Understanding feeling "high" and its role in medical cannabis patient outcomes.

We measure for the first time the associations between subjective patient experiences of feeling "high" and treatment outcomes during real-time flower consumption sessions. Our study uses data from the mobile health app, Releaf App™, through which 1,882 people tracked the effects of flower on a multitude of health conditions during 16,480 medical cannabis self-administration sessions recorded between 6/5/2016 and 3/11/2021. Session-level reported information included plant phenotypes, modes of administration, potencies, baseline and post-administration symptom intensity levels, total dose used, and real-time side effect experiences.

Nationally representative surveys on cannabis use lack product details relevant to public health.

Objectives: Many annual, nationally representative US surveys that assess cannabis use do not collect information on product characteristics despite varying health risks and benefits. Capitalizing on a rich dataset of primarily medical users, the purpose of this study was to describe the degree of potential misclassification in clinically relevant cannabis use measures when primary mode of use is recorded but not product type.

Methods: Analyses consider user-level data from the Releaf App™ database on product types, consumption modes, and potencies in a non-nationally representative sample of 26,322 cannabis administration sessions occurring in 2018, across 3,258 users.

Systematic combinations of major cannabinoid and terpene contents in Cannabis flower and patient outcomes: a proof-of-concept assessment of the Vigil Index of Cannabis Chemovars.

Background: Little is known about the frequency with which different combinations of phytochemicals (chemovars) arise in Cannabis flower or whether common chemovars are associated with distinct pharmacodynamics and patient health outcomes. This study created a clinically relevant, user-friendly, scalable chemovar indexing system summarizing primary cannabinoid and terpene contents and tested whether the most frequently consumed chemovars differ in their treatment effectiveness and experienced side effects.

Methods: Between 09/10/2016 and 03/11/2021, 204 people used the freely available, educational mobile software application, Releaf App, to record 6309 real-time consumption sessions using 633 distinct Cannabis flower products, unique at the user level, with terpene and cannabinoid potency information.

U.S. cannabis laws projected to cost generic and brand pharmaceutical firms billions.

Legalization of cannabis by U.S. states is likely increasing the use of cannabis as an alternative to conventional pharmaceutical drugs.

The impact of Covid-19 on older workers' employment and Social Security spillovers.

Unlabelled: The COVID-19 pandemic represents a major threat to health and economic well-being in the USA, especially for older and disabled workers, and may spill over onto Social Security. We use individual-level from the Current Population Survey, state-level monthly Social Security administrative data on disability benefit applications, and national-level monthly data on Social Security retirement benefit applications to assess the impact of the pandemic on older adults' employment and benefit claiming. State-level monthly Google Trends data are used as a leading indicator of future claiming in the population.

The Effects of Consuming Flower for Treatment of Fatigue.

Objectives: We measure for the first time how commercially available flower products affect feelings of fatigue.

Methods: A total of 1,224 people recorded 3,922 flower self-administration sessions between June 6, 2016, and August 7, 2019, using the Releaf App. Usage sessions included real-time subjective changes in fatigue intensity levels prior to and following consumption, flower characteristics (labeled phenotype, cannabinoid potency levels), combustion method, and any potential experienced side effects.

Cannabis consumption and prosociality.

The existing literature largely focuses on health risks and other pharmacodynamics of using cannabis, with fewer investigations of other normative psychological effects from consumption among otherwise healthy people. We measured several basic constructs of social psychology corresponding to the concept of prosociality among 146 healthy young adults between 18 and 25 years (M = 18.9, SD = 1.

The Effectiveness of Common Cannabis Products for Treatment of Nausea.

Goals: We measure for the first time how a wide range of cannabis products affect nausea intensity in actual time.

Background: Even though the Cannabis plant has been used to treat nausea for millennia, few studies have measured real-time effects of common and commercially available cannabis-based products.

Study: Using the Releaf App, 886 people completed 2220 cannabis self-administration sessions intended to treat nausea between June 6, 2016 and July 8, 2019.

The effectiveness of inhaled Cannabis flower for the treatment of agitation/irritability, anxiety, and common stress.

Background: An observational research design was used to evaluate which types of commonly labeled Cannabis flower product characteristics are associated with changes in momentary feelings of distress-related symptoms.

Methods: We used data from 2306 patient-directed cannabis administration sessions among 670 people who used the real-time Cannabis effects recording software, Releaf App, between June 6, 2016, and February 23, 2019, for tracking the effects of Cannabis flower consumption. Fixed effects multivariable panel regression techniques were used to establish overall relief by symptom type and to determine which labeled product characteristics (e.

Does increasing access-to-care delay accessing of care? Evidence from kidney transplantation.

Policies increasing healthcare availability might decrease the cost of delaying accessing of care, leading to potential negative consequences if patients delay treatment. We analyze a policy designed to increase access to kidney transplantation through the use of time since dialysis inception to prioritize patients for transplant, which was piloted at 26 of the 271 kidney transplant centers in the United States in 2006 and 2007. We model the patient's optimization problem comparing the benefits and costs of early waitlisting and predict that the policy change will lead to delayed waitlisting.

Alleviative effects of Cannabis flower on migraine and headache.

Objective: Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.

Methods: Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions).

The Effectiveness of Flower for Immediate Relief from Symptoms of Depression.

: Scientific research on how consumption of whole, natural flower affects low mood and behavioral motivations more generally is largely nonexistent, and few studies to date have measured how common and commercially available flower used may affect the experience of "depression" in real-time. : We observed 1,819 people who completed 5,876 cannabis self-administration sessions using the ReleafApp™ between 06/07/2016 and 07/08/2019, with the goal of measuring real-time effects of consuming flower for treating symptoms of depression. Results: On average, 95.

Are Transplant Centers That Meet Insurer Minimum Volume Requirements Better Quality?

A pervasive viewpoint in health care is that higher patient volume leads to better outcomes, implying that facility volume can be used to identify high-quality providers. Hundreds of studies documenting a positive correlation between hospital volume and patient survival have motivated payers to use arbitrary minimum volume standards for elective surgical procedures, though it is unknown whether these policies actually improve patient outcomes. Using an instrumental variables approach, we show that minimum volume requirements in kidney transplantation do not reduce posttransplant mortality.

Health insurance and self-assessed health: New evidence from Affordable Care Act repeal fear.

Self-assessed health is one of the most commonly used health measures by economists. However, changes in self-assessed health are not always accompanied by changes in physical health as measured by clinical outcomes. This study provides suggestive evidence that this discrepancy arises because self-assessed health is significantly influenced by psychological factors.

Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado.

This study seeks to understand whether people substitute between recreational cannabis and conventional over-the-counter (OTC) sleep medications. UPC-level grocery store scanner data in a multivariable panel regression design were used to compare the change in the monthly market share of sleep aids with varying dispensary-based recreational cannabis access (existence, sales, and count) in Colorado counties between 12/2013 and 12/2014. We measured annually-differenced market shares for sleep aids as a portion of the overall OTC medication market, thus accounting for store-level demand shifts in OTC medication markets and seasonality, and used the monthly changes in stores' sleep aid market share to control for short-term trends.

The effectiveness of self-directed medical cannabis treatment for pain.

The prior medical literature offers little guidance as to how pain relief and side effect manifestation may vary across commonly used and commercially available cannabis product types. We used the largest dataset in the United States of real-time responses to and side effect reporting from patient-directed cannabis consumption sessions for the treatment of pain under naturalistic conditions in order to identify how cannabis affects momentary pain intensity levels and which product characteristics are the best predictors of therapeutic pain relief. Between 06/06/2016 and 10/24/2018, 2987 people used the ReleafApp to record 20,513 cannabis administration measuring cannabis' effects on momentary pain intensity levels across five pain categories: musculoskeletal, gastrointestinal, nerve, headache-related, or non-specified pain.

The Association between Cannabis Product Characteristics and Symptom Relief.

Federal barriers and logistical challenges have hindered measurement of the real time effects from the types of cannabis products used medically by millions of patients in vivo. Between 06/06/2016 and 03/05/2018, 3,341 people completed 19,910 self- administrated cannabis sessions using the mobile device software, ReleafApp to record: type of cannabis product (dried whole natural Cannabis flower, concentrate, edible, tincture, topical), combustion method (joint, pipe, vaporization), Cannabis subspecies (C. indica and C.

Patient-Reported Symptom Relief Following Medical Cannabis Consumption.

The Releaf App mobile software application (app) data was used to measure self-reported effectiveness and side effects of medical cannabis used under naturalistic conditions. Between 5/03/2016 and 12/16/2017, 2,830 Releaf App users completed 13,638 individual sessions self-administering medical cannabis and indicated their primary health symptom severity rating on an 11-point (0-10) visual analog scale in real-time prior to and following cannabis consumption, along with experienced side effects. Releaf App responders used cannabis to treat myriad health symptoms, the most frequent relating to pain, anxiety, and depressive conditions.

The Role of Cannabis within an Emerging Perspective on Schizophrenia.

Approximately 0.5% of the population is diagnosed with some form of schizophrenia, under the prevailing view that the pathology is best treated using pharmaceutical medications that act on monoamine receptors. We briefly review evidence on the impact of environmental forces, particularly the effect of autoimmune activity, in the expression of schizophrenic profiles and the role of therapy for regulating immunological functioning.

Effectiveness of Raw, Natural Medical Flower for Treating Insomnia under Naturalistic Conditions.

: We use a mobile software application (app) to measure for the first time, which fundamental characteristics of raw, natural medical flower are associated with changes in perceived insomnia under naturalistic conditions. : Four hundred and nine people with a specified condition of insomnia completed 1056 medical cannabis administration sessions using the Releaf App educational software during which they recorded real-time ratings of self-perceived insomnia severity levels prior to and following consumption, experienced side effects, and product characteristics, including combustion method, cannabis subtypes, and/or major cannabinoid contents of cannabis consumed. Within-user effects of different flower characteristics were modeled using a fixed effects panel regression approach with standard errors clustered at the user level.

Reported effects of the Scientific Registry of Transplant Recipients 5-tier rating system on US transplant centers: results of a national survey.

In the United States, the Scientific Registry of Transplant Recipients (SRTR) provides publicly available quality report cards. These reports have historically rated transplant programs using a 3-tier system. In 2016, the SRTR temporarily transitioned to a 5-tier system, which classified more programs as under-performing.

Accuracy of Patient Opioid Use Reporting at the Time of Medical Cannabis License Renewal.

The decision to authorize a patient for continued enrollment in a state-sanctioned medical cannabis program is difficult in part due to the uncertainty in the accuracy of patient symptom reporting and health functioning including any possible effects on other medication use. We conducted a pragmatic convenience study comparing patient reporting of previous and current prescription opioid usage to the opioid prescription records in the Prescription Monitoring Program (PMP) among 131 chronic pain patients (mean age = 54; 54% male) seeking the first annual renewal of their New Mexico Medical Cannabis Program (NMMCP) license. Seventy-six percent of the patients reported using prescription opioids prior to enrollment in the NMMCP, however, the PMP records showed that only 49% of the patients were actually prescribed opioids in the six months prior to enrollment.

Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study.

Background: Current levels and dangers of opioid use in the U.S. warrant the investigation of harm-reducing treatment alternatives.

Effects of Legal Access to Cannabis on Scheduled II-V Drug Prescriptions.

Background: Co-prescribing of scheduled drugs is endemic in the United Sates, increasing health risks to patients and the burden on healthcare systems.

Purpose: We conducted a pragmatic historical cohort study to measure the effect of enrollment in a state-authorized United States' Medical Cannabis Program (MCP) on scheduled II-V drug prescription patterns.

Procedures: Eighty-three chronic pain patients, who enrolled in the New Mexico MCP between April 1, 2010 and October 3, 2015, were compared with 42 nonenrolled patients over a 24-month period (starting 6 months before enrollment for the MCP patients) using the Prescription Monitoring Program.

Organizational learning-by-doing in liver transplantation.

Organizational learning-by-doing implies that production outcomes improve with experience. Prior empirical research documents the existence of organizational learning-by-doing, but provides little insight into why some firms learn while others do not. Among the 124 U.