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54ALTERNATIVETHERAPIESsepoct2011VOL.17NO.5MedicinalUseofCannabisinSpainfollowedbymemoryproblemsandchangesinemotionalstate.Theseadverseeffectswerepresentinpeoplewhousedcannabisdailyandforaperiodexceeding6months.BeneCcialeffectsandremainingadverseeffectsweresomewhatdifferentbasedonthemodeofadministrationused.Morehigh-qualitytrialsarenecessarytoestablishthesafetyproCleoflong-termusewithcannabis.18Long-termusewasfoundinthisstudyasinothers.35Thelateonsetofcannabisuse6-9monthsmaybebecausepatientstendedtousecannabisafterprimarytreatmentsfailedoriftheycouldnottoleratethosetreatments.8OftheentireSpanishsamplen130only13ofpatientssaidthattheirdoctorshadrecommendedtheuseofcannabis.AhighproportionofSpanishpatientsusecannabiswithouttherecommendationofadoctormorethan75soitisnecessarytoprovideinformationforthesepatientstoassistintheirdecisionsabouttreatment.8InastudyperformedintheUnitedkingdomof947usersapproximately16ofpatientssaidtheirdoctorsrecommendeduse.7InthestudyperformedinGermanywith165respondentsdoctorswerewillingtopre-scribedelta-9-tetrahydrocannainolto54.8ofthepatientswhorequestedit.4MostAustralianparticipantshadregulardoctorsandalmostallhadinformedtheircliniciansoftheirtherapeuticuse.5Ogborneetal20002reportedthatmostCanadianshadtoldtheirhealthcareprofessionalsaboutusingcannabisformedicalpurposesandreceivedpositivereactions.SourcesforobtainingcannabiswereverydifferentandreDectconcernsaboutqualityanddosingadjustments.125Asingleoriginoftheplantwithahomogenizationandcontrolofactiveingredientswillprovideanaccuratedoseandsched-uleofadministrationappropriateforpatients.Thereisstillaneedforfurtherinvestigationofdifferentdosageformsforcannabis-basedmedications.17InSpainitisestimatedthatahighnumberofpeopleareusingcannabismedicinallywithoutthesupervisionofahealthcareprofessional.ItisnecessarytoestablishclinicalandadministrativeprotocolstoimprovethissituationinSpain.Acknowledgmentsx0Theauthorsthan3allthepatientsfortheirparticipation.REFERENCES1.McPartlandJMPruittPL.Sideeffectsofpharmaceuticalsnotelicitedbycomparedherbalmedicinesthecaseoftetrahydrocannabinolandmarijuana.Alternx0Therx0Healthx0Med.19995457-62.2.OgborneACSmartRGWeberTBirchmore-TimneyC.Whoisusingcannabisasamedicineandwhyanexploratorystudy.Jx0Psychoactivex0Drugs.2000324435-443.3.HarrisDJonesRTShan3Retal.Self-reportedmarijuanaeffectsandcharacteris-ticsof100SanFranciscomedicalmarijuanaclubmembers.Jx0Addictx0Dis.200019389-103.4.GrotenhermenFSchnelleM.SurveyonthemedicaluseofcannabisandTHCinGermany.Jx0Cannabisx0Ther.20033417-40.5.SwiftWGatesPDillonP.SurveyofAustraliansusingcannabisformedicalpur-poses.Harmx0Reductx0J.2005Oct4218.6.GorterRWButoracMCobianEPvanderSluisW.MedicaluseofcannabisintheNetherlands.Neurology.2005645917-919.7.WareMAAdamsHGuyGW.ThemedicinaluseofcannabisintheUkresultsofanationwidesurvey.Intx0Jx0Clinx0Pract.2005593291-295.8.RabanalTorneroMRamsN.Therapeuticusesofcannabinoids.SeguivexandSeguivex-emesisstudies.Butllx0Infx0Terx0SCS.20082025-30.x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0x0ANINDISPENSIBLEREFERENCEWITHTHELATESTALTERNATIVEAPPROACHESREGAINANACTIVELIFESTYLExcx1ex15x0x18x11x1dx0x6x6x0x1cx19x1bx1bx19x1ex1dx0x7x1cx15x19x13x11x1dx0x1x1dx15x11x1bx0x1ex1dx15x0x19x1dx0x18x15x15x0x11x14x1bx2x0x11x15x0x11x0x0x19x13x15x14x0x19x18x0x1ex1cx15x0x1fx15x0x1ex16x0x11x18x19x19x5x0xax0x13x11x1dx0x12x15x0x11x0x14x15x12x19x1bx19x11x19x1dx17x0x19x1bx1bx1dx15x0x1bx19x1cx19x19x1dx17x0x15x15x14x11x0x1cx1ex15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