{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:51:20Z","timestamp":1782845480584,"version":"3.54.5"},"reference-count":40,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n Since the legalization of medical cannabis in Canada in 2013, prescription of cannabis for medical purposes has become commonplace and a multibillion dollar industry has formed. Much of the media coverage surrounding medical cannabis has been positive in nature, leading to Canadians potentially underestimating the adverse effects of medical cannabis use. In recent years, there has been a large increase in clinic websites advertising the use of medical cannabis for health indications. However, little is known about the quality of the evidence used by these clinic websites to describe the effectiveness of cannabis used for medical purposes.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to identify the indications for medical cannabis reported by cannabis clinics in Ontario, Canada, and the evidence these clinics cited to support cannabis prescription.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a cross-sectional web search to identify all cannabis clinic websites within Ontario, Canada, that had physician involvement and identified their primary purpose as cannabis prescription. Two reviewers independently searched these websites to identify all medical indications for which cannabis was promoted and reviewed and critically appraised all studies cited using the Oxford Centre for Evidence-Based Medicine Levels of Evidence rubric.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 29 clinics were identified, promoting cannabis for 20 different medical indications including migraines, insomnia, and fibromyalgia. There were 235 unique studies cited on these websites to support the effectiveness of cannabis for these indications. A high proportion (36\/235, 15.3%) of the studies were identified to be at the lowest level of evidence (level 5). Only 4 clinic websites included any mention of harms associated with cannabis.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Cannabis clinic websites generally promote cannabis use as medically effective but cite low-quality evidence to support these claims and rarely discuss harms. The recommendation of cannabis as a general therapeutic for many indications unsupported by high-quality evidence is potentially misleading for medical practitioners and patients. This disparity should be carefully evaluated in context of the specific medical indication and an individualized patient risk assessment. Our work illustrates the need to increase the quality of research performed on the medical effects of cannabis.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/45550","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T10:45:45Z","timestamp":1688035545000},"page":"e45550","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the Supporting Evidence of Medical Cannabis Claims Made on Clinic Websites: Cross-Sectional Study"],"prefix":"10.2196","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2164-8263","authenticated-orcid":false,"given":"Braden","family":"O'Neill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4512-4280","authenticated-orcid":false,"given":"Jacob","family":"Ferguson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6646-2010","authenticated-orcid":false,"given":"Lauren","family":"Dalueg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6189-6857","authenticated-orcid":false,"given":"Abban","family":"Yusuf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9807-5024","authenticated-orcid":false,"given":"Abirami","family":"Kirubarajan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5858-4465","authenticated-orcid":false,"given":"Taryn","family":"Lloyd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9159-5729","authenticated-orcid":false,"given":"Eisi","family":"Mollanji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3327-5580","authenticated-orcid":false,"given":"Navindra","family":"Persaud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref1","unstructured":"RaycraftRThe pros, cons and unknowns of legal cannabis in Canada 3 years laterCBC News20212023-05-26https:\/\/www.cbc.ca\/news\/politics\/cannabis-changed-canada-1.6219493"},{"key":"ref2","unstructured":"Cannabis Legalization and RegulationGovernment of Canada20212023-04-07https:\/\/www.justice.gc.ca\/eng\/cj-jp\/cannabis\/"},{"key":"ref3","unstructured":"Cannabis for medical purposes under the Cannabis Act: information and improvementsGovernment of Canada20222023-04-07https:\/\/www.canada.ca\/en\/health-canada\/services\/drugs-medication\/cannabis\/medical-use-cannabis.html"},{"key":"ref4","unstructured":"Accessing cannabis for medical purposes from a licensed producerGovernment of Canada20212023-04-07https:\/\/www.canada.ca\/en\/health-canada\/services\/getting-cannabis-from-licensed-producer\/accessing-from-licensed-producer.html"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000747"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-021-00405-7"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2016.05.002"},{"key":"ref8","unstructured":"Consumer information\u2014cannabis (marihuana, marijuana)Health Canada20162023-05-26https:\/\/www.canada.ca\/en\/health-canada\/services\/drugs-medication\/cannabis\/licensed-producers\/consumer-information-cannabis.html"},{"key":"ref9","unstructured":"Cannabis recalls, adverse reactions and reporting: report side effects from cannabis productsHealth Canada20202023-05-26https:\/\/www.canada.ca\/en\/health-canada\/services\/drugs-medication\/cannabis\/recalls-adverse-reactions-reporting\/report-side-effects-cannabis-products.html"},{"issue":"12","key":"ref10","first-page":"864","volume":"65","author":"Kahan, M","year":"2019","journal-title":"Can Fam Physician"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-005-0916-7"},{"key":"ref12","unstructured":"Canadian Cannabis Survey 2020: SummaryHealth Canada20212023-05-26https:\/\/www.canada.ca\/en\/health-canada\/services\/drugs-medication\/cannabis\/research-data\/canadian-cannabis-survey-2020-summary.html"},{"key":"ref13","unstructured":"Summary report: Consultation on potential market for health products containing cannabis that would not require practitioner oversight InternetGovernment of Canada20202023-05-26https:\/\/www.canada.ca\/en\/health-canada\/services\/publications\/drugs-health-products\/summary-report-consultation-potential-market-health-products-cannabis.html"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.303818"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.202169"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.5770\/cgj.23.424"},{"issue":"2","key":"ref17","first-page":"e78","volume":"64","author":"Allan, GM","year":"2018","journal-title":"Can Fam Physician"},{"issue":"2","key":"ref18","first-page":"111","volume":"64","author":"Allan, GM","year":"2018","journal-title":"Can Fam Physician"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6358"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.640222"},{"key":"ref21","unstructured":"Tory says explosion of marijuana shops in city \"out of control\"CityNews Toronto20162022-08-02https:\/\/toronto.citynews.ca\/2016\/05\/06\/tory-says-explosion-of-marijuana-shops-in-city-out-of-control\/"},{"key":"ref22","unstructured":"Canadian Internet Use Survey, 2020Statistics Canada20212023-05-26https:\/\/www150.statcan.gc.ca\/n1\/daily-quotidien\/210622\/dq210622b-eng.htm"},{"key":"ref23","unstructured":"Formulary SearchOntario Ministry of Health20182023-04-30https:\/\/www.formulary.health.gov.on.ca\/formulary\/results.xhtml?q=%22NABILONE%22&type=1"},{"key":"ref24","unstructured":"Get coverage for prescription drugsOntario Ministry of Health20162022-04-30https:\/\/www.ontario.ca\/page\/get-coverage-prescription-drugs"},{"key":"ref25","unstructured":"Controlled, caring support for members who need medical marijuanaManulife Insurance2022-04-30https:\/\/www.manulife.ca\/business\/news\/group-benefits-news\/medical-marijuana.html"},{"key":"ref26","unstructured":"Medical Cannabis and Group Benefits Plan CoverageSunLife Financial2023-05-26https:\/\/www.sunlife.ca\/static\/canada\/Sponsor\/About%20Group%20Benefits\/Group%20benefits%20products%20and%20services\/The%20Conversation\/Bright%20Papers\/files\/Bright%20Paper%20Medical%20Cannabis%20PDF8090E_Final.pdf"},{"key":"ref27","unstructured":"Drug prior authorization form\u2014medical cannabisCanada Life Assurance Company2022-04-30https:\/\/www.canadalife.com\/"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-001702"},{"key":"ref29","unstructured":"Population estimates, quarterlyStatistics Canada20222023-05-26https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1710000901"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2013.06.006"},{"key":"ref31","unstructured":"College of Physicians and Surgeons of Ontario2022-04-15https:\/\/www.cpso.on.ca\/"},{"key":"ref32","unstructured":"RobertsonKHow to tell the difference between a cannabis clinic and a dispensaryLift & Co Magazine20182022-08-02https:\/\/lift.co\/magazine\/cannabis-clinics-vs-dispensaries"},{"key":"ref33","unstructured":"The 2011 Oxford CEBM Levels of Evidence: introductory documentNational Health Service20112023-05-26https:\/\/en.testingtreatments.org\/2011-oxford-cebm-levels-evidence-introductory-document\/"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.15288\/jsad.2022.83.5"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305477"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2016.01.012"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12459"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291713001438"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2013.00129"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1007\/5584_2016_71"}],"container-title":["Journal of Medical Internet 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