{"id":10986,"date":"2016-06-30T17:12:41","date_gmt":"2016-06-30T17:12:41","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=10986"},"modified":"2017-10-19T11:21:33","modified_gmt":"2017-10-19T11:21:33","slug":"open-access-review-narrative-review-of-the-safety-and-efficacy-of-marijuana-for-the-treatment-of-commonly-state-approved-medical-and-psychiatric-disorders","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2016\/06\/open-access-review-narrative-review-of-the-safety-and-efficacy-of-marijuana-for-the-treatment-of-commonly-state-approved-medical-and-psychiatric-disorders\/","title":{"rendered":"Open Access Review &#8211; Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><span style=\"text-decoration: underline;\"><b><a href=\"http:\/\/www.ascpjournal.org\/\">Addiction Science &amp; Clinical Practice<\/a><\/b><\/span><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Katherine A Belendiuk<\/b><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\/#ins1\">1<\/a><\/span>, <b>Lisa L Baldini<\/b><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\/#ins2\">2<\/a><\/span> and <b>Marcel O Bonn-Miller<\/b><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\/#ins3\">3<\/a><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\/#ins4\">4<\/a><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\/#ins5\">5<\/a><\/span><sup>*<\/sup><\/span><\/p>\n<ul>\n<li>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">*Corresponding author: Marcel O Bonn-Miller <span style=\"text-decoration: underline;\"><a href=\"mailto:Marcel.Bonn-Miller@va.gov\">Marcel.Bonn-Miller@va.gov<\/a><\/span><\/span><\/p>\n<\/li>\n<\/ul>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\">Author Affiliations<\/a><\/span><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><sup>1<\/sup>Institute of Human Development, University of California, 1121 Tolman Hall #1690, Berkeley 94720, CA, USA<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><sup>2<\/sup>Palo Alto University, 1791 Arastradero Road, Palo Alto 94304, CA, USA<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><sup>3<\/sup>Center of Excellence in Substance Abuse Treatment and Education, Philadelphia VA Medical Center, 3900 Woodland Avenue, Philadelphia 19104, PA, USA<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><sup>4<\/sup>Center for Innovation to Implementation and National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park 94025, CA, USA<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><sup>5<\/sup>Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3440 Market Street, Philadelphia 19104, PA, USA<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">For all author emails, please <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/logon\">log on<\/a><\/span>.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Addiction Science &amp; Clinical Practice<\/i> 2015, <b>10<\/b>:10 doi:10.1186\/s13722-015-0032-7<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">The electronic version of this article is the complete one and can be found online at:<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\">http:\/\/www.ascpjournal.org\/content\/10\/1\/10<\/a><\/span><\/span><\/p>\n<table width=\"209\" cellspacing=\"0\" cellpadding=\"16\">\n<colgroup>\n<col width=\"54\" \/>\n<col width=\"91\" \/> <\/colgroup>\n<tbody>\n<tr valign=\"bottom\">\n<td width=\"54\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Received:<\/span><\/p>\n<\/td>\n<td width=\"91\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">29 August 2014<\/span><\/p>\n<\/td>\n<\/tr>\n<tr valign=\"bottom\">\n<td width=\"54\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Accepted:<\/span><\/p>\n<\/td>\n<td width=\"91\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">15 April 2015<\/span><\/p>\n<\/td>\n<\/tr>\n<tr valign=\"bottom\">\n<td width=\"54\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Published:<\/span><\/p>\n<\/td>\n<td width=\"91\">\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">21 April 2015<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">\u00a9 2015 Belendiuk et al.; licensee BioMed Central. <\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<span style=\"text-decoration: underline;\"><a href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\">http:\/\/creativecommons.org\/licenses\/by\/4.0<\/a><\/span>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/) applies to the data made available in this article, unless otherwise stated.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Abstract<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"abs\"><\/a> The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer\u2019s disease, amyotrophic lateral sclerosis, cachexia\/wasting syndrome, cancer, Crohn\u2019s disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus\/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Keywords: <\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Cannabis; Medical marijuana; Marijuana; Medicine; Treatment; Alzheimer\u2019s disease; ALS; Cachexia; Cancer, Crohn\u2019s disease; Epilepsy; Seizures; Glaucoma; Hepatitis C virus; HCV; HIV; AIDS; Multiple sclerosis; MS; Pain; Nausea; Vomiting; Post-traumatic stress disorder; PTSD<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec1\"><\/a> <b>Introduction<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">National estimates suggest that 5.4 million people in the United States above the age of 12 have used marijuana daily or regularly within the past year [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B1\">1<\/a><\/span>]. This represents an increase of approximately 74.2 percent since 2006 [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B1\">1<\/a><\/span>]. Similar increases have also been noted among vulnerable populations in the U.S. (e.g., veterans and adolescents) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B2\">2<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B3\">3<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e182\"><\/a><a name=\"d63676e186\"><\/a><a name=\"d63676e190\"><\/a><a name=\"d63676e194\"><\/a> Marijuana is currently illegal in every country in the world. In 2012, Uruguay voted to legalize state-controlled marijuana sales but implementation of the law has been postponed until 2015. The policy in the Netherlands is mixed, with permissible retail sale of marijuana at coffee shops, but restrictions on production and possession. Notably, as the concentration of THC in marijuana has increased, Dutch coffee shops have begun to close, as perception of marijuana as a \u201csoft\u201d drug transitions to perceptions of marijuana as a \u201chard\u201d drug.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Like the Netherlands, the United States currently has a mixed drug policy; marijuana is an <i>illegal<\/i>Schedule I drug under U.S. Federal law. However, marijuana policies vary by state, with some states (e.g., Colorado and Washington) <i>legalizing<\/i> the use of recreational marijuana (i.e., allowing the legal possession and use of marijuana under state law), and other states <i>decriminalizing <\/i>marijuana (i.e., reducing the penalties for possession and\/or use of small amounts of marijuana to fines or civil penalties). Furthermore, as of this review, 23 states and the District of Columbia have passed legislation allowing medical marijuana (i.e., individuals can defend themselves against criminal charges related to marijuana possession if a medical need is documented) for the treatment of a variety of medical and psychological conditions. Though the list of conditions for which medical marijuana has been allowed varies at the state level, the majority of states agree on its use for Alzheimer\u2019s disease (AD), amyotrophic lateral sclerosis (ALS), cachexia\/wasting syndrome, cancer, Crohn\u2019s disease (CD), epilepsy and seizures, glaucoma, hepatitis C virus (HCV), human immunodeficiency virus (HIV)\/acquired immunodeficiency syndrome (AIDS), multiple sclerosis (MS) and muscle spasticity, severe and chronic pain, severe nausea, and post-traumatic stress disorder (PTSD).<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">The aim of the present review is to provide a summary of the existing empirical literature regarding the effects of marijuana\/cannabinoids on each of the above-noted conditions. Though some recent work has reviewed the adverse effects of marijuana [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B4\">4<\/a><\/span>] or the efficacy of marijuana for certain conditions (e.g., neurologic) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B5\">5<\/a><\/span>], there has yet to be a comprehensive review of the effects of marijuana for each of the medical and psychiatric conditions for which it is currently used.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e217\"><\/a><a name=\"d63676e213\"><\/a> <b>Methods<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec2\"><\/a> The list of all conditions for which medical marijuana is allowed, according to the legislation of each U.S. state for which medical marijuana has been approved, was obtained and examined [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B6\">6<\/a><\/span>]. From this list, common conditions for which medical marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: AD, ALS, cachexia\/wasting syndrome, cancer, CD, epilepsy and seizures, glaucoma, HCV, HIV\/AIDS, MS and muscle spasticity, severe and chronic pain, and severe nausea. Though not presently a qualifying condition in at least 80 percent of states with medical marijuana laws, PTSD was also included in the review, as it is rapidly gaining attention and recognition as the sole psychological disorder for which medical marijuana is allowed.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e227\"><\/a> Studies for this narrative review were included based on a literature search in the following databases: PsycINFO, MEDLINE, and Google Scholar. Within each database, each combination of the following key marijuana terms and the above-listed conditions were used to conduct a search: cannabis, marijuana, marihuana, cannabinoid, delta-9-tetrahydrocannabinol, THC, cannabidiol, CBD, cannabinol, cannabigerol, Marinol, dronabinol, Sativex, Nabilone, and Nabiximols. References within each obtained article were also examined to assure that no studies were overlooked. Only published, English-language studies were included in this review.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Though the primary focus of this review is on studies of marijuana plant effects, as these are most relevant to recent medical marijuana legislation, synthetic or plant-derived cannabinoids (e.g., dronabinol, Nabilone) were also included due to the general dearth of marijuana plant studies for a number of conditions. Indeed, for purposes of the review, references to oral administrations of marijuana constitute a pharmaceutical grade extraction administered in tablet or liquid form (e.g., dronabinol, Nabilone, Nabiximols), while references to smoked administration of marijuana constitute the inhalation of smoke from burned marijuana leaves and flowers. Finally, the present review is organized alphabetically by condition for which marijuana is allowed, rather than in order of disorder for which it is most to least commonly recommended, or strength of the evidence. We chose this approach as there is currently only state-level data [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B7\">7<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B9\">9<\/a><\/span>], rather than national, representative data on the primary conditions for which medical marijuana is used or recommended, and the existing literature and state of the evidence for many conditions remains relatively poor.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e239\"><\/a><a name=\"d63676e235\"><\/a> <b>Results<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec3\"><\/a> <b>Alzheimer\u2019s disease<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">AD, the leading form of dementia in the elderly, is a progressive, age-related disorder characterized by cognitive and memory deterioration [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B10\">10<\/a><\/span>]. AD has several neuropathological markers, including neuritic plaques and neurofibrillary tangles [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B11\">11<\/a><\/span>]. Although several researchers have suggested dronabinol and Nabilone may act on these mechanisms to confer therapeutic effects for patients with AD [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B12\">12<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B13\">13<\/a><\/span>], a recent Cochrane systematic review found no evidence that dronabinol was effective in reducing symptoms of dementia [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B14\">14<\/a><\/span>]. The authors of a placebo-controlled crossover study of 15 patients with AD who were refusing to eat suggest that dronabinol increases weight gain and decreases disturbed behavior [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B15\">15<\/a><\/span>], but there is insufficient quantitative data to support this conclusion [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B14\">14<\/a><\/span>], and one study participant had a grand mal seizure following dronabinol administration [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B15\">15<\/a><\/span>]. Another pilot study of two patients with dementia found that dronabinol reduced nocturnal motor activity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B16\">16<\/a><\/span>]. No studies have examined the effects of smoked marijuana in patients with AD. In sum, there is insufficient evidence to recommend marijuana for the treatment of AD. Future directions should include conducting randomized controlled trials (RCTs) comparing both smoked and oral marijuana to placebo and existing treatments, with sample sizes large enough to detect treatment effects and the safety and tolerability of marijuana.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e286\"><\/a><a name=\"d63676e282\"><\/a><a name=\"d63676e278\"><\/a><a name=\"d63676e274\"><\/a><a name=\"d63676e269\"><\/a><a name=\"d63676e265\"><\/a><a name=\"d63676e261\"><\/a><a name=\"d63676e257\"><\/a><a name=\"d63676e253\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Amyotrophic lateral sclerosis<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">ALS is a fatal neurological disease with symptoms that include weakness, spasticity, and respiratory difficulties. Cannabinoids are hypothesized to act in the regions of established pathophysiology for ALS [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B17\">17<\/a><\/span>] and could be used for symptom management (e.g., pain, spasticity, wasting, respiratory failure, dysphagia, negative mood, and dysautonomia) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B18\">18<\/a><\/span>]. Although there is limited evidence from a survey of patients with ALS that marijuana consumed in a variety of forms (i.e., oral, smoked, vaporized, and eaten) improves speech and swallowing [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B19\">19<\/a><\/span>], the anti-salivatory components of marijuana may reduce the risk of aspiration pneumonia, while also increasing patient comfort [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B18\">18<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B19\">19<\/a><\/span>]. These survey findings indicate that up to 10 percent of patients use marijuana for symptom management, and these self-reports suggest efficacy in increasing appetite and mood and decreasing pain, spasticity, and drooling. However, as is consistent with the half-life of smoked marijuana, the beneficial effects of marijuana on symptoms of ALS were fewer than 3 hours in duration [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B19\">19<\/a><\/span>]. The only randomized, double-blind, placebo-controlled crossover trial of marijuana in patients with ALS has a small sample size (N\u2009=\u200927) and indicates that while 5 mg of dronabinol is well-tolerated, there was no effect on number or intensity of cramps, quality of life, appetite, sleep, or mood [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B20\">20<\/a><\/span>]. There is currently insufficient clinical evidence in humans with ALS to recommend cannabinoids as primary or adjunctive therapy.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e321\"><\/a><a name=\"d63676e317\"><\/a><a name=\"d63676e312\"><\/a><a name=\"d63676e308\"><\/a><a name=\"d63676e304\"><\/a><a name=\"d63676e300\"><\/a><a name=\"d63676e296\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Cachexia\/wasting syndrome<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Cachexia is the general wasting and malnutrition that occurs in the context of chronic diseases such as HIV\/AIDS and cancer. In patients with HIV or cancer, smoked marijuana and dronabinol have been shown to increase weight gain [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B21\">21<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B22\">22<\/a><\/span>] and food intake [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B22\">22<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B23\">23<\/a><\/span>] compared to placebo. In a within-subject, double-blind, staggered, double-dummy study of nine individuals with muscle mass loss, dronabinol resulted in significantly greater calorie consumption than smoked marijuana [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B24\">24<\/a><\/span>]. A within-subject, double-blind, placebo-controlled trial with seven HIV-positive marijuana smokers taking antiretroviral medications found that compared to placebo, dronabinol increased caloric intake [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B25\">25<\/a><\/span>]. Additional studies indicate that dronabinol administration increases appetite, decreases nausea, and protects against weight loss [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B26\">26<\/a><\/span>], with effects on appetite and weight stability enduring in long-term follow-up [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B27\">27<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e331\"><\/a><a name=\"d63676e335\"><\/a><a name=\"d63676e339\"><\/a><a name=\"d63676e343\"><\/a><a name=\"d63676e347\"><\/a><a name=\"d63676e352\"><\/a><a name=\"d63676e356\"><\/a><a name=\"d63676e360\"><\/a> Both dronabinol and smoked marijuana increase the number of eating occasions [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B22\">22<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B25\">25<\/a><\/span>], and smoked marijuana may also affect weight gain and calorie intake by modulating appetite hormones [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B28\">28<\/a><\/span>]. Importantly, weight gain in one study was greater than would have been expected based on increased calorie consumption alone [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B23\">23<\/a><\/span>], which may be particularly relevant for those who have impaired food intake and\/or nausea. These studies demonstrate that marijuana has positive effects on cachexia resulting from a medical condition, but are largely limited by small sample sizes. Additionally, studies comparing THC to FDA-approved medication (i.e., megestrol) indicate that THC is less effective in promoting appetite and weight gain [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B29\">29<\/a><\/span>]. In sum, there is moderate support for the use of cannabinoids for cachexia\/wasting, and dronabinol has been FDA-approved for anorexia associated with weight loss in individuals with AIDS. Additional studies with larger sample sizes that examine the efficacy of marijuana compared to nutritional support\/calorie augmentation in the treatment of cachexia are indicated.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e382\"><\/a><a name=\"d63676e378\"><\/a><a name=\"d63676e374\"><\/a><a name=\"d63676e370\"><\/a><a name=\"d63676e366\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Cancer<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Cancer is a qualifying medical condition in every state that has approved marijuana for medical use [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B30\">30<\/a><\/span>]. The majority of clinical research examining the relation between THC and cancer has evaluated the effect of smoked THC on the risk for cancer, or the palliative effects of THC on chemotherapy-related nausea and emesis, chronic pain, and wasting (reviewed in respective sections); few studies have studied the effect of marijuana in any form on the treatment of primary cancer pathology. <i>In vitro<\/i> and <i>in vivo<\/i> research suggests that cannabinoids inhibit tumor growth [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B30\">30<\/a><\/span>] via several proposed mechanisms (e.g., suppression of cell proliferation, reduced cell migration, increased apoptosis) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B31\">31<\/a><\/span>]; however, <i>in vitro<\/i> and <i>in vivo<\/i> studies also have shown that THC increases tumor growth due to reduced immune response to cancer [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B32\">32<\/a><\/span>]. The only clinical trial of THC on cancer examined intracranial administration of THC to nine patients with recurrent glioblastoma multiforme who had failed surgical- and radiotherapy, and results indicated that THC decreased tumor growth, while being well-tolerated with few psychotropic effects [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B33\">33<\/a><\/span>]. This study is limited by lack of generalizability, and clinical trials with larger representative samples that examine oral or smoked administration of THC are essential to elucidate the effects on cancer pathology. There is currently insufficient evidence to recommend marijuana for the treatment of cancer, but there may be secondary treatment effects on appetite and pain.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e421\"><\/a><a name=\"d63676e417\"><\/a><a name=\"d63676e406\"><\/a><a name=\"d63676e402\"><\/a><a name=\"d63676e392\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Crohn\u2019s disease<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">CD is an inflammatory bowel disease (IBD) that has no cure; treatment targets include reducing inflammation and secondary symptoms. Between 16 percent and 50 percent of patients use marijuana to relieve symptoms of IBD [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B34\">34<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B36\">36<\/a><\/span>], and patients using marijuana for 6 months or longer are five times more likely to have had surgery for their IBD [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B34\">34<\/a><\/span>]; whether marijuana exacerbates disease progression or more severe disease results in self-medication is unclear. Only one placebo-controlled study of the effects of marijuana in patients with CD has been conducted[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B37\">37<\/a><\/span>]. This study found that there was no difference between placebo and smoked marijuana on CD remission (defined as a CD Activity Index (CDAI) of less than 100), and that marijuana was superior to placebo in promoting clinical response (a decrease in CDAI score greater than 100), reducing steroid use, and improving sleep and appetite [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B37\">37<\/a><\/span>]. Importantly, this study did not include objective measurement of inflammatory activity, and there was no significant difference in placebo and treatment groups 2 weeks after treatment cessation [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B37\">37<\/a><\/span>]. Until clinical trials with objective measurement of treatment effects over an extended period of time are conducted to examine the safety and efficacy of marijuana for the treatment of IBD, there is insufficient evidence for the use of marijuana for the treatment of IBD.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e452\"><\/a><a name=\"d63676e447\"><\/a><a name=\"d63676e443\"><\/a><a name=\"d63676e439\"><\/a><a name=\"d63676e435\"><\/a><a name=\"d63676e431\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Epilepsy and seizures<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">The known effects of cannabinoids on epilepsy and seizures are largely from animal studies, surveys, and case studies. Several animal studies indicate that marijuana and its constituents exhibit anticonvulsant effects [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B38\">38<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B41\">41<\/a><\/span>] and reduce seizure-related mortality [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B39\">39<\/a><\/span>], but there is also evidence that cannabinoids can lower the threshold for seizures [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B42\">42<\/a><\/span>], and THC withdrawal increases susceptibility for convulsions [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B42\">42<\/a><\/span>]. Cross-sectional surveys indicate that 16\u201321 percent of patients with epilepsy smoke marijuana [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B43\">43<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B44\">44<\/a><\/span>], with some reporting positive effects (e.g., spasm reduction) and a belief that marijuana is an effective therapy [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B44\">44<\/a><\/span>], and others reporting increased seizure frequency and intensity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B43\">43<\/a><\/span>]. Based on a Cochrane review, the few RCTs that have been conducted in humans include a total of 48 participants [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B45\">45<\/a><\/span>] and only examine treatment with cannabidiol. These trials exhibited heterogeneity of effects: some indicated a reduction in seizure frequency [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B46\">46<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B47\">47<\/a><\/span>], while others demonstrated no effect compared to placebo [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B48\">48<\/a><\/span>]. In addition, none of the studies examined response at greater than 6-month follow-up [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B45\">45<\/a><\/span>]. Systematic reviews of the literature have concluded that there is insufficient clinical data to support or refute the use of cannabinoids for the treatment of epilepsy and seizures [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B5\">5<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B45\">45<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e524\"><\/a><a name=\"d63676e520\"><\/a><a name=\"d63676e516\"><\/a><a name=\"d63676e512\"><\/a><a name=\"d63676e508\"><\/a><a name=\"d63676e503\"><\/a><a name=\"d63676e499\"><\/a><a name=\"d63676e495\"><\/a><a name=\"d63676e491\"><\/a><a name=\"d63676e487\"><\/a><a name=\"d63676e483\"><\/a><a name=\"d63676e478\"><\/a><a name=\"d63676e474\"><\/a><a name=\"d63676e470\"><\/a><a name=\"d63676e466\"><\/a><a name=\"d63676e462\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Glaucoma<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Glaucoma is a neurodegenerative eye disease that can cause blindness by damaging retinal ganglion cells and axons of the optic nerve. Intraocular pressure (IOP) can influence both onset and progression of glaucoma and is often a target for intervention. Small samples have demonstrated reduced IOP following smoked marijuana [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B49\">49<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B50\">50<\/a><\/span>], but the effect is only present in 60\u201365 percent of individuals [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B51\">51<\/a><\/span>] and lasts for 3\u20134 hours, requiring repeated dosing throughout the day [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B52\">52<\/a><\/span>]. Furthermore, patients discontinue marijuana use due to side effects (e.g., dizziness, anxiety, dry mouth, sedation, depression, confusion, weight gain, and distortion of perception[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B53\">53<\/a><\/span>]), and this treatment discontinuity may exacerbate optic nerve damage and obviate the benefits of reduced IOP [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B54\">54<\/a><\/span>]. Limited research and documented toxicity have resulted in the American Glaucoma Society [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B54\">54<\/a><\/span>], Canadian Opthalmological Society [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B55\">55<\/a><\/span>], and the American Academy of Ophthalmology\u2019s Complementary Therapies Task Force [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B52\">52<\/a><\/span>] determining that there is insufficient evidence to indicate that marijuana is safer or more effective than existing pharmacotherapy or surgery for the reduction of IOP. Development of eye drops for topical application of THC would minimize psychoactive and other side effects but is complicated by the high lipophilicity and low water solubility of cannabinoids [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B52\">52<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B56\">56<\/a><\/span>]. Additionally, the distance from the application site to the retina may be too great to afford neuroprotective benefits [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B52\">52<\/a><\/span>], given that only 5 percent of an applied dose penetrates the cornea to the intraocular space [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B56\">56<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e584\"><\/a><a name=\"d63676e580\"><\/a><a name=\"d63676e575\"><\/a><a name=\"d63676e571\"><\/a><a name=\"d63676e567\"><\/a><a name=\"d63676e563\"><\/a><a name=\"d63676e559\"><\/a><a name=\"d63676e555\"><\/a><a name=\"d63676e550\"><\/a><a name=\"d63676e546\"><\/a><a name=\"d63676e542\"><\/a><a name=\"d63676e538\"><\/a><a name=\"d63676e534\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Hepatitis C virus<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">There have been no RCTs examining the use of cannabinoids on HCV infection. Of the studies that have been conducted, one longitudinal study demonstrates that smoked marijuana has no effect on HCV progression in individuals with HIV [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B57\">57<\/a><\/span>]. In contrast, individuals with HCV who smoke marijuana have a higher fibrosis progression rate [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B58\">58<\/a><\/span>] and more severe steatosis [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B59\">59<\/a><\/span>], with daily smokers having a more rapid rate of progression and greater severity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B60\">60<\/a><\/span>] than occasional marijuana users [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B58\">58<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B59\">59<\/a><\/span>]. Marijuana may have independent negative effects on steatosis [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B59\">59<\/a><\/span>], but because none of these findings were in the context of a clinical trial, these correlations are not causal and it is possible that individuals who use marijuana do so to manage greater symptom severity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B60\">60<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e594\"><\/a><a name=\"d63676e598\"><\/a><a name=\"d63676e602\"><\/a><a name=\"d63676e606\"><\/a><a name=\"d63676e610\"><\/a><a name=\"d63676e615\"><\/a><a name=\"d63676e619\"><\/a><a name=\"d63676e623\"><\/a> There may be secondary effects of cannabinoids on HCV treatment side effects: dronabinol and Nabilone stabilized treatment-induced weight-loss [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B61\">61<\/a><\/span>]; and dronabinol, Nabilone, and marijuana procured from a marijuana club (dose and method of administration unspecified) increased HCV treatment duration and reduced post-treatment virological relapse [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B61\">61<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B62\">62<\/a><\/span>]. However, there is also a potential drug-drug interaction between ribavirin, a traditional HCV treatment, and marijuana due to shared cytochrome 450 metabolism [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B63\">63<\/a><\/span>]. Because 90 percent of HCV infections are the result of injection drug use [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B64\">64<\/a><\/span>], treatment of symptoms with marijuana may be contraindicated for this subpopulation, particularly because marijuana use in the context of other substance use (i.e., alcohol) has multiplicative effects on the odds of fibrosis severity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B60\">60<\/a><\/span>]. Given that newer treatments for HCV (e.g., sofosbuvir) are replacing ribavirin, there will likely be less need for use of marijuana in management of treatment-related side effects. In sum, there is currently insufficient empirical support to recommend marijuana for the treatment of HCV.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e650\"><\/a><a name=\"d63676e645\"><\/a><a name=\"d63676e641\"><\/a><a name=\"d63676e637\"><\/a><a name=\"d63676e633\"><\/a><a name=\"d63676e629\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>HIV\/AIDS<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Marijuana use in HIV-infected patients is typically for the management of side effects (e.g., nausea) of older antiretroviral treatments and AIDS-related symptoms, including weight-loss and HIV-associated neuropathy (covered in cachexia and pain sections, respectively). Survey studies indicate that 23 percent of patients with HIV\/AIDS smoked marijuana in the past month and do so largely to improve mood and appetite and reduce pain [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B65\">65<\/a><\/span>]; these patients may exhibit tolerance and need higher doses of THC than are currently approved by the FDA for use in clinical trials [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B25\">25<\/a><\/span>] to experience treatment effects. The few RCTs that have been conducted in a small number of patients with HIV\/AIDS largely examined the effects of marijuana (synthetic or natural marijuana that is smoked or ingested) on symptoms (e.g., nausea and appetite) over a short treatment window (21\u201384 days; see [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B66\">66<\/a><\/span>] for systematic review). Studies examining the effects of marijuana on the pharmacokinetics of antiretroviral medication demonstrated that neither smoked marijuana nor dronabinol affects short-term clinical outcomes (e.g., viral load, CD4 and CD8 counts [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B67\">67<\/a><\/span>]), influences the efficacy of antiretroviral medication [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B68\">68<\/a><\/span>], or indicates that dose adjustments for protease inhibitors are necessary [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B21\">21<\/a><\/span>]. However, individuals who are dependent on marijuana have demonstrated poorer medication adherence and greater HIV symptoms and side effects than nonusers and nondependent users [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B69\">69<\/a><\/span>]. Furthermore, while some studies have no participant withdrawal due to adverse events [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B21\">21<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B70\">70<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B71\">71<\/a><\/span>], others reported treatment-limiting adverse events [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B26\">26<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B72\">72<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B73\">73<\/a><\/span>]. Finally, because drug use is a risk factor for HIV infection [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B74\">74<\/a><\/span>], treatment of symptoms with marijuana may be contraindicated for this subpopulation. In sum, there is variability in short-term outcomes and insufficient long-term data addressing the safety and efficacy of marijuana when used to manage symptoms of HIV\/AIDS and its role in those also using newer, better-tolerated antiretroviral agents.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e714\"><\/a><a name=\"d63676e710\"><\/a><a name=\"d63676e706\"><\/a><a name=\"d63676e701\"><\/a><a name=\"d63676e697\"><\/a><a name=\"d63676e693\"><\/a><a name=\"d63676e689\"><\/a><a name=\"d63676e685\"><\/a><a name=\"d63676e681\"><\/a><a name=\"d63676e676\"><\/a><a name=\"d63676e672\"><\/a><a name=\"d63676e668\"><\/a><a name=\"d63676e664\"><\/a><a name=\"d63676e660\"><\/a> <b>Multiple sclerosis and muscle spasticity<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Muscle spasticity, a common feature of MS, is disordered sensorimotor control that leads to involuntary muscle activation [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B75\">75<\/a><\/span>] that results in pain, sleep disturbance, and increased morbidity[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B76\">76<\/a><\/span>]. The majority of studies examining spasticity have compared oral or sublingual forms of cannabinoids to placebo and found reduced spasm severity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B77\">77<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B84\">84<\/a><\/span>], with symptom improvement enduring at long-term follow-up [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B85\">85<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B87\">87<\/a><\/span>], and also reduced spasm frequency and spasm-related pain and sleep disturbances [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B77\">77<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B88\">88<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B89\">89<\/a><\/span>]. With regard to smoked marijuana, one study found reductions in muscle spasticity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B90\">90<\/a><\/span>]; however, another study showed that smoking marijuana impaired posture and balance in individuals with spasticity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B91\">91<\/a><\/span>], so there is currently insufficient evidence to determine the efficacy of smoked marijuana on spasticity [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B5\">5<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e724\"><\/a><a name=\"d63676e728\"><\/a><a name=\"d63676e732\"><\/a><a name=\"d63676e736\"><\/a><a name=\"d63676e740\"><\/a><a name=\"d63676e745\"><\/a><a name=\"d63676e749\"><\/a><a name=\"d63676e753\"><\/a><a name=\"d63676e757\"><\/a><a name=\"d63676e761\"><\/a><a name=\"d63676e765\"><\/a><a name=\"d63676e770\"><\/a> Surveys of patient populations show that between 14 and 16 percent of patients with MS report using marijuana for symptom management [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B92\">92<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B93\">93<\/a><\/span>] and that compared to non-marijuana-using individuals with MS, marijuana-using individuals with MS have decreased cognitive functioning[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B90\">90<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B94\">94<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B95\">95<\/a><\/span>]. Because cognitive dysfunction is present in 40\u201360 percent of individuals with MS before marijuana administration [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B96\">96<\/a><\/span>], marijuana use may further compromise impaired cerebral functioning in a neurologically vulnerable population. Additionally, future studies should carefully consider outcome assessment. The primary methods of measuring spasticity, the Ashworth Scale and patient self-report, may not be appropriate measures because antispastic drugs do not decrease Ashworth ratings, and patient-reported spasticity severity may be poorly correlated with patient functioning (i.e., a patient whose spasticity compensated for motor weakness may be unable to ambulate with reduced spasticity) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B97\">97<\/a><\/span>]. Importantly for both MS and other neurological disorders, the American Academy of Neurology does not advocate the use of marijuana for the treatment of neurological disorders, due to insufficient evidence regarding treatment efficacy [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B98\">98<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e805\"><\/a><a name=\"d63676e801\"><\/a><a name=\"d63676e797\"><\/a><a name=\"d63676e792\"><\/a><a name=\"d63676e788\"><\/a><a name=\"d63676e784\"><\/a><a name=\"d63676e780\"><\/a><a name=\"d63676e776\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Post-traumatic stress disorder<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">There has been a recent emergence of empirical studies of the effects of marijuana on symptoms of PTSD, borne primarily out of the observation that individuals with PTSD report using marijuana to cope with PTSD symptoms; specifically, hyperarousal, negative affect, and sleep disturbances[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B99\">99<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B101\">101<\/a><\/span>]. Empirical work has consistently demonstrated that the endocannabinoid system plays a significant role in the etiology of PTSD, with greater availability of cannabinoid type 1 receptors documented among those with PTSD than in trauma-exposed or healthy controls [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B102\">102<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B103\">103<\/a><\/span>]. Though the use of marijuana and oral THC [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B104\">104<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B105\">105<\/a><\/span>] have been implicated as a potential mechanism for the mitigation of many PTSD symptoms by way of their effects on the endocannabinoid system, some researchers caution that endocannabinoid activation with plant-based extracts over extended periods may lead to a number of deleterious consequences, including receptor downregulation and addiction [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B102\">102<\/a><\/span>].<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e816\"><\/a><a name=\"d63676e820\"><\/a><a name=\"d63676e824\"><\/a><a name=\"d63676e828\"><\/a><a name=\"d63676e832\"><\/a><a name=\"d63676e837\"><\/a><a name=\"d63676e841\"><\/a> There have been no RCTs of marijuana for the treatment of PTSD, though there has been one small RCT of Nabilone that showed promise for reducing nightmares associated with PTSD [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B106\">106<\/a><\/span>]. One unpublished pilot study of 29 Israeli combat veterans showed reductions in PTSD symptoms following the administration of smoked marijuana, with effects seen up to one year post-treatment[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B107\">107<\/a><\/span>]. Remaining studies have been primarily observational in nature, documenting that PTSD is associated with greater odds of a cannabis use disorder diagnosis [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B108\">108<\/a><\/span>] and greater marijuana craving and withdrawal immediately prior to a marijuana cessation attempt [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B109\">109<\/a><\/span>]. Indeed, sleep difficulties (a hallmark of PTSD) have been associated with poor marijuana cessation outcomes[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B110\">110<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B111\">111<\/a><\/span>], while cannabis use disorders have been associated with poorer PTSD treatment outcomes [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B112\">112<\/a><\/span>]. Given the lack of RCTs studying marijuana as a treatment for PTSD, there is insufficient scientific evidence for its use at this time.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e872\"><\/a><a name=\"d63676e868\"><\/a><a name=\"d63676e863\"><\/a><a name=\"d63676e859\"><\/a><a name=\"d63676e855\"><\/a><a name=\"d63676e851\"><\/a><a name=\"d63676e847\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Severe and chronic pain<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Clinical trials have examined smoked and oral administration of cannabinoids on different types of pain (e.g., neuropathic, post-operative, experimentally induced) in multiple patient populations (e.g., HIV, cancer, and fibromyalgia). Two meta-analyses have been conducted examining the association between marijuana and pain. In the first, 18 RCTs demonstrated that any marijuana preparation containing THC, applied by any route of administration, significantly decreased pain scores from baseline compared to placebo [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B113\">113<\/a><\/span>]. The second examined 19 RCTs of smoked marijuana in individuals with HIV, which also indicated greater efficacy in reducing pain (i.e., sensory neuropathy) compared to placebo [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B114\">114<\/a><\/span>]. Importantly, the first meta-analysis showed that marijuana increased the odds of altered perception, motor function, and cognition by 4 to 5 times[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B113\">113<\/a><\/span>], and the second study did not recommend marijuana as routine therapy [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B114\">114<\/a><\/span>]. Dosage is an important factor to consider for administration of cannabinoids for pain management, as some studies have found that higher doses of smoked marijuana are associated with improved analgesia[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B115\">115<\/a><\/span>], whereas other studies show that higher doses of smoked marijuana increase pain response[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B116\">116<\/a><\/span>]. Because the analgesic effects of marijuana are comparable to those of traditional pain medications [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B117\">117<\/a><\/span>], future research should aim to identify which analgesics provide the lowest risk profile for the management of severe and chronic pain. Although there is preliminary support to suggest that marijuana may have analgesic effects, there is insufficient research on dosing and side effect profile, which precludes recommending marijuana for the management of severe and chronic pain.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e907\"><\/a><a name=\"d63676e903\"><\/a><a name=\"d63676e898\"><\/a><a name=\"d63676e894\"><\/a><a name=\"d63676e890\"><\/a><a name=\"d63676e886\"><\/a><a name=\"d63676e882\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\"><b>Severe nausea<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">The majority of research related to the effects of marijuana on severe nausea has involved oral administration of marijuana to individuals with chemotherapy-induced nausea and vomiting (CINV). Oral marijuana (i.e., THC suspension in sesame oil and gelatin) has been shown to be more effective in reducing CINV than placebo [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B118\">118<\/a><\/span>], including the number and volume of vomiting episodes, and the severity and duration of nausea [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B119\">119<\/a><\/span>]. When compared to traditional anti-emetics, some meta-analytic reviews indicate that oral THC is more effective in reducing CINV[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B120\">120<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B123\">123<\/a><\/span>], others find no significant difference [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B122\">122<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B124\">124<\/a><\/span>]-[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B126\">126<\/a><\/span>], and another suggests that combining both is the most effective at reducing the duration and severity of CINV than either alone [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B127\">127<\/a><\/span>]. Recent advances in both anti-emetic agents and the mechanisms of cannabinoid administration (i.e., sublingual application) warrant future research.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e917\"><\/a><a name=\"d63676e921\"><\/a><a name=\"d63676e925\"><\/a><a name=\"d63676e929\"><\/a><a name=\"d63676e933\"><\/a><a name=\"d63676e938\"><\/a><a name=\"d63676e942\"><\/a><a name=\"d63676e946\"><\/a> Importantly, patients receiving cannabinoids for severe nausea reported toxicities, including paranoid delusions (5%), hallucinations (6%), and dysphoria (13%) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B122\">122<\/a><\/span>]. Additionally, cannabinoid hyperemesis syndrome has been documented, in which persistent and regular marijuana use (i.e., daily or weekly use for more than 1 year) is associated with cyclic vomiting (i.e., episodic nausea and vomiting) [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B128\">128<\/a><\/span>] and nonresponse to treatment for cyclic vomiting [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B129\">129<\/a><\/span>]. Dronabinol has been FDA-approved for CINV in individuals who have not shown a treatment response to traditional anti-emetics, but in line with recommendations from the American Society of Clinical Oncology [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B130\">130<\/a><\/span>] and the European Society for Medical Oncology [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B131\">131<\/a><\/span>], cannabinoids should not be utilized as a first-line treatment for nausea and vomiting.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e968\"><\/a><a name=\"d63676e964\"><\/a><a name=\"d63676e960\"><\/a><a name=\"d63676e956\"><\/a><a name=\"d63676e952\"><\/a> <b>Conclusions<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec4\"><\/a> The reviewed literature highlights the dearth of rigorous research on the effects of marijuana for the most common conditions for which it is currently recommended. It is paramount that well-designed RCTs with larger sample sizes be conducted to determine the actual medical benefits and adverse effects of marijuana for each of the above conditions. Indeed, recent reviews [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B4\">4<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B132\">132<\/a><\/span>] comprehensively discuss adverse events associated with marijuana use, and while it is beyond the scope of the current paper to review these effects in-depth, they are important to consider when evaluating whether or not to recommend marijuana for a medical or psychiatric disorder in place of other existing treatment options.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e982\"><\/a><a name=\"d63676e978\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Given the extensive literature speaking to the harms associated with marijuana use, research on the comparative safety, tolerability, efficacy, and risk of marijuana compared to existing pharmacological agents is needed. The present literature also illuminates the need for research into the effects of isolated cannabinoids (e.g., THC, CBD) as well as species of smoked marijuana (e.g., indica and sativa), as the majority of medical marijuana users ingest marijuana by smoking the marijuana plant [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B133\">133<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B134\">134<\/a><\/span>], which contains a wide variety of phytocannabinoids at varying potencies [<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B135\">135<\/a><\/span>],[<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10#B136\">136<\/a><\/span>]. Furthermore, improved and objective measurement of clinical outcomes should be implemented in clinical trials to determine treatment efficacy. Finally, little research has considered the issues of dose, duration, and potency. If research identifies a therapeutic effect of marijuana for medical or psychiatric conditions, there will need to be revisions in marijuana policy to increase quality control so that dose and potency are valid and reliable. Additionally, risk of abuse and diversion can be decreased by developing prescribing practices with continued supervision of a medical professional, creating prescription monitoring programs to reduce the risk of \u201cdoctor shopping\u201d, and identifying provisions for the safe disposal of unused cannabinoids. In sum, the current literature does not adequately support the widespread adoption and use of marijuana for medical and psychiatric conditions at this time.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"d63676e1000\"><\/a><a name=\"d63676e996\"><\/a><a name=\"d63676e992\"><\/a><a name=\"d63676e988\"><\/a><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">Source: :<span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/content\/10\/1\/10\">http:\/\/www.ascpjournal.org\/content\/10\/1\/10<\/a><\/span> 21<sup>st<\/sup> April 2015<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Abbreviations<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec5\"><\/a> THC: \u0394<sup>9<\/sup>-tetrahydrocannabinol<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">HIV: Human immunodeficiency virus<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">AIDS: Acquired immunodeficiency syndrome<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">RCTs: Randomized controlled trials<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">IOP: Intraocular pressure<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">MS: Multiple sclerosis<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">CINV: Chemotherapy-induced nausea and vomiting<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">HCV: Hepatitis C virus<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">ALS: Amyotrophic lateral sclerosis<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">CD: Crohn\u2019s disease<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">IBD: Inflammatory bowel disease<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">AD: Alzheimer\u2019s disease<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">PTSD: Post-traumatic stress disorder<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">CB1: Cannabinoid type 1<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">CBD: Cannabidiol<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Competing interests<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec6\"><\/a> Dr. Belendiuk holds stock in Shire Pharmaceuticals.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Authors\u2019 contributions<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"sec7\"><\/a> Dr. KAB synthesized the literature and authored sections of the manuscript. Ms. LLB assisted with the literature search and synthesis. Dr. MOB-M conceived the review, assisted in the search and synthesis of existing literature, and authored sections of the manuscript. All authors read and approved the final manuscript.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>Acknowledgements<\/b><\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><a name=\"ack\"><\/a> Dr. Belendiuk\u2019s salary was supported by National Institute of Mental Health R01 MH40564.<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">Dr. Bonn-Miller\u2019s salary was supported by the VA Center of Excellence for Substance Abuse Treatment and Education.<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">Literature review and synthesis was supported by a grant from the VA Substance Use Disorder Quality Enhancement Research Initiative (SUDQ-LIP1410).<\/span><\/p>\n<p align=\"justify\"><span style=\"color: #0000ff; font-family: verdana, geneva, sans-serif; font-size: 10pt;\">The above funding agencies played no role in the writing of the manuscript or decision to submit the manuscript for publication. The expressed views do not necessarily represent those of the Department of Veterans Affairs.<\/span><\/p>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><b>References<\/b><\/span><\/p>\n<ol>\n<li>\n<ol>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Substance Abuse and Mental Health Services Administration: <i>Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings<\/i>. Department of Health and Human Services, Rockville, MD. U.S; 2013. <\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bonn-Miller MO, Harris AH, Trafton JA: <b>Prevalence of cannabis use disorder diagnoses among veterans in 2002, 2008, and 2009.<\/b><i> Psycholog Serv<\/i> 2012, <b>9:<\/b>404-16. <\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<ol start=\"3\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Johnston LD, O&#8217;Malley PM, Miech RA, Bachman JG, Schulenberg JE: <i>Monitoring the Future national results on drug use: 1975\u20132013: Overview, Key Findings on Adolescent Drug Use<\/i>. Institute for Social Research, The University of Michigan, Ann Arbor; 2014. <\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Volkow ND, Baler RD, Compton WM, Weiss SR: <b>Adverse health effects of marijuana use.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>N Engl J Med<\/i> 2014, <b>370:<\/b>2219-27. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24897085\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24897085\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"5\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Koppel BS, Brust JC, Fife T, Bronstein J, Youssof S, Gronseth G, <i>et al<\/i>.: <b>Systematic review: efficacy and safety of medical marijuana in selected neurologic disorders: report of the guideline development subcommittee of the American academy of neurology.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2014, <b>82:<\/b>1556-63. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24778283\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24778283\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"6\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Procon.org. 23 legal medical marijuana states and DC: Laws, fees, and possession limits. Retrieved April 9, 2015, from [http:\/\/medicalmarijuana.procon.org\/view.resource.php?resourceID=000881]<\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bonn-Miller MO, Boden MT, Bucossi MM, Babson KA: <b>Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Drug Alcohol Abuse<\/i> 2014, <b>40:<\/b>23-30. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24205805\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24205805\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"8\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ilgen MA, Bohnert K, Kleinberg F, Jannausch M, Bohnert ASB, Walton MA, <i>et al<\/i>.:<b>Characteristics of adults seeking medical marijuana certification.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Drug Alcohol Depend<\/i> 2013, <b>132:<\/b>654-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23683791\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23683791\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"9\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Nunberg H, Kilmer B, Pacula RL, Burgdorf J: <b>An analysis of applicants presenting to a medical marijuana specialty practice in California.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Drug Policy Anal.<\/i> 2011, <b>4:<\/b>1. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23750291\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23750291\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"10\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Minati L, Edginton T, Bruzzone MG, Giaccone G: <b>Reviews: current concepts in Alzheimer&#8217;s disease: a multidisciplinary review.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Alzheimers Dis Other Demen<\/i> 2009, <b>24:<\/b>95-121. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/19116299\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=19116299\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"11\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Fagan SG, Campbell VA: <b>The influence of cannabinoids on generic traits of neurodegeneration.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Br J Pharmacol<\/i> 2014, <b>171:<\/b>1347-60. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24172185\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24172185\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"12\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Gowran A, Noonan J, Campbell VA: <b>The multiplicity of action of cannabinoids: implications for treating neurodegeneration.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>CNS Neurosci Ther<\/i> 2011, <b>17:<\/b>637-44. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20875047\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20875047\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"13\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Aso E, Ferrer I: <b>Cannabinoids for treatment of Alzheimer\u2019s disease: moving toward the clinic.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Front Pharmacol<\/i> 2014, <b>5:<\/b>37. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24634659\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24634659\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"14\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Krishnan S, Cairns R, Howard R: <b>Cannabinoids for the treatment of dementia.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Cochrane Database Syst Rev<\/i> 2009, <b>2:<\/b>CD007204. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/19370677\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=19370677\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"15\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ: <b>Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer&#8217;s disease.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Int J Geriatr Psychiatry<\/i> 1997, <b>12:<\/b>913-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/9309469\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=9309469\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"16\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Walther S, Sch\u00fcpbach B, Seifritz E, Homan P, Strik W: <b>Randomized, controlled crossover trial of dronabinol, 2.5 mg, for agitation in 2 patients with dementia.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Clin Psychopharmacol<\/i> 2011, <b>31:<\/b>256-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21364345\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21364345\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"17\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Carter GT, Abood ME, Aggarwal SK, Weiss MD: <b>Cannabis and amyotrophic lateral sclerosis: hypothetical and practical applications, and a call for clinical trials.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Hosp Palliat Care<\/i> 2010, <b>27:<\/b>347-56. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20439484\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20439484\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"18\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Carter GT, Rosen BS: <b>Marijuana in the management of amyotrophic lateral sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Hosp Palliat Care<\/i> 2001, <b>18:<\/b>264-70. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/11467101\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=11467101\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"19\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Amtmann D, Weydt P, Johnson KL, Jensen MP, Carter GT: <b>Survey of cannabis use in patients with amyotrophic lateral sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Hosp Palliat Care<\/i> 2004, <b>21:<\/b>95-104. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15055508\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15055508\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"20\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Weber M, Goldman B, Truniger S: <b>Tetrahydrocannabinol (THC) for cramps in amyotrophic lateral sclerosis: a randomised, double-blind crossover trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Neurol Neurosurg Psychiatry<\/i> 2010, <b>81:<\/b>1135-40. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20498181\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20498181\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"21\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Abrams DI, Hilton JF, Leiser RJ, Shade SB, Elbeik TA, Aweeka FT, <i>et al<\/i>.: <b>Short-term effects of cannabinoids in patients with HIV-1 infection: a randomized, placebo-controlled clinical trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ann Intern Med<\/i> 2003, <b>139:<\/b>258-66. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12965981\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12965981\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"22\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Haney M, Gunderson EW, Rabkin J, Hart CL, Vosburg SK, Comer SD, <i>et al<\/i>.: <b>Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Acquir Immune Defic Syndr<\/i> 2007, <b>45:<\/b>545-54. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17589370\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17589370\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"23\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Foltin RW, Fischman MW, Byrne MF: <b>Effects of smoked marijuana on food intake and body weight of humans living in a residential laboratory.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Appetite<\/i> 1988, <b>11:<\/b>1-14. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/3228283\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=3228283\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"24\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Haney M: <b>Effects of smoked marijuana in healthy and HIV+ marijuana smokers.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Clin Pharmacol<\/i> 2002, <b>42:<\/b>34S-40. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12412834\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12412834\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"25\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bedi G, Foltin RW, Gunderson EW, Rabkin J, Hart CL, Comer SD, <i>et al<\/i>.: <b>Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Psychopharmacol (Berl)<\/i> 2010, <b>212:<\/b>675-86. <\/span><\/p>\n<ol start=\"26\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, <i>et al<\/i>.: <b>Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pain Symptom Manage<\/i> 1995, <b>10:<\/b>89-97. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/7730690\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=7730690\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"27\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Beal JE, Olson R, Lefkowitz L, Laubenstein L, Bellman P, Yangco B, <i>et al<\/i>.: <b>Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pain Symptom Manage<\/i> 1997, <b>14:<\/b>7-14. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/9223837\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=9223837\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"28\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Riggs PK, Vaida F, Rossi SS, Sorkin LS, Gouaux B, Grant I, <i>et al<\/i>.: <b>A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Brain Res<\/i> 2012, <b>1431:<\/b>46-52. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22133305\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22133305\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"29\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, <i>et al<\/i>.: <b>Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a north central cancer treatment group study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Clin Oncol<\/i> 2002, <b>20:<\/b>567-73. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/11786587\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=11786587\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"30\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bowles DW, O\u2019Bryant CL, Camidge DR, Jimeno A: <b>The intersection between cannabis and cancer in the United States.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Crit Rev Oncol Hematol<\/i> 2012, <b>83:<\/b>1-10. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22019199\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22019199\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"31\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Pisanti S, Malfitano AM, Grimaldi C, Santoro A, Gazzerro P, Laezza C, <i>et al<\/i>.: <b>Use of cannabinoid receptor agonists in cancer therapy as palliative and curative agents.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Best Prac Res Clin Endocrinol Metab<\/i> 2009, <b>23:<\/b>117-31. <\/span><\/p>\n<ol start=\"32\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">McKallip RJ, Nagarkatti M, Nagarkatti PS: <b>\u0394-9-tetrahydrocannabinol enhances breast cancer growth and metastasis by suppression of the antitumor immune response.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Immunol<\/i> 2005, <b>174:<\/b>3281-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15749859\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15749859\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"33\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Guzman M, Duarte MJ, Blazquez C, Ravina J, Rosa MC, Galve-Roperh I, <i>et al<\/i>.: <b>A pilot clinical study of \u03949-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Br J Cancer<\/i> 2006, <b>95:<\/b>197-203. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/16804518\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=16804518\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"34\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Storr M, Devlin S, Kaplan GG, Panaccione R, Andrews CN: <b>Cannabis use provides symptom relief in patients with inflammatory bowel disease but is associated with worse disease prognosis in patients with Crohn&#8217;s disease.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Inflamm Bowel Dis<\/i> 2014, <b>20:<\/b>472-80. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24407485\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24407485\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"35\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Lal S, Prasad N, Ryan M, Tangri S, Silverberg MS, Gordon A, <i>et al<\/i>.: <b>Cannabis use amongst patients with inflammatory bowel disease.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Gastroenterol Hepatol<\/i> 2011, <b>23:<\/b>891-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21795981\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21795981\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"36\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Allegretti JR, Courtwright A, Lucci M, Korzenik JR, Levine J: <b>Marijuana use patterns among patients with inflammatory bowel disease.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Inflamm Bowel Dis<\/i> 2013, <b>19:<\/b>2809-14. <\/span><\/p>\n<ol start=\"37\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Naftali T, Bar-Lev Schleider L, Dotan I, Lansky EP, Sklerovsky Benjaminov F, Konikoff FM:<b>Cannabis induces a clinical response in patients with Crohn&#8217;s disease: a prospective placebo-controlled study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Gastroenterol Hepatol<\/i> 2013, <b>11:<\/b>1276-80. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23648372\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23648372\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"38\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Hill TD, Cascio MG, Romano B, Duncan M, Pertwee RG, Williams CM, <i>et al<\/i>.: <b>Cannabidivarin-rich cannabis extracts are anticonvulsant in mouse and rat via a CB1 receptor-independent mechanism.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Br J Pharmacol<\/i> 2013, <b>170:<\/b>679-92. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23902406\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23902406\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"39\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Jones NA, Glyn SE, Akiyama S, Hill TD, Hill AJ, Weston SE, <i>et al<\/i>.: <b>Cannabidiol exerts anti-convulsant effects in animal models of temporal lobe and partial seizures.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Seizure<\/i> 2012, <b>21:<\/b>344-52. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22520455\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22520455\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"40\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wallace MJ, Blair RE, Falenski KW, Martin BR, DeLorenzo RJ: <b>The endogenous cannabinoid system regulates seizure frequency and duration in a model of temporal lobe epilepsy.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pharmacol Exp Ther<\/i> 2003, <b>307:<\/b>129-37. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12954810\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12954810\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"41\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Jones NA, Hill AJ, Smith I, Bevan SA, Williams CM, Whalley BJ, <i>et al<\/i>.: <b>Cannabidiol displays antiepileptiform and antiseizure properties in vitro and in vivo.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pharmacol Exp Ther<\/i> 2010, <b>332:<\/b>569-77. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/19906779\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=19906779\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"42\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Gordon E, Devinsky O: <b>Alcohol and marijuana: effects on epilepsy and use by patients with epilepsy.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Epilepsia<\/i> 2001, <b>42:<\/b>1266-72. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/11737161\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=11737161\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"43\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Hamerle M, Ghaeni L, Kowski A, Weissinger F, Holtkamp M: <b>Cannabis and other illicit drug use in epilepsy patients.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Neurol<\/i> 2014, <b>21:<\/b>167-70. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23311572\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23311572\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"44\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Gross DW, Hamm J, Ashworth NL, Quigley D: <b>Marijuana use and epilepsy: prevalence in patients of a tertiary care epilepsy center.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2004, <b>62:<\/b>2095-7. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15184622\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15184622\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"45\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Gloss D, Vickrey B: <b>Cannabinoids for epilepsy.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Cochrane Database Syst Rev<\/i> 2014, <b>3:<\/b>CD009270. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24595491\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24595491\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"46\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Mechoulam R, Carlini EA: <b>Toward drugs derived from cannabis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Naturwissenschaften<\/i> 1978, <b>65:<\/b>174-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/351429\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=351429\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"47\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Cunha JM, Carlini EA, Pereira AE, Ramos OL, Pimentel C, Gagliardi R, <i>et al<\/i>.: <b>Chronic administration of cannabidiol to healthy volunteers and epileptic patients.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Pharmacology<\/i> 1980, <b>21:<\/b>175-85. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/7413719\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=7413719\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"48\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ames FR, Cridland S: <b>Anticonvulsant effect of cannabidiol.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>S Afr Med J<\/i> 1986, <b>69:<\/b>14. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/3941934\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=3941934\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"49\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Merritt JC, Crawford WJ, Alexander PC, Anduze AL, Gelbart SS: <b>Effect of marihuana on intraocular and blood pressure in glaucoma.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ophthalmology<\/i> 1980, <b>87:<\/b>222-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/7053160\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=7053160\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"50\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Hepler RS, Frank IR: <b>Marihuana smoking and intraocular pressure.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>JAMA<\/i> 1971, <b>217:<\/b>1392. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/5109652\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=5109652\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"51\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Green K: <b>Marijuana smoking vs cannabinoids for glaucoma therapy.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Arch Ophthalmol<\/i> 1998, <b>116:<\/b>1433-7. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/9823341\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=9823341\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"52\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Nucci C, Bari M, Span\u00f2 A, Corasaniti M, Bagetta G, Maccarrone M, <i>et al<\/i>.: <b>Potential roles of (endo) cannabinoids in the treatment of glaucoma: from intraocular pressure control to neuroprotection.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Prog Brain Res<\/i> 2008, <b>173:<\/b>451-64. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18929127\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18929127\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"53\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Flach AJ: <b>Delta-9-tetrahydrocannabinol (THC) in the treatment of end-stage open-angle glaucoma.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Trans Am Ophthalmol Soc<\/i> 2002, <b>100:<\/b>215-22. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12545695\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12545695\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"54\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Jampel H: <b>American glaucoma society position statement: marijuana and the treatment of glaucoma.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Glaucoma<\/i> 2010, <b>19:<\/b>75-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20160576\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20160576\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"55\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Buys YM, Rafuse PE: <b>Canadian ophthalmological society policy statement on the medical use of marijuana for glaucoma.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Can J Ophthalmol<\/i> 2010, <b>45:<\/b>324-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20676153\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20676153\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"56\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Tomida I, Pertwee RG, Azuara-Blanco A: <b>Cannabinoids and glaucoma.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Br J Ophthalmol<\/i> 2004, <b>88:<\/b>708-13. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15090428\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15090428\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"57\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Brunet L, Moodie EE, Rollet K, Cooper C, Walmsley S, Potter M, <i>et al<\/i>.: <b>Marijuana smoking does not accelerate progression of liver disease in HIV-hepatitis C coinfection: a longitudinal cohort analysis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Infect Dis<\/i> 2013, <b>57:<\/b>663-70. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23811492\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23811492\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"58\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">H\u00e9zode C, Roudot-Thoraval F, Nguyen S, Grenard P, Julien B, Zafrani E-S, <i>et al<\/i>.: <b>Daily cannabis smoking as a risk factor for progression of fibrosis in chronic hepatitis C.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Hepatology<\/i> 2005, <b>42:<\/b>63-71. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15892090\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15892090\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"59\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">H\u00e9zode C, Zafrani ES, Roudot-Thoraval F, Costentin C, Hessami A, Bouvier\u2013Alias M, <i>et al<\/i>.:<b>Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Gastroenterology<\/i> 2008, <b>134:<\/b>432-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18242211\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18242211\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"60\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ishida JH, Peters MG, Jin C, Louie K, Tan V, Bacchetti P, <i>et al<\/i>.: <b>Influence of cannabis use on severity of hepatitis C disease.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Gastroenterol Hepatol<\/i> 2008, <b>6:<\/b>69-75. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18166478\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18166478\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"61\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Costiniuk CT, Mills E, Cooper CL: <b>Evaluation of oral cannabinoid-containing medications for the management of interferon and ribavirin-induced anorexia, nausea and weight loss in patients treated for chronic hepatitis C virus.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Can J Gastroenterol<\/i> 2008, <b>22:<\/b>376-80. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18414712\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18414712\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"62\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Sylvestre DL, Clements BJ, Malibu Y: <b>Cannabis use improves retention and virological outcomes in patients treated for hepatitis C.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Gastroenterol Hepatol<\/i> 2006, <b>18:<\/b>1057-63. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/16957511\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=16957511\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"63\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Glue P: <b>The clinical pharmacology of ribavirin.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Semin Liver Dis<\/i> 1998, <b>19S:<\/b>17-24. <\/span><\/p>\n<ol start=\"64\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wasley A, Grytdal S, Gallagher K: Centers for Disease Control and Prevention (CDC):<b>Surveillance for acute viral hepatitis &#8212; United States, 2006.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>MMWR Surveill Summ<\/i> 2008, <b>57:<\/b>1-24. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18354374\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18354374\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"65\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Prentiss D, Power R, Balmas G, Tzuang G, Israelski DM: <b>Patterns of marijuana use among patients with HIV\/AIDS followed in a public health care setting.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Acquir Immune Defic Syndr<\/i> 2004, <b>35:<\/b>38-45. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/14707790\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=14707790\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"66\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Lutge EE, Gray A, Siegfried N: <b>The medical use of cannabis for reducing morbidity and mortality in patients with HIV\/AIDS.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Cochrane Database Syst Rev<\/i> 2013, <b>4:<\/b>CD005175. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23633327\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23633327\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"67\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bredt BM, Higuera-Alhino D, Shade SB, Hebert SJ, McCune JM, Abrams DI: <b>Short-term effects of cannabinoids on immune phenotype and function in HIV-1-infected patients.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Clin Pharmacol<\/i> 2002, <b>42:<\/b>82S-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12412840\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12412840\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"68\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Kosel BW, Aweeka FT, Benowitz NL, Shade SB, Hilton JF, Lizak PS, <i>et al<\/i>.: <b>The effects of cannabinoids on the pharmacokinetics of indinavir and nelfinavir.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>AIDS<\/i> 2002, <b>16:<\/b>543-50. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/11872997\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=11872997\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"69\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bonn-Miller MO, Oser ML, Bucossi MM, Trafton JA: <b>Cannabis use and HIV antiretroviral therapy adherence and HIV-related symptoms.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Behav Med<\/i> 2014, <b>37:<\/b>1-10. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23054178\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23054178\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"70\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Haney M, Rabkin J, Gunderson E, Foltin RW: <b>Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on caloric intake and mood.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Psychopharmacology (Berl)<\/i> 2005, <b>181:<\/b>170-8. <\/span><\/p>\n<ol start=\"71\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Abrams DI, Jay CA, Shade SB, Vizoso H, Reda H, Press S, <i>et al<\/i>.: <b>Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2007, <b>68:<\/b>515-21. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17296917\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17296917\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"72\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ellis RJ, Toperoff W, Vaida F, van den Brande G, Gonzales J, Gouaux B, <i>et al<\/i>.: <b>Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neuropsychopharmacology<\/i> 2009, <b>34:<\/b>672-80. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18688212\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18688212\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"73\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Struwe M, Kaempfer SH, Geiger CJ, Pavia AT, Plasse TF, Shepard KV, <i>et al<\/i>.: <b>Effect of dronabinol on nutritional status in HIV infection.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ann Pharmacother<\/i> 1993, <b>27:<\/b>827-31. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/8395916\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=8395916\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"74\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Centers for Disease Control and Prevention (CDC). HIV and substance use in the United States. Retrieved April 9, 2015, from [http:\/\/www.cdc.gov\/hiv\/risk\/behavior\/substanceuse.html]<\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Pandyan AD, Gregoric M, Barnes MP, Wood D, van Wijck F, Burridge J, <i>et al<\/i>.: <b>Spasticity: clinical perceptions, neurological realities and meaningful measurement.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Disabil Rehabil<\/i> 2005, <b>27:<\/b>2-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15799140\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15799140\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"76\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Beard S, Hunn A, Wight J: <b>Treatments for spasticity and pain in multiple sclerosis: a systematic review.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Health Technol Assess<\/i> 2003, <b>7<\/b>(40)<b>:<\/b>1-111. <\/span><\/p>\n<ol start=\"77\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Novotna A, Mares J, Ratcliffe S, Novakova I, Vachova M, Zapletalova O, <i>et al<\/i>.: <b>A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols*(Sativex\u00ae), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Neurol<\/i> 2011, <b>18:<\/b>1122-31. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21362108\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21362108\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"78\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wade DT, Makela P, Robson P, House H, Bateman C: <b>Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Mult Scler<\/i> 2004, <b>10:<\/b>434-41. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15327042\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15327042\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"79\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Collin C, Davies P, Mutiboko IK, Ratcliffe S: <b>Randomized controlled trial of cannabis-based medicine in spasticity caused by multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Neurol<\/i> 2007, <b>14:<\/b>290-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17355549\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17355549\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"80\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wade DT, Collin C, Stott C, Duncombe P: <b>Meta-analysis of the efficacy and safety of Sativex (nabiximols), on spasticity in people with multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Mult Scler<\/i> 2010, <b>16:<\/b>707-14. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20558502\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20558502\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"81\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wade DT, Robson P, House H, Makela P, Aram J: <b>A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Rehabil<\/i> 2003, <b>17:<\/b>21-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12617376\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12617376\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"82\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, <i>et al<\/i>.: <b>Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Neurol Neurosurg Psychiatry<\/i> 2005, <b>76:<\/b>1664-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/16291891\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=16291891\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"83\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, <i>et al<\/i>.: <b>Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Lancet<\/i> 2003, <b>362:<\/b>1517-26. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/14615106\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=14615106\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"84\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Pooyania S, Ethans K, Szturm T, Casey A, Perry D: <b>A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Arch Phys Med Rehabil<\/i> 2010, <b>91:<\/b>703-7. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20434606\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20434606\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"85\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wade DT, Makela PM, House H, Bateman C, Robson P: <b>Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Mult Scler<\/i> 2006, <b>12:<\/b>639-45. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17086911\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17086911\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"86\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Serpell MG, Notcutt W, Collin C: <b>Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Neurol<\/i> 2013, <b>260:<\/b>285-95. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22878432\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22878432\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"87\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Notcutt W, Langford R, Davies P, Ratcliffe S, Potts R: <b>A placebo-controlled, parallel-group, randomized withdrawal study of subjects with symptoms of spasticity due to multiple sclerosis who are receiving long-term Sativex\u00ae(nabiximols).<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Mult Scler<\/i> 2012, <b>18:<\/b>219-28. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21878454\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21878454\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"88\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Flachenecker P, Henze T, Zettl UK: <b>Nabiximols (THC\/CBD oromucosal spray, Sativex\u00ae) in clinical practice\u2014results of a multicenter, non-interventional study (MOVE 2) in patients with multiple sclerosis spasticity.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur Neurol<\/i> 2014, <b>71:<\/b>271-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24525548\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24525548\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"89\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Rog DJ, Nurmikko TJ, Friede T, Young CA: <b>Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2005, <b>65:<\/b>812-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/16186518\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=16186518\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"90\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Corey-Bloom J, Wolfson T, Gamst A, Jin S, Marcotte TD, Bentley H, <i>et al<\/i>.: <b>Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>CMAJ<\/i> 2012, <b>184:<\/b>1143-50. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22586334\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22586334\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"91\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Greenberg HS, Werness SA, Pugh JE, Andrus RO, Anderson DJ, Domino EF: <b>Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteers.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Pharmacol Ther<\/i> 1994, <b>55:<\/b>324-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/8143398\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=8143398\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"92\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Clark AJ, Ware MA, Yazer E, Murray TJ, Lynch ME: <b>Patterns of cannabis use among patients with multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2004, <b>62:<\/b>2098-100. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/15184623\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=15184623\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"93\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Page SA, Verhoef MJ, Stebbins RA, Metz LM, Levy JC: <b>Cannabis use as described by people with multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Can J Neurol Sci<\/i> 2003, <b>30:<\/b>201-5. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/12945941\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=12945941\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"94\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Pavisian B, MacIntosh BJ, Szilagyi G, Staines RW, O&#8217;Connor P, Feinstein A: <b>Effects of cannabis on cognition in patients with MS: a psychometric and MRI study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2014, <b>82:<\/b>1879-87. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24789863\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24789863\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"95\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Honarmand K, Tierney MC, O&#8217;Connor P, Feinstein A: <b>Effects of cannabis on cognitive function in patients with multiple sclerosis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 2011, <b>76:<\/b>1153-60. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21444900\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21444900\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"96\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Rao SM, Leo GJ, Bernardin L, Unverzagt F: <b>Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Neurology<\/i> 1991, <b>41:<\/b>685-91. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/2027484\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=2027484\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"97\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Leussink VI, Husseini L, Warnke C, Broussalis E, Hartung HP, Kieseier BC: <b>Symptomatic therapy in multiple sclerosis: the role of cannabinoids in treating spasticity.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ther Adv Neurol Disord<\/i> 2012, <b>5:<\/b>255-66. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22973422\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22973422\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"98\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">American Academy of Neurology. Position statement: Use of medical marijuana for neurologic disorders. Retrieved April 9, 2015, from [https:\/\/www.aan.com\/uploadedFiles\/Website_Library_Assets\/Documents\/6.Public_Policy\/1.Stay_Informed\/2.Position_Statements\/3.PDFs_of_all_Position_Statements\/Final%20Medical%20Marijuana%20Position%20Statement.pdf]<\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bonn-Miller MO, Vujanovic AA, Feldner MT, Bernstein A, Zvolensky MJ: <b>Posttraumatic stress symptom severity predicts marijuana use coping motives among traumatic event-exposed marijuana users.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Trauma Stress<\/i> 2007, <b>20:<\/b>577-86. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17721963\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17721963\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"100\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bremner JD, Southwick SM, Darnell A, Charney DS: <b>Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Amer J Psychiatry<\/i> 1996, <b>153:<\/b>369-75. <\/span><\/p>\n<ol start=\"101\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Vandrey R, Babson KA, Herrmann ES, Bonn-Miller MO: <b>Interactions between disordered sleep, post-traumatic stress disorder, and substance use disorders.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Int Rev Psychiatry<\/i> 2014, <b>26:<\/b>237-47. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24892898\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24892898\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"102\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Neumeister A, Normandin MD, Pietrzak RH, Piomelli D, Zheng MQ, Gujarro-Anton A, <i>et al<\/i>.:<b>Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Mol Psychiatry<\/i> 2013, <b>18:<\/b>1034-40. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23670490\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23670490\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"103\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Passie T, Emrich HM, Karst M, Brandt SD, Halpern JH: <b>Mitigation of post-traumatic stress symptoms by cannabis resin: a review of the clinical and neurobiological evidence.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Drug Test Anal<\/i> 2012, <b>4:<\/b>649-59. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/22736575\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=22736575\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"104\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Roitman P, Mechoulam R, Cooper-Kazaz R, Shalev A: <b>Preliminary, open-label, pilot study of add-on oral \u0394-tetrahydrocannabinol in chronic post-traumatic stress disorder.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Clin Drug Investig<\/i> 2014, <b>34:<\/b>587-91. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24935052\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24935052\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"105\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Fraser GA: <b>The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD).<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>CNS Neurosci Ther<\/i> 2009, <b>15:<\/b>84-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/19228182\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=19228182\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"106\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Jetly R, Heber A, Fraser G, Boisvert D: <b>The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: a preliminary randomized, double-blind, placebo-controlled cross-over design study.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Psychoneuroendocrinology<\/i> 2015, <b>51:<\/b>585-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/25467221\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=25467221\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"107\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Mashiah M. Medical cannabis as treatment for chronic combat PTSD: Promising results in an open pilot study [presentation]. Patients Out of Time Conference; Tuscon, Arizona; 2012.<\/span><\/li>\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Cougle JR, Bonn-Miller MO, Vujanovic AA, Zvolensky MJ, Hawkins KA: <b>Posttraumatic stress disorder and cannabis use in a nationally representative sample.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Psychol Addict Behav<\/i> 2011, <b>25:<\/b>554-8. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21480682\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21480682\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"109\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Boden MT, Babson KA, Vujanovic AA, Short NA, Bonn-Miller MO: <b>Posttraumatic stress disorder and cannabis use characteristics among military veterans with cannabis dependence.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Addict<\/i> 2013, <b>22:<\/b>277-84. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23617872\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23617872\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"110\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Babson KA, Boden MT, Harris AH, Stickle TR, Bonn-Miller MO: <b>Poor sleep quality as a risk factor for lapse following a cannabis quit attempt.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Subst Abuse Treat<\/i> 2013, <b>44:<\/b>438-43. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23098380\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23098380\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"111\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Babson KA, Boden MT, Bonn-Miller MO: <b>The impact of perceived sleep quality and sleep efficiency\/duration on cannabis use during a self-guided quit attempt.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Addict Behav<\/i> 2013, <b>38:<\/b>2707-13. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23906725\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23906725\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"112\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Bonn-Miller MO, Boden MT, Vujanovic AA, Drescher KD: <b>Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Psychological Trauma: Theory, Research, Practice, and Policy<\/i> 2013, <b>5:<\/b>193-200. <\/span><\/p>\n<ol start=\"113\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Mart\u00edn-S\u00e1nchez E, Furukawa TA, Taylor J, Martin JL: <b>Systematic review and meta-analysis of cannabis treatment for chronic pain.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Pain Med<\/i> 2009, <b>10:<\/b>1353-68. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/19732371\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=19732371\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"114\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Phillips TJC, Cherry CL, Cox S, Marshall SJ, Rice ASC: <b>Pharmacological treatment of painful HIV-associated sensory neuropathy: a systematic review and meta-analysis of randomised controlled trials.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>PLoS One<\/i> 2010, <b>5:<\/b>e14433. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21203440\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21203440\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"115\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ware MA, Wang T, Shapiro S, Robinson A, Ducruet T, Huynh T, <i>et al<\/i>.: <b>Smoked cannabis for chronic neuropathic pain: a randomized controlled trial.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>CMAJ<\/i> 2010, <b>182:<\/b>E694-701. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/20805210\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=20805210\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"116\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wallace M, Schulteis G, Atkinson JH, Wolfson T, Lazzaretto D, Bentley H, <i>et al<\/i>.: <b>Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Anesthesiology<\/i> 2007, <b>107:<\/b>785-96. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18073554\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18073554\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"117\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Wilsey B, Marcotte T, Deutsch R, Gouaux B, Sakai S, Donaghe H: <b>Low-dose vaporized cannabis significantly improves neuropathic pain.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pain<\/i> 2013, <b>14:<\/b>136-48. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/23237736\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=23237736\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"118\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Sallan SE, Zinberg NE, Frei E 3rd: <b>Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>N Engl J Med<\/i> 1975, <b>293:<\/b>795-7. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/1099449\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=1099449\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"119\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, <i>et al<\/i>.: <b>Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate: a prospective, randomized evaluation.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ann Intern Med<\/i> 1979, <b>91:<\/b>819-24. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/293141\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=293141\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"120\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Orr LE, McKernan JF, Bloome B: <b>Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Arch Intern Med<\/i> 1980, <b>140:<\/b>1431-3. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/6254456\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=6254456\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"121\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ben Amar M: <b>Cannabinoids in medicine: a review of their therapeutic potential.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Ethnopharmacol<\/i> 2006, <b>105:<\/b>1-25. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/16540272\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=16540272\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"122\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Machado Rocha FC, Stefano SC, De Cassia HR, Rosa Oliveira LM, Da Silveira DX:<b>Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Eur J Cancer Care (Engl)<\/i> 2008, <b>17:<\/b>431-43. <\/span><\/p>\n<ol start=\"123\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Tram\u00e8r MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ: <b>Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>BMJ<\/i> 2001, <b>323:<\/b>16-21. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/11440936\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=11440936\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"124\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Frytak S, Moertel CG, O&#8217;Fallon JR, Rubin J, Creagan ET, O&#8217;Connell MJ, <i>et al<\/i>.: <b>Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ann Intern Med<\/i> 1979, <b>91:<\/b>825-30. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/517882\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=517882\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"125\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K: <b>Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Cancer<\/i> 1982, <b>50:<\/b>636-45. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/6284334\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=6284334\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"126\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang HM, <i>et al<\/i>.: <b>Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Curr Med Res Opin<\/i> 2007, <b>23:<\/b>533-43. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/17355735\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=17355735\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"127\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Lane M, Vogel CL, Ferguson J, Krasnow S, Saiers JL, Hamm J, <i>et al<\/i>.: <b>Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Pain Symptom Manage<\/i> 1991, <b>6:<\/b>352-9. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/1652611\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=1652611\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"128\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Sun S, Zimmermann AE: <b>Cannabinoid hyperemesis syndrome.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Hosp Pharm<\/i> 2013, <b>48:<\/b>650-5. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24421535\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24421535\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"129\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Hejazi RA, McCallum RW: <b>Review article: cyclic vomiting syndrome in adults\u2013rediscovering and redefining an old entity.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Aliment Pharmacol Ther<\/i> 2011, <b>34:<\/b>263-73. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21668458\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21668458\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"130\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Basch E, Prestrud AA, Hesketh PJ, Kris MG, Feyer PC, Somerfield MR, <i>et al<\/i>.: <b>Antiemetics: American society of clinical oncology clinical practice guideline update.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Clin Oncol<\/i> 2011, <b>29:<\/b>4189-98. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21947834\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21947834\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"131\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Roila F, Herrstedt J, Aapro M, Gralla RJ, Einhorn LH, Ballatori E, <i>et al<\/i>.: <b>Guideline update for MASCC and ESMO in the prevention of chemotherapy-and radiotherapy-induced nausea and vomiting: results of the Perugia consensus conference.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Ann Onco<\/i> 2010, <b>21<\/b>(5)<b>:<\/b>232-43. <\/span><\/p>\n<ol start=\"132\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Gordon AJ, Conley JW, Gordon JM: <b>Medical consequences of marijuana use: a review of current literature.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Curr Psychiatry Rep<\/i> 2013, <b>15:<\/b>419. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24234874\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24234874\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"133\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Reinarman C, Nunberg H, Lanthier F, Heddleston T: <b>Who are medical marijuana patients? Population characteristics from nine California assessment clinics.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Psychoactive Drugs<\/i> 2011, <b>43:<\/b>128-35. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21858958\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21858958\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"134\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Walsh Z, Callaway R, Belle-Isle L, Capler R, Kay R, Lucas P, <i>et al<\/i>.: <b>Cannabis for therapeutic purposes: patient characteristics, access, and reasons for use.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Int J Drug Policy<\/i> 2013, <b>24:<\/b>511-6. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/24095000\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=24095000\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"135\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Potter DJ, Clark P, Brown MB: <b>Potency of delta 9-THC and other cannabinoids in cannabis in England in 2005: implications for psychoactivity and pharmacology.<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>J Forensic Sci<\/i> 2008, <b>53:<\/b>90-4. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/18279244\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=18279244\">Publisher Full Text<\/a><\/span><\/span><\/p>\n<ol start=\"136\">\n<li><span style=\"font-size: 10pt; font-family: verdana, geneva, sans-serif; color: #0000ff;\">Hillig KW, Mahlberg PG: <b>A chemotaxonomic analysis of cannabinoid variation in cannabis (Cannabaceae).<\/b><\/span><\/li>\n<\/ol>\n<p><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\"><i>Am J Bot<\/i> 2004, <b>91:<\/b>966-75. <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ascpjournal.org\/pubmed\/21653452\">PubMed Abstract<\/a><\/span> | <span style=\"text-decoration: underline;\"><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/eutils\/elink.fcgi?dbfrom=pubmed&amp;cmd=prlinks&amp;retmode=ref&amp;id=21653452\">Publisher Full Text<\/a><\/span><\/span><\/li>\n<\/ol>\n<p align=\"justify\"><span style=\"font-family: verdana, geneva, sans-serif; font-size: 10pt; color: #0000ff;\">\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; Addiction Science &amp; Clinical Practice Katherine A Belendiuk1, Lisa L Baldini2 and Marcel O Bonn-Miller345* *Corresponding author: Marcel O Bonn-Miller Marcel.Bonn-Miller@va.gov Author Affiliations 1Institute of Human Development, University of California, 1121 Tolman Hall #1690, Berkeley 94720, CA, USA 2Palo Alto University, 1791 Arastradero Road, Palo Alto 94304, CA, USA 3Center of Excellence in Substance [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11,78,101],"tags":[],"class_list":["post-10986","post","type-post","status-publish","format-standard","hentry","category-effects-of-drugs","category-medicine-and-marijuana","category-psychiatric-drugs"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/10986","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=10986"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/10986\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=10986"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=10986"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=10986"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}