Anecdotal reports from passionate medical cannabis patients have always driven the cannabis movement.
Without decades of hard advocacy and personal experience, legal medical cannabis programs would never be where they are today. The stories of these warriors continue to inspire research and change minds of policy makers. But, do anecdotal reports have value as a part of clinical research? There are many new crowd-source data apps popping up that pull cannabis consumer information. What is the role of this data in pushing cannabis forward as a medicine?
Despite the growing legal landscape, it is still challenging to take cannabis (or cannabis-based pharmaceuticals) into clinical trials. There may be an ever-increasing number of preliminary studies on medical cannabis, but the clinical trial is still a difficult bar to reach for a federally restricted substance. Remember, it has only been a few years since the first cannabis-based drug – Epidiolex – reached the U.S. market. Largely, cannabis clinical trials are few and far between.
Because well-controlled studies are so rare, cannabis session tracking technology has risen to fill the void. These apps provide valuable data to researchers about trends, medical applications, and reported efficacy of medical cannabis. Do they replace the need for clinical trials? No. But they do serve a very real purpose: mobile cannabis tracking apps connect researchers with real-world use of cannabis.
High Tech Anecdotal Reports: Cannabis Tracking Apps
Over the last few years, several companies have launched mobile applications for medical cannabis patients designed to capture and analyze these individual anecdotal reports under the umbrella of big data. In the words of one of these such companies, “Our mission is to advance the scientific understanding of cannabis and its legitimization by guiding responsible medical and recreational uses through DATA!”
Most of the apps work in similar ways to pull information from individual sessions in order to feed it into larger data analysis. On the one end, medical cannabis patients login to the mobile app before each session. They report strain, dose, and symptoms before and after dosing. At the consumer level, the apps provide session history and aim to help the patient learn about what strains and doses provided the most relief. In some cases, the app may even connect with a network of dispensaries to sell the consumers useful products based on their preferences.
At the other end of the data funnel is the analytics side of the application. Individual anecdotal reports become data points that help cultivators gain customer insights; researchers monitor clinical efficacy; and help scientists conduct clinical research. This end of the funnel is where most of the applications turn a profit, by selling the aggregate user data.
The Value of Clinical Trials
Clinical trials are valuable because they are well controlled. That means the study facilitator controls one or all of the parameters. For example, a study may be blinded, double-blinded, placebo concurrent, no-treatment concurrent, dose-response concurrent, or have multiple control groups. Each layer of control helps ensure the results can be replicated, and that the conclusions are based on valid data.
The anecdotal reports, however, like the ones that come from cannabis session tracking apps, are entirely uncontrolled. Here are a few of the pitfalls of relying on data from the cannabis sessions tracking apps:
- App users may report the experience of specific medical conditions, but these are unconfirmed and perhaps even undiagnosed by a healthcare professional. So while articles like, “The Effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression,” looked at 1,819 people and 5,876 cannabis self-administration sessions for the treatment of depression, their diagnosis is unconfirmed.1)(Li, X., Diviant, J. P., Stith, S. S., Brockelman, F., Keeling, K., Hall, B., & Vigil, J. M. (2020). The Effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression. The Yale journal of biology and medicine, 93(2), 251–264.
- Cannabis products used during tracked sessions are untested and highly variable. Still, to this day, cannabis frustrates many researchers because of its variability. One plant to the next can have remarkably different compound composition, even if these are the same strain. Therefore, most cannabis studies use pharmaceutical preparations, to add a layer of control. On self-administered mobile apps, patients report strain names, but there is no testing for cannabinoid profile. Even if someone finds Pink Kush useful for chronic pain, who is to say if another pink kush from another region is the same?
- Dose size is highly suspect with self-administered applications. Again, cannabis continues to frustrate scientists because it seems everyone has a different effective dose. Not to mention, inhaled routes of administration. The variability between one person and the next can be extreme during a smoke session.
The Value of Anecdotal Reports
Yet, it’s not all bad. Cannabis tracking apps, and the subsequent aggregate data, reporting, and study that comes out of them, provide valuable information to researchers on real-world use. These mobile apps help scientists see how patients are already using cannabis, and with what anecdotal results.
One of the most recent studies working with one of these apps, “The Effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression,” discovered that cannabis consumers found substantial short term relief from cannabis use. As they concluded, “The findings suggest that, at least in the short term, the vast majority of patients that use cannabis experience antidepressant effects.” The information gathered within this data analysis helps pave the way for future, well-controlled study.
But, in the words of the authors, “Future research on Cannabis and depression is needed, directly comparing the short- and long-term treatment effectiveness and side effect severity of Cannabis use with conventional antidepressant treatment, in conjunction with conventional treatment approaches, and in the presence of clinically discouraged behaviors, such as alcohol consumption.”
Benefits to Both Anecdotal Reports and Clinical Research
Anecdotal research, like that collected from cannabis apps, is important for piquing scientists’ interest and directing the course of study. Because patients already report relief from medical cannabis, it’s worth figuring out why through well-controlled trials.
Clinical trials hone in on the true nature of the relief, assesses side effects, and helps create a framework for a specific cannabinoid profile, dose, and treatment protocol to guide effective and safe patient use. Taken together, patient reports and clinical evidence are a powerful program for progressing medical cannabis research.
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|1.||↑||(Li, X., Diviant, J. P., Stith, S. S., Brockelman, F., Keeling, K., Hall, B., & Vigil, J. M. (2020). The Effectiveness of Cannabis Flower for Immediate Relief from Symptoms of Depression. The Yale journal of biology and medicine, 93(2), 251–264.|