# Cannabis effects on physical and mental health in medical cannabis patients

> **NIH NIH R01** · RUTGERS BIOMEDICAL AND HEALTH SCIENCES · 2024 · $686,376

## Abstract

ABSTRACT
With increasing legalization of medicinal cannabis, there is an urgent need to identify patients at-risk for
cannabis use disorder (CUD), which can occur as an unintended adverse effect of using medicinal cannabis.
A national survey indicated that 11% who used medicinal cannabis met criteria for a past year DSM-IV CUD.
However, DSM-based CUD diagnosis has limitations when applied to medicinal cannabis (MC). Specifically,
many MC patients might report tolerance and withdrawal due to frequent MC use, but not show a pathological
pattern of cannabis use (e.g., impaired control over use). To improve identification of MC patients who show a
pathological pattern of use, we extend DSM-5’s model for diagnosing substance use disorder for prescription
medication to MC (CUD-MC). CUD-MC addresses limitations by putting the focus on symptoms indicating a
pathological pattern of cannabis use, and recognizing that tolerance and withdrawal might occur as expected
neuroadaptations from cannabis used in a medicinal dosing regimen. However, tolerance can be a significant
clinical problem because it decreases a medication's effects, resulting in dose escalation and, for some people,
impaired control over use, whereas withdrawal can drive continuing, heavy cannabis use (e.g., use to avoid or
relieve withdrawal) that may be associated with cannabis-related problems. This project investigates the roles
of tolerance and withdrawal in the likelihood of a pathological pattern of cannabis use (CUD-MC), and identifies
risk factors for cannabis misuse in MC patients to help prevent the iatrogenic effect of CUD-MC resulting from
MC use. To generate new insights into the roles of tolerance to specific cannabis effects (e.g., relief of pain,
anxiety) and withdrawal in likelihood of CUD-MC over 2-year follow-up, this project uses the innovative
combination of Ecological Momentary Assessment (EMA) with longer-term follow-up to examine the likelihood
of CUD-MC, focusing on two key criteria, tolerance and withdrawal, in MC patients. This project will recruit
patients (N=400, age >18; 50% female; 25% new patients), e.g., from MC dispensaries. In this repeated
measures study, participants complete a baseline visit, followed by 14-day EMA. Follow-ups at 6-month
intervals through 18-months trigger 14-day EMA data collection. Follow-ups occur on-line at 6- and 18-months;
and in-person at 12- and 24-months to collect biomarkers such as quantitative THC and CBD metabolite level
and lung function measures (spirometry). Project aims are to (1) examine how DSM-5 tolerance is associated
with THC dose, specific cannabis effects (e.g., relief of pain, anxiety) and CUD-MC; (2) determine how pattern
of MC use (in EMA and at longer intervals) is associated with DSM-5 withdrawal and CUD-MC over 2-years;
and (3) identify risk factors for CUD-MC; and examine cannabis-related health outcomes (e.g., lung
functioning), including change in use of other medications, over 2-years. Identifying risk ...

## Key facts

- **NIH application ID:** 10874043
- **Project number:** 1R01DA058663-01A1
- **Recipient organization:** RUTGERS BIOMEDICAL AND HEALTH SCIENCES
- **Principal Investigator:** Tammy Chung
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $686,376
- **Award type:** 1
- **Project period:** 2024-06-15 → 2029-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10874043

## Citation

> US National Institutes of Health, RePORTER application 10874043, Cannabis effects on physical and mental health in medical cannabis patients (1R01DA058663-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10874043. Licensed CC0.

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