2017). Can we make cannabis safer? The Lancet. Psychiatry, 4(8), 643–648. https://doi.org/10.1016/S2215-0366(17)30075-5
  • Englund, A., Oliver, D., Chesney, E., Chester, L., Wilson, J., Sovi, S., De Micheli, A., Hodsoll, J., Fusar-Poli, P., Strang, J., Murray, R. M., Freeman, T. P., & McGuire, P. (2022). Does cannabidiol make cannabis safer? A randomised, double-blind, cross-over trial of cannabis with four different CBD: THC ratios. Neuropsychopharmacology, 48(6), 869–876. https://doi.org/10.1038/s41386-022-01478-z
  • Eriksen, T., & Christoffersen, D. J. (2020, August 19). (Have you also ingested cannabis without knowing it? (Har du også indtaget cannabis uden at vide det?). Retrieved May 06, 2022, from https://videnskab.dk/forskerzonen/krop-sundhed/har-du-ogsaa-indtaget-cannabis-uden-at-vide-det
  • European Monitoring Centre for Drugs and Drug Addiction. (2020). Low-THC cannabis products in Europe. Luxembourg: Publications Office of the European Union Retrieved from https://www.emcdda.europa.eu/publications/ad-hoc-publication/low-thc-cannabis-products-europe_en
  • Evans, D. G. (2020). Medical fraud, mislabeling, contamination: All common in CBD products. Missouri Medicine, 117(5), 394.
  • Fasinu, P. S., Phillips, S., ElSohly, M. A., & Walker, L. A. (2016). Current status and prospects for cannabidiol preparations as new therapeutic agents. Pharmacotherapy, 36(7), 781–796. https://doi.org/10.1002/phar.1780
  • Fedorova, E. V., Wong, C. F., Ataiants, J., Iverson, E., Conn, B. M., & Lankenau, S. E. (2021). Cannabidiol (CBD) and other drug use among young adults who use cannabis in Los Angeles. Drug and Alcohol Dependence, 221, 108648. https://doi.org/10.1016/j.drugalcdep.2021.108648
  • Fortin, D., Di Beo, V., Massin, S., Bisiou, Y., Carrieri, P., & Barré, T. (2021). Reasons for using cannabidiol: A cross-sectional study of French cannabidiol users. Journal of Cannabis Research, 3(1), 46. https://doi.org/10.1186/s42238-021-00102-z
  • Fortin, D., Di Beo, V., Massin, S., Bisiou, Y., Carrieri, P., & Barré, T. (2022). A “Good” Smoke? The off-label use of cannabidiol to reduce cannabis Use. Frontiers in Psychiatry, 13, 829944. https://doi.org/10.3389/fpsyt.2022.829944
  • Fortin, D., Marcellin, F., Carrieri, P., Mancini, J., & Barré, T. (2022). Medical cannabis: Toward a new policy and health model for an ancient medicine. Frontiers in Public Health, 10, 904291. https://doi.org/10.3389/fpubh.2022.904291
  • Fortin, D., & Massin, S. (2020). Medical cannabis: Thinking out of the box of the healthcare system. Journal de gestion et d’economie de la sante, 2(2), 110–118. https://www.cairn.info/revue-journal-de-gestion-et-d-economie-de-la-sante-2020-2-page-110.htm
  • Freeman, A. M., Petrilli, K., Lees, R., Hindocha, C., Mokrysz, C., Curran, H. V., Saunders, R., & Freeman, T. P. (2019). How does cannabidiol (CBD) influence the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review. Neuroscience and Biobehavioral Reviews, 107, 696–712. https://doi.org/10.1016/j.neubiorev.2019.09.036
  • Freeman, T., & Winstock, A. (2015). Examining the profile of high-potency cannabis and its association with severity of cannabis dependence. Psychological Medicine, 45(15), 3181–3189. https://doi.org/10.1017/S0033291715001178
  • Freeman, T. P., Craft, S., Wilson, J., Stylianou, S., ElSohly, M., Di Forti, M., & Lynskey, M. T. (2020). Changes in delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) concentrations in cannabis over time: Systematic review and meta-analysis. Addiction, 116(5), 1000–1010. https://doi.org/10.1111/add.15253
  • Freeman, T. P., Hindocha, C., Baio, G., Shaban, N. D. C., Thomas, E. M., Astbury, D., Freeman, A. M., Lees, R., Craft, S., Morrison, P. D., Bloomfield, M. A. P., O’Ryan, D., Kinghorn, J., Morgan, C. J. A., Mofeez, A., & Curran, H. V. (2020). Cannabidiol for the treatment of cannabis use disorder: A phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. The Lancet. Psychiatry, 7(10), 865–874. https://doi.org/10.1016/S2215-0366(20)30290-X
  • Freeman, T. P., van der Pol, P., Kuijpers, W., Wisselink, J., Das, R. K., Rigter, S., van Laar, M., Griffiths, P., Swift, W., Niesink, R., & Lynskey, M. T. (2018). Changes in cannabis potency and first-time admissions to drug treatment: A 16-year study in the Netherlands. Psychological Medicine, 48(14), 2346–2352. https://doi.org/10.1017/S0033291717003877
  • Gardiner, K. M., Singleton, J. A., Sheridan, J., Kyle, G. J., & Nissen, L. M. (2019). Health professional beliefs, knowledge, and concerns surrounding medicinal cannabis–a systematic review. PLoS One, 14(5), e0216556. https://doi.org/10.1371/journal.pone.0216556
  • Goodman, S., Wadsworth, E., Schauer, G., & Hammond, D. (2020). Use and perceptions of cannabidiol products in Canada and in the United States. Cannabis and Cannabinoid Research, 7(3), 355–364. https://doi.org/10.1089/can.2020.009
  • Graham, M., Lucas, C. J., Schneider, J., Martin, J. H., & Hall, W. (2020). Translational hurdles with cannabis medicines. Pharmacoepidemiology and Drug Safety, 29(10), 1325–1330. https://doi.org/10.1002/pds.4999
  • Grosen, J. (2022). Young influencers advertise cannabis products on Instagram: "It’s troubling" (Unge influencere reklamerer for cannabisprodukter på Instagram: “Det er bekymrende”). Radio4. Retrieved November 04, 2022, from https://www.radio4.dk/nyheder/unge-influencere-reklamerer-for-cannabisprodukter-paa-instagram-og-det-moeder-kritik/
  • Grotenhermen, F., & Schnelle, M. (2003). Survey on the medical use of cannabis and THC in Germany. Journal of Cannabis Therapeutics, 3(2), 17–40. https://doi.org/10.1300/J175v03n02_03
  • Gruber, S. A., Smith, R. T., Dahlgren, M. K., Lambros, A. M., & Sagar, K. A. (2021). No pain, all gain? Interim analyses from a longitudinal, observational study examining the impact of medical cannabis treatment on chronic pain and related symptoms. Experimental and Clinical Psychopharmacology, 29(2), 147–156. https://doi.org/10.1037/pha0000435
  • Gulbransen, G., Xu, W., & Arroll, B. (2020). Cannabidiol prescription in clinical practice: An audit on the first 400 patients in New Zealand. BJGP Open, 4(1), bjgpopen20X101010. https://doi.org/10.3399/bjgpopen20X10101
  • Gustavsen, S., Søndergaard, H., Andresen, S., Magyari, M., Sørensen, P., Sellebjerg, F., & Oturai, A. (2019). Illegal cannabis use is common among Danes with multiple sclerosis. Multiple Sclerosis and Related Disorders, 33, 5–12. https://doi.org/10.1016/j.msard.2019.05.008
  • Hamilton, L. C. (2012). Statistics with Stata: Version 12 (Vol. 12). Cengage Learning.
  • Hazekamp, A. (2018). The trouble with CBD Oil. Medical Cannabis and Cannabinoids, 1(1), 65–72. https://doi.org/10.1159/000489287
  • Hazekamp, A., Ware, M. A., Muller-Vahl, K. R., Abrams, D., & Grotenhermen, F. (2013). The medicinal use of cannabis and cannabinoids–an international cross-sectional survey on administration forms. Journal of Psychoactive Drugs, 45(3), 199–210. https://doi.org/10.1080/02791072.2013.805976
  • Heiervang, E., & Goodman, R. (2011). Advantages and limitations of web-based surveys: Evidence from a child mental health survey. Social Psychiatry and Psychiatric Epidemiology, 46(1), 69–76. https://doi.org/10.1007/s00127-009-0171-9
  • Houborg, E., & Enghoff, O. (2018). Cannabis in Danish newspapers. Tidsskrift for Forskning i Sygdom og Samfund, 15(28), 173–204. https://doi.org/10.7146/tfss.v15i28.107265
  • Hsu, T. (2019, August 13). Ads Pitching CBD as a Cure-All Are Everywhere. Oversight Hasn’t Kept Up. New York Times. https://www.nytimes.com/2019/08/13/business/media/cbd-marijuana-fda.html
  • Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side-effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and Cannabinoid Research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034
  • International Medical Cannabis Patient Coalition. (2017). Warning for consumers of CBD and cannabis oils sold on the EU market. Retrieved April 30, 2022 from http://imcpc.org/warning-for-consumers-of-cbd-and-cannabis-oils-sold-on-the-eu-market/
  • Iseger, T. A., & Bossong, M. G. (2015). A systematic review of the antipsychotic properties of cannabidiol in humans. Schizophrenia Research, 162(1–3), 153–161. https://doi.org/10.1016/j.schres.2015.01.033
  • Jensen, M. P., Chen, C., & Brugger, A. M. (2003). Interpretation of visual analog scale ratings and change scores: A reanalysis of two clinical trials of postoperative pain. The Journal of Pain, 4(7), 407–414. https://doi.org/10.1016/S1526-5900(03)00716-8
  • Johnson, E., Kilgore, M., & Babalonis, S. (2022). Cannabidiol (CBD) product contamination: Quantitative analysis of Δ9-tetrahydrocannabinol (Δ9-THC) concentrations found in commercially available CBD products. Drug and Alcohol Dependence, 237, 109522. https://doi.org/10.1016/j.drugalcdep.2022.109522
  • Joinson, A. N., & Paine, C. B. (2007). Self-disclosure, privacy and the Internet. In K. Y. A. M. Adam, N. Joinson, & Tom Postmes (Eds.), The Oxford handbook of Internet psychology (pp. 235–250). Oxford University Press.
  • Kays, K. M., Keith, T. L., & Broughal, M. T. (2013). Best practice in online survey research with sensitive topics. In Advancing research methods with new technologies (pp. 157–168). IGI Global.
  • Krarup, N. (2022). Diamond daughter in cannabis-fuckup (Diamantdatter i cannabisbrøler). Ekstra Bladet, 12, 30. https://ekstrabladet.dk/underholdning/dkkendte/diamantdatter-i-cannabisbroeler/9568442
  • Krumpal, I. (2013). Determinants of social desirability bias in sensitive surveys: A literature review. Quality & Quantity, 47(4), 2025–2047. https://doi.org/10.1007/s11135-011-9640-9
  • Kvamme, S. L. (2022a). Do-It-Yourself medicine. Exploring the use of cannabis as medicine in Denmark Aarhus University]. Aarhus BSS. https://psy.au.dk/fileadmin/site_files/filer_rusmiddelforskning/dokumenter/ph.d.-afhandlinger/Sinikka_L._Kvamme._Do-It-Yourself_medicine._Exploring_the_use_of_cannabis_as_medicin_in_Denmark.pdf
  • Kvamme, S. L. (2022b). With medicine in mind? Exploring the relevance of having recreational experience when becoming a medicinal cannabis user. contemporary drug problems, 49(2), 192–212. https://doi.org/10.1177/00914509211070741
  • Kvamme, S. L., Pedersen, M. M., Alagem-Iversen, S., & Thylstrup, B. (2021a). Beyond the high: Mapping patterns of use and motives for use of cannabis as medicine. Nordisk Alkohol- & Narkotikatidskrift, 38(3), 270–292. https://doi.org/10.1177/1455072520985967
  • Kvamme, S. L., Pedersen, M. M., Thomsen, K. R., & Thylstrup, B. (2021b). Exploring the use of cannabis as a substitute for prescription drugs in a convenience sample. Harm Reduction Journal, 18(1), 72. https://doi.org/10.1186/s12954-021-00520-5
  • Lachenmeier, D. W., Habel, S., Fischer, B., Herbi, F., Zerbe, Y., Bock, V., de Rezende, T. R., Walch, S. G., & Sproll, C. (2019). Are adverse effects of cannabidiol (CBD) products caused by tetrahydrocannabinol (THC) contamination? F1000Research, 8(8), 1394. https://doi.org/10.12688/f1000research.19931.1
  • Lachenmeier, D. W., & Walch, S. G. (2020). Cannabidiol (CBD): A strong plea for mandatory pre-marketing approval of food supplements. Journal of Consumer Protection and Food Safety, 15(2), 97–98. https://doi.org/10.1007/s00003-020-01281-2
  • Leas, E. C., Nobles, A. L., Caputi, T. L., Dredze, M., Smith, D. M., & Ayers, J. W. (2019). Trends in internet searches for cannabidiol (CBD) in the United States. JAMA Network Open, 2(10), e1913853-e1913853. https://doi.org/10.1001/jamanetworkopen.2019.13853
  • Legare, C. A., Raup-Konsavage, W. M., & Vrana, K. E. (2022). Therapeutic potential of cannabis, cannabidiol, and cannabinoid-based pharmaceuticals. Pharmacology, 107(3–4), 131–149. https://doi.org/10.1159/000521683
  • Lenton, S., Frank, V. A., Barratt, M. J., Potter, G. R., & Decorte, T. (2018). Growing practices and the use of potentially harmful chemical additives among a sample of small-scale cannabis growers in three countries. Drug and Alcohol Dependence, 192, 250–256. https://doi.org/10.1016/j.drugalcdep.2018.07.040
  • Li, X., Diviant, J. P., Stith, S. S., Brockelman, F., Keeling, K., Hall, B., & Vigil, J. M. (2020). Focus: Plant-based medicine and pharmacology: The effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression. Yale Journal of Biology and Medicine, 93(2), 251.
  • Li, X., Vigil, J. M., Stith, S. S., Brockelman, F., Keeling, K., & Hall, B. (2019). The effectiveness of self-directed medical cannabis treatment for pain. Complementary Therapies in Medicine, 46, 123–130. https://doi.org/10.1016/j.ctim.2019.07.022
  • MacCallum, C. A., & Russo, E. B. (2018). Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine, 49, 12–19. https://doi.org/10.1016/j.ejim.2018.01.004
  • Manthey, J. (2019). Cannabis use in Europe: Current trends and public health concerns. The International Journal on Drug Policy, 68, 93–96. https://doi.org/10.1016/j.drugpo.2019.03.006
  • Marangoni, I. P., & Marangoni, A. G. (2019). Cannabis edibles: Dosing, encapsulation, and stability considerations. Current Opinion in Food Science, 28, 1–6. https://doi.org/10.1016/j.cofs.2019.01.005
  • Martin, E. L., Strickland, J. C., Schlienz, N. J., Munson, J., Jackson, H., Bonn-Miller, M. O., & Vandrey, R. (2021). Antidepressant and anxiolytic effects of medicinal cannabis use in an observational trial. Frontiers in Psychiatry, 12, 729800. https://doi.org/10.3389/fpsyt.2021.729800
  • Martínez, V., Iriondo De-Hond, A., Borrelli, F., Capasso, R., Del Castillo, M. D., & Abalo, R. (2020). Cannabidiol and other non-psychoactive cannabinoids for prevention and treatment of gastrointestinal disorders: Useful nutraceuticals? International Journal of Molecular Sciences, 21(9), 3067. https://doi.org/10.3390/ijms21093067
  • McGregor, I. S., Cairns, E. A., Abelev, S., Cohen, R., Henderson, M., Couch, D., Arnold, J. C., & Gauld, N. (2020). Access to cannabidiol without a prescription: A cross-country comparison and analysis. The International Journal on Drug Policy, 85, 102935. https://doi.org/10.1016/j.drugpo.2020.102935
  • Meier, M. H. (2017). Associations between butane hash oil use and cannabis-related problems. Drug and Alcohol Dependence, 179, 25–31. https://doi.org/10.1016/j.drugalcdep.2017.06.015
  • Ministry of Health. (2016, November 08). Agreement on medical cannabis pilot programme (Aftale om forsøgsordning med medicinsk cannabis). http://sundhedsministeriet.dk/Aktuelt/Nyheder/Medicin/2016/November/∼/media/Filer%20-%20dokumenter/Aftale-om-medicinsk-cannabis/Politisk-aftale-om-forsogsordning-med-medicinsk-cannabis.ashx
  • Moltke, J., & Hindocha, C. (2021). Reasons for Cannabidiol use: A cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. Journal of Cannabis Research, 3(1), 5. https://doi.org/10.1186/s42238-021-00061-5
  • Morgan, C. J., Freeman, T. P., Hindocha, C., Schafer, G., Gardner, C., & Curran, H. V. (2018). Individual and combined effects of acute delta-9-tetrahydrocannabinol and cannabidiol on psychotomimetic symptoms and memory function. Translational Psychiatry, 8(1), 181. https://doi.org/10.1038/s41398-018-0191-x
  • National Academies of Sciences Engineering and Medicine. (2017). The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. NASEM. https://doi.org/10.17226/24625
  • Navarrete, F., García-Gutiérrez, M. S., Gasparyan, A., Austrich-Olivares, A., & Manzanares, J. (2021). Role of cannabidiol in the therapeutic intervention for substance use disorders. Frontiers in Pharmacology, 12, 626010. https://doi.org/10.3389/fphar.2021.626010
  • Nielsen, S. W., Ruhlmann, C. H., Eckhoff, L., Brønnum, D., Herrstedt, J., & Dalton, S. O. (2021). Cannabis use among Danish patients with cancer: A cross-sectional survey of sociodemographic traits, quality of life, and patient experiences. Supportive Care in Cancer, 30(2), 1181–1190. https://doi.org/10.1007/s00520-021-06515-z
  • Pavlovic, R., Nenna, G., Calvi, L., Panseri, S., Borgonovo, G., Giupponi, L., Cannazza, G., & Giorgi, A. (2018). Quality traits of “cannabidiol oils”: Cannabinoids content, terpene fingerprint and oxidation stability of European commercially available preparations. Molecules, 23(5), 1230. https://doi.org/10.3390/molecules23051230
  • Piomelli, D., Solomon, R., Abrams, D., Balla, A., Grant, I., Marcotte, T., & Yoder, J. (2019). Regulatory barriers to research on Cannabis and Cannabinoids: A proposed path forward. Cannabis and Cannabinoid Research, 4(1), 21–32. https://doi.org/10.1089/can.2019.0010
  • Potter, D. J., Clark, P., & Brown, M. B. (2008). Potency of Δ9–THC and other cannabinoids in cannabis in England in 2005: Implications for psychoactivity and pharmacology. Journal of Forensic Sciences, 53(1), 90–94. https://doi.org/10.1111/j.1556-4029.2007.00603.x
  • Potter, D. J., Hammond, K., Tuffnell, S., Walker, C., & Di Forti, M. (2018). Potency of Δ9–tetrahydrocannabinol and other cannabinoids in cannabis in England in 2016: Implications for public health and pharmacology. Drug Testing and Analysis, 10(4), 628–635. https://doi.org/10.1002/dta.2368
  • Quattrone, D., Ferraro, L., Tripoli, G., La Cascia, C., Quigley, H., Quattrone, A., Jongsma, H. E., Del Peschio, S., Gatto, G., Gayer-Anderson, C., Jones, P. B., Kirkbride, J. B., La Barbera, D., Tarricone, I., Berardi, D., Tosato, S., Lasalvia, A., Szöke, A., Arango, C., … Di Forti, M. (2021). Daily use of high-potency cannabis is associated with more positive symptoms in first-episode psychosis patients: The EU-GEI case–control study. Psychological Medicine, 51(8), 1329–1337. https://doi.org/10.1017/S0033291720000082
  • Rapin, L., Gamaoun, R., El Hage, C., Arboleda, M. F., & Prosk, E. (2021). Cannabidiol use and effectiveness: Real-world evidence from a Canadian medical cannabis clinic. Journal of Cannabis Research, 3(1), 19. https://doi.org/10.1186/s42238-021-00078-w
  • Reiman, A., Welty, M., & Solomon, P. (2017). Cannabis as a substitute for opioid-based pain medication: Patient self-report. Cannabis and Cannabinoid Research, 2(1), 160–166. https://doi.org/10.1089/can.2017.0012
  • Reinarman, C., Nunberg, H., Lanthier, F., & Heddleston, T. (2011). Who are medical marijuana patients? Population characteristics from nine California assessment clinics. Journal of Psychoactive Drugs, 43(2), 128–135. https://doi.org/10.1080/02791072.2011.587700
  • Rothwell, P. M. (2005). External validity of randomised controlled trials: To whom do the results of this trial apply? Lancet, 365(9453), 82–93. https://doi.org/10.1016/S0140-6736(04)17670-8
  • Rueda, S., Limanto, E., & Chaiton, M. (2022). Cannabis clinical research in purgatory: Canadian researchers caught between an inflexible regulatory environment and a conflicted industry. Lancet Regional Health, 7, 100171. https://doi.org/10.1016/j.lana.2021.100171
  • Rømer Thomsen, K., Callesen, M. B., & Ewing, S. W. F. (2017). Recommendation to reconsider examining cannabis subtypes together due to opposing effects on brain, cognition and behavior. Neuroscience and Biobehavioral Reviews, 80, 156–158. https://doi.org/10.1016/j.neubiorev.2017.05.025
  • Rømer Thomsen, K., Lindholst, C., Thylstrup, B., Kvamme, S., Reitzel, L. A., Worm-Leonhard, M., Englund, A., Freeman, T. P., & Hesse, M. (2019). Changes in the composition of cannabis from 2000-2017 in Denmark: Analysis of confiscated samples of cannabis resin. Experimental and Clinical Psychopharmacology, 27(4), 402–411. https://doi.org/10.1037/pha0000303
  • Sagar, K. A., Dahlgren, M. K., Lambros, A. M., Smith, R. T., El-Abboud, C., & Gruber, S. A. (2021). An observational, longitudinal study of cognition in medical cannabis patients over the course of 12 months of treatment: Preliminary results. Journal of the International Neuropsychological Society, 27(6), 648–660. https://doi.org/10.1017/S1355617721000114
  • Schilling, J. M., Hughes, C. G., Wallace, M. S., Sexton, M., Backonja, M., & Moeller-Bertram, T. (2021). Cannabidiol as a treatment for chronic pain: A survey of patients’ perspectives and attitudes. Journal of Pain Research, 14, 1241–1250. https://doi.org/10.2147/JPR.S278718
  • Schlag, A. K., Zafar, R. R., Lynskey, M. T., Athanasiou-Fragkouli, A., Phillips, L. D., & Nutt, D. J. (2022). The value of real world evidence: The case of medical cannabis. Frontiers in Psychiatry, 13, 1027159. https://doi.org/10.3389/fpsyt.2022.1027159
  • Sexton, M., Cuttler, C., Finnell, J. S., & Mischley, L. K. (2016). A cross-sectional survey of medical cannabis users: Patterns of use and perceived efficacy. Cannabis and Cannabinoid Research, 1(1), 131–138. https://doi.org/10.1089/can.2016.0007
  • Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal, 23(1), 18–041. https://doi.org/10.7812/TPP/18-041
  • The Ministry of the Interior and Health. (2023). Ban on the euphoric substance HHC. Retrieved from https://www.ft.dk/samling/20222/almdel/SUU/bilag/196/2698983/index.htm
  • Thomsen, K. R., Thylstrup, B., Kenyon, E. A., Lees, R., Baandrup, L., Ewing, S. W. F., & Freeman, T. P. (2021). Cannabinoids for the treatment of cannabis use disorder: New avenues for reaching and helping youth? Neuroscience and Biobehavioral Reviews, 132, 169–180. https://doi.org/10.1016/j.neubiorev.2021.11.033
  • Undonno Store. (2022). Retrieved December13, 2022, from https://www.udonnostore.com/da
  • Vandrey, R., Raber, J. C., Raber, M. E., Douglass, B., Miller, C., & Bonn-Miller, M. O. (2015). Cannabinoid dose and label accuracy in edible medical cannabis products. JAMA, 313(24), 2491–2493. https://doi.org/10.1001/jama.2015.6613
  • Veziari, Y., Leach, M. J., & Kumar, S. (2017). Barriers to the conduct and application of research in complementary and alternative medicine: A systematic review. BMC Complementary and Alternative Medicine, 17(1), 166. https://doi.org/10.1186/s12906-017-1660-0
  • Wagoner, K. G., Lazard, A. J., Romero-Sandoval, E. A., & Reboussin, B. A. (2021). Health claims about cannabidiol products: A retrospective analysis of US Food and Drug Administration warning letters from 2015 to 2019. Cannabis and Cannabinoid Research, 6(6), 559–563. https://doi.org/10.1089/can.2020.0166
  • Ware, M., Adams, H., & Guy, G. (2005). The medicinal use of cannabis in the UK: Results of a nationwide survey. International Journal of Clinical Practice, 59(3), 291–295. https://doi.org/10.1111/j.1742-1241.2004.00271.x
  • Webb, C. W., & Webb, S. M. (2014). Therapeutic benefits of cannabis: A patient survey. Hawai’i Journal of Medicine & Public Health, 73(4), 109.
  • Weedshop. (2022). Retrieved December, 13, 2022, from https://weedshop.dk/
  • Wheeler, M., Merten, J. W., Gordon, B. T., & Hamadi, H. (2020). CBD (cannabidiol) product attitudes, knowledge, and use among young adults. Substance Use & Misuse, 55(7), 1138–1145. https://doi.org/10.1080/10826084.2020.1729201
  • Wise, J. (2019). European drug agency approves cannabis-based medicine for severe forms of epilepsy. BMJ, 366, l5708. https://doi.org/10.1136/bmj.l5708
  • World Health Organization: Expert Committee on Drug Dependence. (2018, 4-7 June). Cannabidiol (CBD) Critical Review Report. Retrieved 04.02.2022 from https://apps.who.int/iris/bitstream/handle/10665/279948/9789241210225-eng.pdf
  • Zenone, M. A., Snyder, J., & Crooks, V. (2021). Selling cannabidiol products in Canada: A framing analysis of advertising claims by online retailers. BMC Public Health, 21(1), 1285. https://doi.org/10.1186/s12889-021-11282-x