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Daily Physical and Psychiatric Symptom Trajectories Before and After Medical Cannabis Use

Robert Dvorak
University of Central Florida

Older adults account for a disproportional amount of medical costs. Conditions such as pain, emotional distress, and malnutrition are common in this population. Treatment for these conditions has been purported by Medical Cannabis (MC). Cannabis legalization is becoming widely accepted. MC may offer an important alternative approach to treating such conditions, and may reduce polypharmacy, a significant issue in this population. Furthermore, reports indicate a growing acceptance of MC among older adults, and an increase in their use of MC as a way to treat common and persistent medical and psychiatric symptoms. However, there are several issues associated with the proliferation of MC, particularly in this population. Due to a lack of rigorous randomized control studies, the efficacy of MC remains unclear. The current study examines physical (pain, nausea, appetite) and psychiatric (trauma, anxiety, depression) symptoms before and after medical cannabis use at the momentary level in older adults (M = 61.41, SD = 2.11). Participants with medical cannabis cards were enrolled in a 15-day ecological momentary assessment study. They completed up to 6 surveys per day assessing physical and psychiatric symptoms and MC use in the moment. Data were analyzed using a multilevel latent trajectory model that examined depression, anxiety, trauma symptoms, nausea, loss of appetite, and pain across the day. The model included time of day (time), day separated by pre- and post- use (use), and an interaction of the time x use to model trajectories across the day. For every symptom, there was a significant and robust effect of medical cannabis (ps = <.001 to .034). Most symptoms were elevated prior to MC, decreased following MC, and remained decreased for the day. One symptom, trauma, increased steadily prior to MC use (b = 0.11, p = .002) then dropped precipitously following use (b = -0.57, p < .001). Once trauma decreased, the trajectory for the remainder of the day was constant (b = 0.01, p = .470). The results highlight the effectiveness of MC in reducing symptoms at the momentary level and suggest broad effects across a wide array of physical and psychiatric symptoms.

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