Cannabis Practices and Cannabinoid/Terpene Preferences in Medical Cannabis Patients Who Use Cannabis for Pain and Anxiety.

Therapeutic potential of cannabinoids and terpenes in cannabis products is complicated by the possibility to alleviate pain yet exacerbate anxiety symptoms. Little is known about how cannabis practices, and preferences for cannabinoids and terpenes differ among medical cannabis patients who use cannabis to relieve pain, or anxiety, or both. A concurrent explanatory mixed-methods design was utilized. The quantitative analytical sample (n = 1,060) consisted of participants who self-reported past 90-day cannabis use to relieve: physical pain only (14.8%), feeling uptight/anxious only (29.5%), or both conditions (55.7%). We examined between-group differences in demographic variables, cannabis practices and preferences. Qualitative interviews with a subsample of patients (n = 39) were analyzed thematically regarding cannabinoid/terpene preferences to contextualize quantitative results. Compared to the Anxiety-only group, pain groups were more likely to use high potency flower/extract products (i.e., moon rocks/caviar), topicals/creams and CBD; the Pain/anxiety group was more likely to use Rick Simpson Oil and look for CBD, CBN, CBG and CBC. Both quantitative and qualitative data supported preferences for CBD and caryophyllene for pain relief, myrcene for pain and anxiety relief, while Anxiety-only group was less likely to prefer terpinolene. Future studies need to assess if cannabis practices and preferences are associated with symptom improvements over time.