In 2017, a National Academies of Sciences, Engineering, and Medicine (NASEM) report comprehensively evaluated the body of evidence regarding cannabis health effects through the year 2016. The objectives of this study are to identify and map the most recently (2016–2019) published literature across approved conditions for medical cannabis and to evaluate the quality of identified recent systematic reviews, published following the NASEM report. Following the literature search from 5 databases and consultation with experts, 11 conditions were identified for evidence compilation and evaluation: amyotrophic lateral sclerosis, autism, cancer, chronic noncancer pain, Crohn’s disease, epilepsy, glaucoma, human immunodeficiency virus/AIDS, multiple sclerosis (MS), Parkinson’s disease, and posttraumatic stress disorder. A total of 198 studies were included after screening for condition-specific relevance and after imposing the following exclusion criteria: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome definition, intervention definition, sample size, study setting, and reported effect size. Few completed randomized controlled trials (RCTs) were identified. Studies classified as systematic reviews were graded using the Assessing the Methodological Quality of Systematic Reviews-2 tool to evaluate the quality of evidence. Few high-quality systematic reviews were available for most conditions, with the exceptions of MS (9 of 9 graded moderate/high quality; evidence for 2/9 indicating cannabis improved outcomes; evidence for 7/9 indicating cannabis inconclusive), epilepsy (3 of 4 graded moderate/high quality; 3 indicating cannabis improved outcomes; 1 indicating cannabis inconclusive), and chronic noncancer pain (12 of 13 graded moderate/high quality; evidence for 7/13 indicating cannabis improved outcomes; evidence from 6/7 indicating cannabis inconclusive). Among RCTs, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic noncancer pain). The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions, and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions.

Several US states have enacted laws to limit either opioid prescription days’ supply or morphine milligram equivalents for the treatment of acute pain.¹ On July 1, 2018, Florida implemented House Bill 21 (HB21), which limits the days’ supply of Schedule II opioids to 3 days for acute pain prescriptions.² Prescribers can extend to a 7-day supply if they document an exception. This quality improvement study aims to assess the outcomes associated with Florida’s restriction law on opioid prescribing by evaluating the number of new opioid users and the number of units dispensed per prescription before and after the policy change.

An estimated 1.4 million individuals in the US had a diagnosis of opioid use disorder (OUD) in 2019.¹ Despite clinical guidelines and supporting evidence^2-4 for the effectiveness and safety of medication treatment for OUD (MOUD), fewer than 35% to 58% of adults diagnosed with OUD in the US received treatment according to 2019 estimates.^5,6 Buprenorphine and buprenorphine-naloxone combination products (hereafter buprenorphine for OUD) are associated with decreased opioid-related overdoses and infectious disease transmission.⁷