The prevalence of cannabis use almost tripled over the past decade among older surgical patients—a population already at higher risk of perioperative complications—yet evidence linking use to adverse outcomes remains equivocal and mostly limited to retrospective cohort studies.

When considering only high-quality systematic reviews, as evaluated by the AMSTAR 2 tool, 42 out of 67 descriptions of treatment effects for up to 20 health outcomes were classified as ‘Positive’ or ‘Potentially Positive.’ These outcomes included pain, insomnia, seizures, anxiety, muscle spasticity, multiple sclerosis, urinary incontinence, anorexia, and patient safety.

Although existing literature suggests a direct role of cannabinoids in the pathogenesis of atherosclerosis, the correlation between cannabinoids and other vascular diseases was only reported in some case series or observational studies, and its role and precise mechanisms remain unclear.

Eight of nine total studies reported statistically significant, positive OSA outcomes due to cannabinoid therapy including reductions in the apnea hypopnea index and improvements in patient-reported daytime sleepiness scales. Between 70% and 80% of study participants reported neuropsychiatric and gastrointestinal adverse events attributable to cannabinoids.

Despite promising preclinical and observational evidence that MC and cannabis-derived compounds are useful in the management of rheumatic disease-related pain, there remains limited high-quality clinical evidence to substantiate these findings.

Most of the trials reviewed are considered exploratory and do not focus on specific types of clinical anxiety or ADs as the primary condition studied. Participant numbers, CBD dose, treatment duration, and CBD formulation vary widely among the studies, and all but two are single-center studies.

Subsequent studies documented how the tapering and discontinuation of long-term opioid therapy was correlated with illicit opioid use, emergency department visits and opioid-related hospitalizations, mental health crises and overdose events, and increased risk of death from suicide or overdose.

The activation of CB2 appears to protect the brain and its functions from damage under neuroinflammatory actions, making it an attractive target in a variety of neurological conditions such as Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, and Huntington’s disease.