{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:23Z","timestamp":1792787723609,"version":"4.5.0"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Joint Research Fund of The Hebrew University of Jerusalem and Hadassah Medical Center.","id":[{"id":"https:\/\/ror.org\/03qxff017","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cannabis &amp; Cannabinoid Research"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>With the increasing use of medical cannabis (MC) worldwide, understanding potential sex-related differences in treatment patterns and outcomes has become increasingly important. The objective of this study was to characterize medical cannabis use in Israel, focusing on sex-related differences in usage patterns and adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a population-based, retrospective cohort study using data from the Israeli Medical Cannabis Agency registry (April 2018\u2013March 2022). The dataset includes license holders\u2019 demographics, indication for use, monthly dose, THC\/CBD concentrations, and reported adverse effects. Sex-related differences were assessed using time-series analyses, Cox models, and relative risk estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 135,698 individuals (62% men) were issued a license to use MC in Israel during the study period. Men using MC were significantly younger than women (49 \u00b1 18.3 vs. 55.3 \u00b1 18.1). The leading indications among both sexes were chronic pain, symptoms related to oncological disease and chemotherapy treatment, and post-traumatic stress disorder. At initiation, men received higher monthly quantities than women (29.3 g vs. 26.1 g;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), higher THC concentrations (14.3% vs. 11.9%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and lower CBD concentrations (5.1% vs. 6.5%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). These differences remained significant over 2 years. Men had a lower discontinuation rate (HR 0.95, 95% CI: 0.93\u20130.97). Women were more likely than men to report at least one adverse effect (RR 1.51, 95% CI: 1.43\u20131.58).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Sex-related differences in MC use likely reflect biological, behavioral, and systemic factors, influencing both outcomes and risk of misuse. These disparities highlight the need for sex-informed clinical approaches and further research to support equitable, evidence-based treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/25785125261497797","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:02:12Z","timestamp":1792162932000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex-Related Differences in Medical Cannabis Use: A Nationwide Database Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7306-9354","authenticated-orcid":false,"given":"Noa","family":"Yakirevich Amir","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel."},{"name":"Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Treves","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacy, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliad","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Hadassah Medical Center, Jerusalem, Israel."},{"name":"Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbal","family":"Reuveni","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Florentin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Matok","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacy, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Bonne","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Hadassah Medical Center, Jerusalem, Israel."},{"name":"Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_3_7_2_1","unstructured":"1.United Nations Office on Drugs and Crime. World Drug Report 2021: Booklet 3\u2014Drug Market Trends: Cannabis Opioids. UNODC: Vienna Austria; 2021. Available from: www.unodc.org\/unodc\/en\/data-and-analysis\/wdr2021.html [Last accessed: 4November 2024]."},{"key":"e_1_3_7_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17020509"},{"key":"e_1_3_7_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/can.2016.0010"},{"key":"e_1_3_7_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/13816128113199990430"},{"key":"e_1_3_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/prp2.950"},{"key":"e_1_3_7_7_1","volume-title":"Molecular and Cellular Mechanisms Underlying Brain Region-Specific Endocannabinoid System Modulation by Estradiol across the Rodent Estrus Cycle","author":"Kim HJJ","year":"2023","unstructured":"6.Kim HJJ, , Zagzoog A, , Black T, et al. Molecular and Cellular Mechanisms Underlying Brain Region-Specific Endocannabinoid System Modulation by Estradiol across the Rodent Estrus Cycle. Vol 195. 1st ed. 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Up-to-Date Data from Patient Licenses\u2014Israel Medical Cannabis Unit. Israel Ministry of Health: Jerusalem Israel; 2025. Available from: https:\/\/www.gov.il\/he\/pages\/licenses-status-march-2025 [Last accessed: 9July 2025]."},{"key":"e_1_3_7_21_1","doi-asserted-by":"publisher","DOI":"10.2217\/17455057.5.1.79"},{"key":"e_1_3_7_22_1","doi-asserted-by":"publisher","DOI":"10.1345\/APH.1A113"},{"key":"e_1_3_7_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3360"},{"key":"e_1_3_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/J.PAIN.0000000000002557"},{"key":"e_1_3_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.BJA.2019.03.023"},{"key":"e_1_3_7_26_1","unstructured":"25.World Health Organization. International agency for research on cancer. International Agency for Research on Cancer: Lyon France; 2022. Available from: https:\/\/gco.iarc.who.int\/today\/en"},{"key":"e_1_3_7_27_1","unstructured":"26.Israel Ministry of Health. National Cancer Registry data. 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