Objectives: Type 2 diabetes (T2D) is a chronic, low-grade inflammatory condition affecting around 537 million people worldwide. Conventional diabetes management strategies are unable to prevent diabetes-related complications, and as a result, current guidelines prioritize achieving T2D remission as the primary clinical objective rather than simply managing the condition. Methods: “Decoding Diabetes” is a customized online program designed to promote diabetes remission through yoga-based lifestyle interventions. The program includes yoga practices such as asanas, pranayama, meditation, yogic diet (a plant-based vegetarian diet), and weekly lectures on diabetes, benefits of yoga, importance of lifestyle changes, and ways to enhance physical activity. Participants were also given weekly tasks based on the lifestyle modifications with regular follow-up for the duration of the 3-month program. Before enrolment, the patient’s height, weight, body mass index, fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated hemoglobin A1c (HbA1c) were measured. All parameters were assessed at the end of the third month, and HbA1c was reassessed at the end of the sixth month. Results: All three participants showed improvements in anthropometric and glycemic outcomes after 3 months. The mean body weight reduced by 3.2 kg. FBS decreased from 130, 138, and 284 mg/dL to 96, 83, and 84 mg/dL, respectively. PPBS decreased from 268, 298, and 390 mg/dL to 167, 154, and 120 mg/dL, respectively. HbA1c reduced from 7.8%, 8.1%, and 9.43% to 5.6%, 5.9%, and 6.21%, respectively. At 6-month follow-up, HbA1c remained below or near remission thresholds (5.7%, 5.9%, and 6.01%) without antidiabetic medication. Conclusions: This case series highlights the therapeutic potential of online yoga-based lifestyle intervention in T2D remission. Further clinical trials with a larger sample size are required to validate our findings.
Snehapana (internal oleation/therapeutic intake of medicated unctuous substance) constitutes a unique treatment entity in the Ayurveda medical system. It comprises intake of any form of Sneha (lipid medium/fat) orally. Still, there are prevailing concerns about whether administration of escalating doses of medicated lipids leads to dyslipidemia and whether dyslipidemic patients can safely undergo Snehapana . Hence, the present systematic review is planned to systematically evaluate the available evidence on the therapeutic efficacy and safety of Snehapana on lipid profile. The objective of the study is to conduct a systematic review and meta-analysis of published clinical data and grey literature in view of evaluating the effect of medicated Snehapana on lipid profile by keeping the non-medicated Snehapana group as a comparator in the participants undergoing Snehapana. Randomized controlled trials (RCT), quasi-randomized controlled trials, controlled clinical trial (CCT), comparative clinical trial, and multi-arm clinical trials will be included in the study. The study participants include those who have undergone medicated Snehapana in any module. Data from the electronic databases such as PubMed, Cochrane CENTRAL, AYUSH Research Portal, DHARA, Shodhganga, Ayurvedic Research Database, Institute for Teaching and Research in Ayurveda, Gujarat Ayurveda University, Jamnagar, and other relevant journals will be searched. Two investigators will independently screen all the potentially eligible articles identified by a primary comprehensive search. Data from the selected studies will be extracted separately by two review authors for data analysis. The risk of bias will be evaluated using appropriate available tools. Meta-analysis will be done if studies are found eligible. If a sufficient number of studies are not available and if heterogeneity is detected, systematic qualitative synthesis shall include case series, case reports, and single-case study designs. The proposed review is focused on addressing the concerns related to the effect of snehapana on lipid status. In addition, the study shall identify the future areas of research related to the safety of Snehapana , considering the lacunas of the existing literature. The study is prospectively registered with PROSPERO with registration number CRD42022376754.
Purpose: This article presents evidence from surveys and ethnographic interviews addressing family home health care practices and communication between families and their childcare providers about such practices. Drawing on research supporting the value of family-centered care (FCC) and consistency of care (COC) in childcare, researchers sought to understand the nature of at-home health care and health-supportive behaviors and practices among our research participants (families with young children) and to assess the extent to which families are comfortable sharing the nature of these practices with their providers. Results: Our findings suggest that families seek out and use a variety of health-supportive behaviors at home that they do not necessarily share with childcare providers. Such practices include a focus on healthful foods (including alternative diets that may go against official recommendations) as well as other simple practices like regular exercise, yoga, or gardening. The article presents the research study and its findings and presents a recommendation to develop an educational curriculum designed to support families and increase both Family-centered care (FCC) and Consistency of care (COC) by encouraging better communication between families and providers. The curriculum will support an aim to educate childcare providers on the benefits of some of the most common integrative health care strategies and provide practical examples for integrating these practices in professional and family-home childcare settings.
Background: Dyspnea and pain are subjective sensations influenced by emotional and cognitive factors, often limiting the effectiveness of pharmacological treatments. Yoga has been explored as a non-pharmacological approach, but most studies rely on subjective reports rather than quantitative measures. This study assessed dyspnea and pain in healthy adults using respiratory resistance and thermal stimulation before and after a single yoga session to clarify its immediate sensory effects under controlled conditions. Methods: In this randomized crossover trial, 27 adults underwent both a 60-min yoga session and a control rest condition. The sensations of dyspnea, pain threshold, and heart rate variability (coefficient of variation of R-R intervals [CVRR]) were assessed before and after yoga and rest sessions. Dyspnea response was quantified using slope values derived from log-transformed Borg scores. Statistical analyses included t-tests, correlation coefficients, and regression models. Significance was set at p < 0.05. Results: Twenty-seven subjects completed both trials. Compared with the control condition, the yoga condition significantly reduced dyspnea ratings at higher resistance levels and decreased the slope of Borg scores (p < 0.001). Pain threshold did not differ between conditions overall but showed a significant positive correlation with yoga experience (rho = 0.51, p = 0.01). CVRR increased significantly only in experienced yoga practitioners. Conclusion: A single yoga session may produce immediate reductions in dyspnea regardless of prior experience. Pain relief and autonomic enhancement were observed only in experienced yoga practitioners, indicating distinct mechanisms and practice-dependent effects across symptoms.
Introduction: Although cannabis has promise as a supportive care agent for patients with cancer undergoing chemotherapy or radiation, there is little evidence about its use among patients undergoing immune checkpoint inhibitor (ICI) therapy. We evaluated the extent of and reasons for cannabis use among patients currently receiving ICIs at a large cancer center. Materials and Methods: We conducted a survey among adults undergoing ICI treatment for melanoma or kidney cancer. Patients reported frequency of cannabis use since the start of ICI treatment, modes of ingestion, reasons for use, and experiences with cannabis. Results: Among 160 respondents, the median age was 65 years, 90% were White, 70% were male, and 68% had kidney cancer. Twenty-one percent of respondents used cannabis during ICI treatment (n = 34). Most users ingested cannabis through food (71%) or by smoking it (41%). The most common reasons for using cannabis during ICI treatment were for recreation (68%) or to address symptoms (65%), which included mood impairment (44%), difficulty sleeping (32%), and aching muscles or joints (30%). Of patients reporting cannabis use to address those symptoms, >80% reported symptom improvement. Eighteen percent of respondents spoke to their oncology team about using cannabis during ICI treatment. Discussion: Cannabis use during ICI treatment is relatively common. Patients report using cannabis for recreation and to successfully address symptoms. Additional research into the symptom management benefits of cannabis and its impact on ICI treatment effectiveness is needed to inform patients and their providers and to establish clinical care guidelines.
Background: Chronic low back pain (CLBP) is a leading cause of disability, often managed with opioids despite risks. Cannabis, containing tetrahydrocannabinol (THC) and cannabidiol, offers a potential alternative, but long-term data are limited. Objective: To evaluate the efficacy, safety, and opioid-sparing effects of cannabis therapy over 10 years in CLBP patients. Methods: In a prospective study (2013-2023), 168 adults (135 males, mean age 47 +/- 19 years) with CLBP (>= 1 year) and anatomical abnormalities (e.g., disc herniation, 83%) received cannabis (20% THC, 50 +/- 10 g/month) at a specialized orthopedic clinic. Baseline treatments included opioids (91%) and surgery (47%). Outcomes-pain (Visual Analogue Scale, VAS), disability (Oswestry Disability Index, ODI), quality of life (SF-12), and opioid use-were assessed at baseline, 1, 3, 12, 24, 60, and 120 months. Statistical analysis used ANOVA, t-tests, and Kruskal-Wallis; missing data were imputed via Last Observation Carried Forward.Results: At 10 years (n = 159), VAS decreased from 84.6 +/- 14.8 to 7.0 +/- 11.0 (p < 0.0001), ODI from 61.7 +/- 13.7 to 4.0 +/- 6.0 (p < 0.0001), and SF-12 Physical and Mental Component Summaries improved by 21.1 points each (p < 0.0001). Opioid use dropped from 91% to 8.2% (morphine equivalent dose: 30 +/- 12 to 1 +/- 3 mg, p < 0.001). Six patients (3.6%) discontinued due to adverse effects; nine die. Conclusions: Long-term cannabis therapy significantly reduced pain, disability, and opioid dependence in CLBP, with sustained quality-of-life gains, supporting its role in chronic pain management.
Objectives: Pediatric chronic pain negatively affects emotional, psychological, and social function. This may be due to differences in interoception, the ability to notice and contextualize sensations arising inside the body, and alexithymia, the inability to identify and communicate emotions, as has been shown in adults. In children with chronic pain, interoceptive impairment include difficulties perceiving, interpreting, or responding to physical symptoms such as hunger or pain. Alexithymia symptoms include limited emotional vocabulary or reliance on complaining about physical symptoms to communicate emotional distress. Both alexithymia and interoceptive impairment could contribute to the development or maintenance of chronic pain and lead to issues with pain management. However, whether these are altered in pediatric chronic pain has not been investigated. Methods: The protocol was written prospectively and indexed online in the International Prospective Register of Systematic Reviews (PROSPERO; #42023439236). The literature search included the Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO, PubMed/MEDLINE, Scopus, and Google Scholar databases. Eligible studies included participants aged ≤18 years old with chronic pain conditions, assessed for symptoms of alexithymia or interoception. Study screening and data extraction were completed independently in duplicate. PRISMA guidelines were followed; the Newcastle-Ottawa Scale assessed risk of bias. Results: Fourteen studies assessing alexithymia in children/adolescents with/without chronic pain were identified. Of eight studies that reported mean alexithymia symptoms between groups, six reported significantly higher symptoms in the pain group. Alexithymia symptoms were associated with “pain bother” and “interference” but not “intensity.” Two studies also assessed interoception; one compared pain/non-pain groups, finding a significant association between decreased self-reported interoception and higher chronic pain. Conclusions: Alexithymia symptoms may be increased in children/adolescents with chronic pain. Our review was limited by incomplete reporting and inconsistent measures across studies, decreasing certainty in the overall strength of the evidence. There is a need to understand the role of interoception and alexithymia in pediatric pain to better mitigate and treat pediatric pain. More research is warranted.
Objectives: The goal of the prospective study was to understand changes in pain and function among patients with knee or hip osteoarthritis (OA) in an integrative pain center. Little is known about how integrative health treatments interact with mainstream medical treatments for knee or hip osteoarthritis. Our clinical case series describes the outcomes of 42 patients diagnosed with knee or hip osteoarthritis who were assessed in the Comprehensive Pain Center at Oregon Health & Science University from July 2020 to July 2022 during the onset of the COVID-19 pandemic.Methods: Most patient visits shifted to virtual appointments due to COVID-19. As part of usual care during COVID-19, patients received virtual visits with pain providers and health psychologists. In addition, in-person visits for acupuncture, chiropractic, massage, and Rolfing were available. Patient-reported outcomes were collected via phone and stored in REDCap Cloud prior to visits. A multipronged data-gathering approach was implemented with REDCap Cloud, including questionnaires obtained over the telephone and in person with iPads using a QR code for participant identification.Results: There were 34 females and 8 males with a median age of 63.1 (range: 34-78) with an average of 11 clinic visits. Their initial PROMIS Global physical mean score was 33.9, and mental was 38.7. At 12 months, mean outcomes were improved among 17 patients who provided follow-up data on the Hip Dysfunction and Osteoarthritis Outcome Score, Knee Dysfunction and Osteoarthritis Outcome Score, and Brief Pain Inventory.Conclusions: With patient care shifted to virtual appointments, data collection was challenging. Although one cannot infer causality from a case series, some patients seeking integrative care for osteoarthritis trended towards improved outcomes despite difficulties due to widespread treatment disruption with COVID-19.
Objectives: We describe navigating pandemic-related obstacles while implementing a quality improvement (QI) project for patients with osteoarthritis (OA) in an integrative health pain clinic. Methods: The Comprehensive Pain Center at Oregon Health & Science University delivers integrative health therapies in conjunction with mainstream medical treatments. This project aimed to collect mental and physical health data from all OA visits for a year. Assessments were to start in March 2020; however, the pandemic onset drastically altered clinical care. Results: Physicians and psychologists shifted to telehealth, which was not possible for acupuncture, chiropractic, massage therapy, or Rolfing therapy. Data were collected via telephone calls, which took longer than anticipated, as for many patients this interaction was their only contact with anyone outside home. COVID-19 episodes, staff shortages, and other difficulties necessitated adaptive procedures. Several adapted strategies were identified as likely to be applicable in future circumstances of similarly major disruptions in QI projects. Conclusions: This QI project was greatly reshaped by sudden changes in patient pathways during COVID-19.
Introduction: Bile duct fistulas (BDFs) stemming mainly from surgery after cholecystectomy present a significant global health challenge due to their associated morbidity and complications. If proven effective, alternative treatments may be preferred, given the invasive nature of the conventional treatment. Case presentation: This is the case of a 54-year-old female patient with bile duct injury that occurred during laparoscopic cholecystectomy, resulting in a BDF and liver abscess. Conventional treatment provided little benefit, resulting in a shift toward homeopathic treatment. Notably, homeopathy not only addressed immediate postoperative concerns but also played a beneficial role in healing the fistula and managing chronic conditions. Conclusion: The case showed sustained improvement in liver function and overall well-being throughout a 6-year follow-up, despite the initial grim prognosis. Further, research is imperative to gain a better understanding of the benefits of the treatment observed here.
Background: In traditional healing systems, life-force energy or subtle human energy fields have been recognized for millennia. Parallel to conventional therapy, its popularity has grown tremendously in recent years. Due to limited scientific research on biofield therapies, the authors investigated the potential impact of distant biofield/blessing energy interventions on individuals with psychological impairments via virtual methods. Methods: A total of 119 participants (56 male, 63 female) with one or more psycho-mental symptoms were enrolled in these randomized, placebo-controlled, double-blind clinical trials. Two remote biofield/blessing energy interventions, each lasting approximately 5 min, were delivered to 38 subjects in the biofield intervention group on days 0 and 90. Subjects were assessed using standardized psychological questionnaires, which employed a validated scoring scale, as well as safety parameters. Results: Participants in the biofield (blessing) intervention group reported significantly lower levels of perceived psychological symptoms (fatigue, sleep disturbances, stress, cognitive impairment, and emotional distress) compared with both naive and sham control groups (p < 0.0001). Biofield intervention was safe and well-tolerated in all three groups. Conclusion: Distant biofield/blessing energy healing sessions were found to significantly improve psychological and mental health, enhance overall well-being, and pose no safety risks. Therefore, further research is needed to identify key variables for a larger scale intervention study on health outcomes and underlying mechanisms.
Objective: This large-scale survey aimed to investigate the use of Complementary and Integrative Medicine (CIM) across France.Design: Observation multicentric study.Setting: This survey study was conducted from October 10, 2022 to October 28, 2022 in medical, surgical, and obstetric clinics across France. Self-administered questionnaires specifically designed for the study were used to collect data related to subjects' prior use of CIM (type of therapy used, reasons for use, cost, duration, who recommended the therapy) and patient demographic data. The questionnaires were made available at the admissions office, secretary's office, or waiting rooms of clinics.Results: A total of 1178 questionnaires collected in 26 multipurpose clinics were analyzed. Two-thirds of patients (65%) reported having used at least one CIM, with a mean of four therapies used per patient. Osteopathy, massage, homeopathy, acupuncture, and psychotherapy were the most frequently reported therapies. More women than men declared using these therapies, and users were significantly younger than nonusers. Therapies were used for a variety of health conditions, but were most commonly used to treat pain (32%), anxiety (11%), cancer (9%), well-being (8%), and stress (7%). Patients mainly discussed use with family members (53%), doctors (52%), and/or partners (45%). Friends (29%), doctors (26%), or family members (18%) most commonly recommended therapies. Patients estimated spending a median of 330 over a median duration of 24 months. Depending on the therapy, 71%-92% of patients would recommend CIM to others.Conclusions: A substantial number of patients seen in French multipurpose clinics, particularly female and young adults, report using CIM. Patients have a positive opinion of these therapies, report using them long term, and devote a significant budget to them.
Background: The Clificol (R) COVID-19 Support Project is an innovative international data collection project aimed at tackling some of the core questions in homeopathy, including the aspect of treatment individualization. This article further analyzes the symptoms used and remedies prescribed.Methods: We conducted an international clinical case registry study (ClifiCol) of patients with confirmed or suspected COVID-19. In China, the symptoms were collected with the aid of a questionnaire, whereas, in all the other countries, participating homeopaths could freely record the symptoms that informed the remedy prescription. The symptom rubrics and remedies used in non-Chinese countries were further analyzed.Results: The database consisting of 1227 cases, as collected between January 10, 2020, and October 31, 2021, was used as a basis for the analyses. It included 868 cases (1354 prescriptions) from 29 non-Chinese countries. We observed an unexpectedly high level of variability. This was expressed, among others, by the very large number of repertory rubrics used in general. In total, 1190 of the 1403 rubrics (85%) were used less than five times. A higher proportion of uncommon rubrics was not associated with faster recovery from COVID-19. In total, 137 homeopathic remedies were used; the three most frequently used ones (Bryonia alba, Phosphorus, and Arsenicum album) were used in 42% of all prescription episodes. The 88 least commonly used remedies (out of a total of 137) accounted for only 9% of all prescription episodes.Conclusions: A small subset of the most commonly used symptom rubrics and remedies covered the great majority of prescriptions. Focusing on the most common symptoms and remedies for the statistical validation of homeopathy is justified and will greatly enhance the ability of clinical case registry projects to contribute to improving homeopathic practice.
Background: Medical marijuana (MM) use is increasing, requiring health care professionals, such as dentists, to possess a working knowledge of MM. Previous studies have indicated that MM education is lacking in current health care education. The aim of this study is to understand dental practitioners’ views and expertise around MM. Methods: A 50-question survey was created to assess, in detail, dental and dental hygiene faculty and students’ knowledge, practice, and attitudes toward MM, and to identify possible correlations between responses. The survey was modeled after a previous survey conducted among practicing pharmacists. All faculty dentists, faculty dental hygienists, students, and residents at the Arthur A. Dugoni School of Dentistry, University of the Pacific, were invited by email to participate. Results: A total of 219 surveys were included in this study. The factor with the most abundant correlations was the opinion that MM is valuable for pain. This view had a positive correlation with the opinions that (1) MM may be better than nonsteroidal anti-inflammatory drugs, acetaminophen, and narcotics for pain control and risk/benefit ratios, (2) that physicians and pharmacies should dispense MM, (3) that recreational marijuana should be approved, (4) agreement with the current MM dispensing methods, (5) a preference for patients to use MM, (6) favoring MM if it were available by prescription and US Food and Drug Administration (FDA) approved, (7) preferring the use of Cannabidiol (CBD) formulations, and (8) feeling that more research and education (as well as continuing education credits) are needed. Conclusions: Having more information and control over both the product and access to it might lead to increased comfort for providers. This would lead to better outcomes as well as greater communication between patients and their providers. Practical Implications: The findings of this survey suggest more MM education and research is needed—statements with which the majority participants of this study have explicitly and strongly agreed.
Background: Medicinal cannabinoids have generated significant interest from clinicians and families as a potential therapy for a range of paediatric conditions in recent years. There are increasing numbers of clinical studies in this area and also an increased awareness of medicinal cannabinoids in the community. Objective: The aim of this review was to identify the available evidence for medicinal cannabinoids in paediatrics, identify significant gaps in the evidence base, summarise the findings from included studies, and inform the need for further research and systematic reviews. Design: A scoping review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A literature search was performed, including the reference lists of included studies. Inclusion criteria consisted of peer-reviewed articles that measured the effect of cannabinoids in children, from any time period, written in English, included human paediatric subjects, and involved the administration of any formulation of cannabinoid. Results: A total of 1825 articles were screened in the review process, of which 111 were included in the final analysis. Good evidence was found for the use of medicinal cannabinoids in severe seizure disorders and for the control of chemotherapy-induced nausea and vomiting. There was limited but promising evidence for a range of other conditions, including Fragile X syndrome, fetal alcohol syndrome, post-traumatic stress disorder, autism, and some gastrointestinal disorders. Conclusions: Medicinal cannabinoids have been shown to be effective for some paediatric conditions; however, further research is required, particularly in the area of chronic pain and palliative care.
Acute appendicitis is the most common surgical emergency worldwide with peak incidence in the age range of 10 – 19 years, and the standard treatment procedure is the surgical removal of the appendix to avoid complications such as its rupture, peritonitis, and sepsis. The COVID-19 pandemic required the global population to stay indoors to stop the spread of virus, which led to a decline in the number of patients visiting the hospital for non- COVID -19 related emergencies. This is a case of a 9-year-old girl who tested positive for COVID -19 and developed acute appendicitis and benefited from individualised classical homeopathy. Further scientific investigation is necessary to establish the relevance of individualised classical homeopathy in treating serious acute conditions such as acute appendicitis.
Aim: The aim of our study is to describe Chinese herbal medicine (CHM) therapy, outcomes, and safety with patients experiencing symptoms possibly related to the novel 2019 Coronavirus (COVID-19). Method: In this ongoing prospective, longitudinal, descriptive cohort study at an East Asian medicine school clinical faculty practice, we are observing participants with symptoms related to COVID-19 who consent to participate in telehealth visits and receive individualized CHM. Following screening according to inclusion and exclusion criteria, all participants are asked to obtain a COVID-19 test at the time of enrollment. Licensed practitioners with at least 15 years of CHM practice experience are determining the number of telehealth consultations necessary for each participant. All participants are recommended individualized CHM dispensed either as loose herbs to be decocted at home or granules. Follow-up at 24 and 48 h after each telehealth consult will provide clinicians with information to determine if an additional telehealth consultation is necessary. Additional scheduled follow-up is at 3, 6, and 12 months. We began this study observing telehealth interactions as the clinic was closed to in-person visits. The clinic opened again to in-person visits in late 2020, and we have continued data collection. Ethics and Dissemination: The study has received Institutional Review Board ethics approval and is currently enrolling. Data from this cohort study will be presented online for real-time dissemination to clinicians and scientists, at scientific conferences, and published in peer-review journals. Describing individualized CHM treatment as a potential COVID-19 therapy will provide vital preliminary data on methods, feasibility, acceptability, tolerability, effectiveness, and safety. Findings from our study will inform future controlled trials of individualized CHM therapy for symptoms related to COVID-19. Trial Registration: ClinicalTrials.gov registration number: NCT04380870.
Aim: The objectives of this study were to evaluate the responses of overweight college students to two types of Tai Chi intervention programs, to ensure data quality by assessing repeatability and reliability, and to assess changes in variable means after training. Additionally, the study aimed to compare the exercise intensity between the two types of Tai Chi during 30 min of practice. Methods: Participants underwent a 2-week Tai Chi intervention program, consisting of 1-h sessions, three times a week. Measurements of heart rate (HR) and energy expenditure were obtained using a Polar heart rate monitor (H10), while flexibility, upper and lower limb strength, balance, and aerobic endurance were measured before and after the intervention. Repeatability was established using Bland-Altman plots, and reliability was assessed using intraclass correlation coefficient (ICC). Between-group variables were compared using independent t-tests, while paired t-tests were used to compare changes within each group between pre- and post-tests in the mean of variables. Results: Bland-Altman plots showed good repeatability of pre- and post-test and ICC values for all measured variables ranging from 0.54 to 0.99. There were no significant changes observed in the mean of all measured variables from pre- to post-testing in both groups (p > 0.05). Significant difference was observed in metablic equivalent (MET) value (5.75 +/- 0.66 vs. 4.65 +/- 0.40) and maximum HR (141.80 +/- 10.83 vs. 117.50 +/- 10.97) between the two different types of Tai Chi in 30 min of Tai Chi practice (p < 0.001). Conclusions: The training and assessments were safe and appropriate for overweight Chinese male college students, and the measurement methods used in the study were reliable. A 2-week Tai Chi training did not result in changes in the mean of variables. The study suggests the possibility of further research under well-designed training programs and close supervision by researchers. Clinical Trials Registry Identifier ChiCTR2200059427; April 29, 2022.
Introduction: Cannabinol (CBN) was discovered in 1896, but its commercial use did not take off until recently, and there have been few studies on its use, safety, and efficacy. Japan has strict regulations on cannabis, but CBN products have been legally distributed since late 2020. It is possible to speculate that these products are used for different purposes than in places such as some states of the United States where cannabis is legal, but no academic research has been conducted to date.Objective: To conduct a quantitative evaluation of the use, self-assessed efficacy, dependence, and adverse events of CBN products in Japan.Methods: An online questionnaire was created for CBN users, and a request for responses was disseminated via social networking service.Results: In total, 515 valid responses were obtained. Regarding the purpose of use, 174 (33.8%) were medical, 136 (26.4%) were recreational, and 199 (38.6%) were both. The most common medical purposes were sleeping disorder (N = 325), anxiety (N = 186), and depression (N = 181). Statistically significant subjective symptom improvement was observed before and after CBN use for sleeping disorder, anxiety, and chronic pain. In addition, 82.7% of users reported improved physical quality of life (QOL), 84.1% reported improved mental QOL, and 55.4% reported improved social QOL. The rate of adverse events experienced was 9.9%, and 5.2% were classified as substance use disorders.Conclusions: CBN is used in Japan primarily for self-mental-health care applications, not on a prescription basis, and contributes to improved QOL. The experience rate of adverse events was 10%, the severity was mild, and the dependence was considered milder than that of cannabis.
