JMIR Publications

ABSTRACT

Background:

Since medical cannabis was legalized in Canada in 2013, prescription of cannabis for medical purposes has become commonplace.

Objective:

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.

Methods:

We conducted a cross-sectional online search to identify all cannabis clinic websites within Ontario, Canada that had: (1) physician involvement and (2) 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.

Results:

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; 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.

Conclusions:

Cannabis clinic websites generally promote cannabis use as medically effective but cite low quality evidence to support these claims, and rarely discuss harms. 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.