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Kelly Sagar, PhD






McLean Hospital/Harvard Medical School




Kelly Sagar, M. Kathryn Dahlgren, Rosemary T. Smith, Deniz Kosereisoglu, Grace R. Neale, Alexa J., Taghian, Staci A. Gruber

Principal Investigator


Exploring the Impact of Sex Assigned at Birth on Treatment Outcomes in a Longitudinal, Observational Study of Medical Cannabis Patients


Currently, a wide variety of medical cannabis products are available in the marketplace and claim to be effective for many conditions, yet little research has been conducted to determine whether potential therapeutic effects related to medical cannabis use differ as a function of assigned sex. Accordingly, using data from an ongoing, longitudinal study of patients using real-world medical cannabis (MC) products, we examined whether sex assigned at birth influences treatment outcomes. Patients interested in exploring MC treatment were assessed before initiating MC use, and returned for follow-up visits after 3, 6, and 12 months of MC treatment. As part of a larger study from the Marijuana Investigations for Neuroscientific Discovery (MIND) program, participants completed measures assessing the most common indications for MC use: anxiety/mood, sleep, and pain. Preliminary analyses utilizing paired t-tests were used to assess within-subject changes on clinical ratings at each follow-up visit relative to baseline for all MC patients; specific changes among male and female patients were then examined separately. Results generally revealed significant improvements across the larger group patients on measures of anxiety, mood, sleep, and pain relative to baseline. Interestingly, when patients were divided by assigned sex, overall improvements appear to be more strongly driven by reported improvements among females, particularly on measures of mood and anxiety. Taken together, results provide preliminary evidence that women may derive more positive outcomes from real-world, cannabinoid-based treatments. Future analyses, planned as part of the Women’s Health Initiative at MIND (WHIM), are needed to pinpoint specific factors that influence treatment outcomes among male vs female MC patients, including biological variables as well as characteristics of MC use such as indication for use, frequency of use, product choice/cannabinoid exposure, and route of administration.

Research Context

Most cannabis-based research has primarily focused on predominantly male samples, as historically cannabis use is more common among men than women. However, given decreased stigma and growing acceptance of cannabis, a trend for increased use among women, particularly for medical purposes, is beginning to emerge and narrow the gender gap. Although there is a paucity of data on cannabis-related sex differences, early evidence suggests that biological factors and differences related to cannabis-use patterns likely contribute to differential outcomes in men vs. women. This work explores potential sex-differences related to treatment outcomes in a group of MC patients using commercially-available cannabinoid-based products over the course of 3 to 12 months.