The findings show there is misleading and inaccurate information readily available to consumers online.

Seventy-six percent of claims made by websites were inaccurate and were based on low-quality evidence. Of the medical marijuana claims reviewed, 10% of websites made appropriate cause and effect conclusions. Furthermore, approximately 3% of the medical marijuana claims were written by a healthcare professional.

The purpose of this study was to evaluate the accuracy and quality of medical marijuana claims on popular websites. Methods : Commonly used websites containing claims regarding medical marijuana were selected by utilizing three online marketing tools that rank websites based on number of views, number of visitors, and visitor engagement. Once the top ten most popular websites were selected, medical claims regarding marijuana were reviewed for accuracy and quality using evidence-based tools.

With increasing popularity of marijuana, consumers are likely turning to the internet for information regarding medical marijuana. Accuracy of medical marijuana claims is a significant concern because consumers change their medication management based on information from a single website.

References

1. Babson, KA, Sottile, J, Morabito, D. Cannabis, Cannabinoids, and Sleep: A review of the literature . Curr Psychiatry Rep. 2017 ;19(4): 23 .

Google Scholar Crossref | Medline

2. Mucke, M, Phillips, T, Radbruch, L, et al. Cannabis-based medicines for chronic neuropathic pain in adults . Cochrane Database Syst Rev. 2018 ;3: CD012182 . DOI: 10.1002/14651858.CD012182.pub2

Google Scholar Medline

3. Nugent, SM, Morasco, BJ, O’Neil, ME, et al. The effects of cannabis among adults with chronic pain and an overview of general harms: A systematic review . Ann Intern Med. 2017 ;167(5): 319 – 331 .

Google Scholar Crossref | Medline

4. O’Neil, ME, Nugent, SM, Morasco, BJ, et al. Benefits and harms of plant-based cannabis for posttraumatic stress disorder: A systematic review . Ann Intern Med. 2017 ;167(5): 332 – 340 .

Google Scholar Crossref | Medline

5. Bogdanovic, V, Mrdjanovic, J, Borisev, I. A Review of the Therapeutic Antitumor Potential of Cannabinoids . J Altern Complement Med. 2017 ;23(11): 831 – 836 .

Google Scholar Crossref | Medline

6. Goyal, H, Singla, U, Gupta, U, et al. Role of cannabis in digestive disorders . Eur J Gasroenterol Hepatol. 2017 ;29(2): 135 – 143 .

Google Scholar Crossref | Medline

7. Marijuana . NIDA. Published 2018 . Accessed May 03, 2018. https://www.drugabuse.gov/publications/research-reports/marijuana

Google Scholar

8. Kaiser Family Foundation . The digital divide and access to health information online. Menlo Park, CA . 2011 ; Report No. 8176.

Google Scholar

9. Wartella, E, Rideout, V, Zupancic, H, et al. Teens, health, and technology: a national survey . Center on Media and Human Development. Evanston, IL : Northwestern University ; 2015 .

Google Scholar

10. Boyer, EW, Shannon, M, Hibberd, PL. The internet and psychoactive substance use among innovative drug users . Pediatrics. 2005 ;115(2): 302 – 305 .

Google Scholar Crossref | Medline | ISI

11. Mitchell, A, Grieco, E, Sumida, N. Americans favor protecting information freedoms over government steps to restrict false news online . Pew Research Center. 2018 . Accessed April 25, 2018. http://www.journalism.org/2018/04/19/americans-favor-protecting-information-freedoms-over-government-steps-to-restrict-false-news-online/

Google Scholar

12. Center for Drug Evaluation and Research. Buying Medicines Over the Internet : Health Information on the Web . U S Food and Drug Administration . Published 2016 . Accessed April 18, 2018. https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/buyingmedicinesovertheinternet/ucm202863.htm

Google Scholar

13. Bryant, PJ, Pace, HA. The Pharmacist’s Guide to Evidence Based Medicine for Clinical Decision Making. 1st ed . Bethesda, MD : American Society of Health-System Pharmacists ; 2009 .

Google Scholar

14. Digital World Market Intelligence Platform [Internet] . SimilarWeb.com. Accessed June 19, 2018. http://www.similarweb.com/

Google Scholar

15. All-in-one Marketing Toolkit [Internet] . SEMrush Blog . Accessed June 19, 2018. http://www.semrush.com/

Google Scholar

16. Keyword Research, Competitor Analysis, & Website Ranking | Alexa [Internet] . Alexa Internet . Accessed date June 19, 2018. http://www.alexa.com/

Google Scholar

17. The World’s Cannabis Information Resource [Internet] . Leafly . Accessed June 15, 2018. https://www.leafly.com/

Google Scholar

18. Cannabis News, Culture And Information [Internet] . HERB . Accessed June 15, 2018. https://herb.co/

Google Scholar

19. World’s Best Online Headshop [Internet] . Grasscity . Accessed June 15, 2018. https://www.grasscity.com/eu_en/

Google Scholar

20. High Times • The Magazine Of High Society [Internet] . High Times. High Times . Accessed June 15, 2018. https://hightimes.com/

Google Scholar

21. National Institute on Drug Abuse. National Institute on Drug Abuse (NIDA) [Internet]. NIDA . Accessed June 15, 2018. https://www.drugabuse.gov/

Google Scholar

22. Marijuana [Internet]. Marijuana . Published 2018 . Accessed June 15, 2018. https://www.marijuana.com/

Google Scholar

23. Marijuana News and Information - The Weed Blog [Internet] . The Intellectualist. The Intellectualist . Accessed June 15, 2018. https://www.themaven.net/theweedblog/

Google Scholar

24. Marijuana news and resources [Internet]. The Cannabist. The Cannabist . Accessed June 15, 2018. https://www.thecannabist.co/

Google Scholar

25. Medical Marijuana Inc. - Legal Cannabis Leader: Hemp CBD Oil [Internet] . Medical Marijuana, Inc. Medical Marijuana, Inc . Accessed June 15, 2018. https://www.medicalmarijuanainc.com/

Google Scholar

26. NORML - Working to Reform Marijuana Laws [Internet] . The National Organization for the Reform of Marijuana Laws . Accessed June 15, 2018. Available from: http://norml.org/

Google Scholar

27. Chitika Staff . The Value of Google Results Positioning. Chitika : Online Advertising Network . 2013 . Accessed September 24, 2018. https://chitika.com/2013/06/07/the-value-of-google-result-positioning-2/

Google Scholar

28. De Jong, BC, Prentiss, D, McFarland, W, et al. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea . J Acquir Immune Defic Syndr. 2005 ;38(1): 43 – 46 .

Google Scholar Crossref | Medline

29. Pacher, P, Batkai, S, Kunos, G. Cardiovascular pharmacology of cannabis . Handb Exp Pharmacol. 2005 ;(168): 599 – 625 .

Google Scholar Crossref | Medline

30. Rhyne, DN, Anderson, SL, Gedde, M, et al. Effects of marijuana on migraine headache frequency in an adult population . Pharmacotherapy. 2016 ;36(5) 505 – 510 .

Google Scholar Crossref | Medline

31. Keen, L, Abbate, A, Blanden, G, et al. Confirmed marijuana use and lymphocyte count in black people living with HIV . Drug Alcohol Depend. 2017 ;180: 22 – 25 .

Google Scholar Crossref | Medline

32. Penner, EA, Buettner, H, Mittleman, MA. The impact of marijuana use on glucose, insulin, and insulin resistance among US adults . Am J Med. 2013 ;126(7): 583 – 589 .

Google Scholar Crossref | Medline

33. Jadoon, K, Tan, GD, O’Sullivan, SE. A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study . JCI Insight. 2017 ;2(11): e93760 .

Google Scholar Crossref | Medline

34. Filbey, FM, Aslan, S, Lu, H, et al. Residual effects of THC vs novel measures of brain perfusion and metabolism in a large group of chronic cannabis users . Neuropsychopharmacology. 2017 : 1 – 8 .

Google Scholar Medline

35. Cooper, RE, Williams, E, Seegobin, S, et al. Cannabinoids in attention-deficit/hyperactive disorder: A randomized-controlled trial . Eur Neuropsychopharmacol. 2017 ;27: 795 – 808 .

Google Scholar Crossref | Medline

36. Devinsky, O, Cross, JH, Laux, L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet syndrome . N Engl J Med. 2017 ;376(21) 2011 – 2020 .

Google Scholar Crossref | Medline

37. Sullivan, SE, Sun, Y, Bennett, AJ, et al. Time-dependent vascular actions of cannabidiol in the rat aorta . Eur J Pharmacol. 2009 ;612(1-3): 61 – 68 .

Google Scholar Crossref | Medline

38. Eubanks, LM, Rogers, CJ, Beuscher, AE, et al. A molecular link between the active component of marijuana and Alzheimer’s disease pathology . Mol Pharm. 2006 ;3(6): 773 – 777 .

Google Scholar Crossref | Medline

39. Ishada, JH, Aeur, R, Vittinghoff, E, et al. Marijuana use and estimated glomerular filtration rate in young adults . Clin J Am Soc Nephrol. 2017 ;12(10): 1578 – 1587 .

Google Scholar Crossref | Medline

40. Scott, KA, Dalgleish, AG, Liu, WM. The combination of cannabidiol and delta-9-tetrahydrocannabinol enhances the anticancer effects of radiation in an orthotopic murine glioma model . Mol Cancer Ther. 2014 ;13(12) 2955 – 2967 .

Google Scholar Crossref | Medline

41. Bachhuber, MA, Soloner, B, Cunninham, CO, et al. Medical cannabis laws and opioid analgesic overdose mortality in the United States, 1999-2010 . JAMA Intern Med. 2014 ;174(10) 1668 – 1673 .

Google Scholar Crossref | Medline | ISI

42. Antonelli, T, Tomasini, MC, Tattoli, M, et al. Prenatal exposure to the CB1 receptor agonist WIN 55,212-2 causes learning disruption associated with impaired cortical NMDA receptor function and emotional reactivity changes in rat offspring . Cereb Cortex. 2005 ;15(12): 2013 – 2020 .

Google Scholar Crossref | Medline

43. Venderova, K, Ruzicka, E, Vorisek, V, et al. Survey on cannabis use in Parkinson’s disease: Subjective improvement of motor symptoms . Mov Disord. 2004 ;19(9) 1102 – 1106 .

Google Scholar Crossref | Medline

44. Scott, KA, Dalgleish, AG, Liu, WM. Anticancer effects of phytocannabinoids used with chemotherapy leukaemia cells can be improved by altering the sequence of their administration . Int J Oncol. 2017 ;51(1): 369 – 377 .

Google Scholar Crossref | Medline

45. Brunet, L, Moodie, EEM, Rollet, K; et al. Canadian Co-infection Cohort Investigators. Marijuana smoking does not accelerate progression of liver disease in HIV-hepatitis C coinfection: A longitudinal cohort analysis . Clin Infect Dis. 2015 ;57(5): 663 – 670 .

Google Scholar Crossref

46. Hayakawa, K, Mishima, K, Fujiwara, M. Therapeutic potential of non-psychotropic cannabidiol in ischemic stroke . Pharmaceuticals. 2010 ;3(7): 2197 – 2212 .

Google Scholar Crossref | Medline

47. Reiman, A, Welty, M, Solomon, P. Cannabis as a substitute for opioid-based pain medication: patient self-report . Cannabis Cannabinoid Res. 2017 ;2(1) 160 – 166 .

Google Scholar Crossref | Medline

48. Rhyne, DN, Anderson, SL, Gedde, M, et al. Effects of medical marijuana on migraine headache frequency in an adult population . Pharmacotherapy. 2016 ;36(5): 505 – 510 .

Google Scholar Crossref | Medline

49. Livingston, MD, Barnett, TE, Delcher, C, et al. Recreational cannabis legalization and opioid-related deaths in Colorado, 2000-2015 . Am J Public Health. 2017 ;107(11) 1827 – 1829 .

Google Scholar Crossref | Medline

50. Blanco, C, Hasin, DS, Wall, MM, et al. Cannabis use and risk of psychiatric disorders: Prospective evidence from a US national longitudinal study . JAMA Psychiatry. 2016 ;73(4) 388 – 395 .

Google Scholar Crossref | Medline

51. Goyal, H, Guerreso, K, Smith, B, et al. Severity and outcomes of acute alcoholic pancreatitis in cannabis users . Transl Gastroenterol Hepatol. 2017 ;2(60): 1 – 8 .

Google Scholar Medline

52. Singer, M, Azim, A, O’Keefe, T, et al. How does marijuana affect outcomes after trauma in ICU patients? A propensity-matched analysis . J Trauma Acute Care Surg. 2017 ;83(5): 846 – 849 .

Google Scholar Crossref | Medline

53. Kindred, JH, Li, K, Ketelhut, NB, et al. Cannabis use in people with Parkinson’s disease and Multiple Sclerosis: A web-based investigation . Complement Ther Med. 2017 ;33: 99 – 104 .

Google Scholar Crossref | Medline

54. Ishida, JH, Auer, R, Vittinghoff, E, et al. Marijuana use and estimated glomerular filtration rate in young adults . Clin J Am Soc Nephrol. 2017 ;12(10): 1578 – 1587 .

Google Scholar Crossref | Medline

55. Adams, JW, Bryant, KJ, Edelman, JE, et al. Associated of cannabis, stimulant, and alcohol use with mortality prognosis among HIV-infected men . AIDS Behav. 2018 ;22(4): 1341 – 1351 . DOI 10.1007/s10461-017-1905-4

Google Scholar Crossref | Medline

56. Cavazos-Rehg, PA, Krauss, MJ, Cahn, E, et al. Marijuana promotion online: an investigation of dispensary practices . Prev Sci. 2019 ;20(2): 280 – 290 .

Google Scholar Crossref | Medline

57. Krauss, MJ, Sowles, SJ, Sehi, A, et al. Marijuana advertising exposure among current marijuana users in the U.S . Drug Alcohol Depend. 2017 ;174: 192 – 200 .

Google Scholar Crossref | Medline

58. CSAM . The Adverse Effects of Marijuana (for healthcare professionals) . Accessed October 2, 2018. https://www.csam-asam.org/adverse-effects-marijuana-healthcare-professionals

Google Scholar

59. Devitt-Lee, A . Project CBD: CBD-Drug Interactions: Role of Cytochrome P450 . 2015 . Accessed October 2, 2018. https://www.projectcbd.org/science/cannabis-pharmacology/cbd-drug-interactions-role-cytochrome-p450

Google Scholar

60. Harewood, GC, Hendrick, LM. Prospective, controlled assessment of the impact of formal evidence-based medicine teaching workshop on ability to appraise the medical literature . Ir J Med Sci. 2010 ;179(1): 91 – 94 .

Google Scholar Crossref | Medline

61. Berger, B, Steckelberg, A, Meyer, G, et al. Training of patient and consumer representatives in the basic competencies of evidence-based medicine: a feasibility study . BMC Med Educ. 2010 ;10: 16 .

Google Scholar Crossref | Medline