{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:01Z","timestamp":1787008201291,"version":"build-2736575974"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2019,10]]},"abstract":"Abstract<\/jats:title>\n \n Objectives:<\/jats:title>\n To determine the relative contributions of tetrahydrocannabinol (THC) and cannabidiol (CBD) to patients' self-ratings of efficacy for common palliative care symptoms.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n This is an electronic record-based retrospective cohort study. Model development used logistic regression with bootstrapped confidence intervals (CIs), with standard errors clustered to account for multiple observations by each patient.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n This is a national Canadian patient portal.<\/jats:p>\n <\/jats:sec>\n \n Participants:<\/jats:title>\n A total of 2,431 patients participated.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures:<\/jats:title>\n Self-ratings of efficacy of cannabis, defined as a three-point reduction in neuropathic pain, anorexia, anxiety symptoms, depressive symptoms, insomnia, and post-traumatic flashbacks.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n We included 26,150 observations between October 1, 2017 and November 28, 2018. Of the six symptoms, response was associated with increased THC:CBD ratio for neuropathic pain (odds ratio [OR]: 3.58; 95% CI: 1.32\u20139.68;\n p<\/jats:italic>\n \u2009=\u20090.012), insomnia (OR: 2.93; 95% CI: 1.75\u20134.91;\n p<\/jats:italic>\n \u2009<\u20090.001), and depressive symptoms (OR: 1.63; 95% CI: 1.07\u20132.49;\n p<\/jats:italic>\n \u2009=\u20090.022). Increased THC:CBD ratio was not associated with a greater response of post-traumatic stress disorder (PTSD)-related flashbacks (OR: 1.43; 95% CI: 0.60\u20133.41;\n p<\/jats:italic>\n \u2009=\u20090.415) or anorexia (OR: 1.61; 95% CI: 0.70\u20133.73;\n p<\/jats:italic>\n \u2009=\u20090.265). The response for anxiety symptoms was not significant (OR: 1.13; 95% CI: 0.77\u20131.64;\n p<\/jats:italic>\n \u2009=\u20090.53), but showed an inverted U-shaped curve, with maximal benefit at a 1:1 ratio (50% THC).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n These preliminary results offer a unique view of real-world medical cannabis use and identify several areas for future research.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/jpm.2018.0658","type":"journal-article","created":{"date-parts":[[2019,8,6]],"date-time":"2019-08-06T14:37:17Z","timestamp":1565102237000},"page":"1180-1184","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Benefit of Tetrahydrocannabinol versus Cannabidiol for Common Palliative Care Symptoms"],"prefix":"10.1177","volume":"22","author":[{"given":"David J.","family":"Casarett","sequence":"first","affiliation":[{"name":"Department of Medicine at Duke University, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica N.","family":"Beliveau","sequence":"additional","affiliation":[{"name":"Department of Medicine at Duke University, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle S.","family":"Arbus","sequence":"additional","affiliation":[{"name":"Research Department, Strainprint Technologies Ltd., Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,9,30]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909112454215"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2018.1462543"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2011.12.002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6358"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001293"},{"key":"e_1_3_2_7_2","unstructured":"Medicine NAoSEa: The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. www.nationalacademies.org\/hmd\/Reports\/2017\/health-effects-of-cannabis-and-cannabinoids.aspx (last accessed December 7 2018)."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2009.00703.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0155"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2008.120"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000176753.45410.8b"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/M17-0477"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2012.10.009"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091414"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.12.010"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000363"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7502-9"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/j.1532-2149.2013.00445.x"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2015.07.009"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1545109707300157"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(94)00117-4"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.2.567"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.5308"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jpm.2018.0658","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2018.0658","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jpm.2018.0658","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:05:02Z","timestamp":1777655102000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jpm.2018.0658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,30]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1089\/jpm.2018.0658"],"URL":"https:\/\/doi.org\/10.1089\/jpm.2018.0658","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,30]]}}}