Medical & Clinical Research

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The Medical and Clinical Research Track highlights human-focused cannabis research across epidemiology, clinical trials, observational studies, and real-world evidence. Sessions explore therapeutic applications, safety and tolerability, dosing strategies, health outcomes, public health implications, vulnerable populations, and translational research linking biological mechanisms to clinical effects. Emphasis is placed on methodological rigor, ethical considerations, patient-centered outcomes, and the integration of cannabis research into broader healthcare and public health contexts.

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Advancing the Therapeutic Potential of Cannabinoids for Anxiety and Related Disorders

Cannabinoid products are widely used by the public to self-manage anxiety symptoms, often in lieu of physician-prescribed medications. The growing availability and strongly marketed therapeutic benefit of cannabinoids has outpaced existing empirical data. There is limited high-quality evidence regarding which cannabinoid compounds (e.g., CBD, THC, minor cannabinoids), formulations, or dosing strategies confer meaningful clinical benefit for anxiety and related disorders. Rigorous randomized controlled trials in well-characterized anxiety disorder samples remain scarce, and mechanistic understanding of how cannabinoids modulate anxiety is still emerging. This session will convene leading investigators conducting experimental and clinical trials research to address these gaps. Presentations will highlight studies examining the efficacy, safety, dosing parameters, and target engagement of cannabinoid interventions across anxiety and stress-related conditions. Speakers will present emerging data on cannabinoid-related targets (e.g., modulation of endocannabinoid signaling, threat reactivity) and clinical endpoints (e.g., symptoms and functioning) relevant to advancing understanding of the therapeutic potential of cannabinoids for anxiety. By bringing together researchers committed to methodological rigor, this session aims to clarify what is currently known, identify critical limitations in the evidence base, and outline priorities for future trials. It seeks to close the gap between widespread public use of cannabinoids for self-managing anxiety and the level of scientific evidence required to inform clinical guidance and the responsible development of cannabinoid-based treatments for anxiety disorders.

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Biased Signaling and Beyond: Emerging Pharmacological Insights into the Endocannabinoid System

Advances in receptor pharmacology are reshaping our understanding of ECS‑targeting compounds. This session explores biased signaling, pathway‑selective ligands, and novel cannabinoid‑receptor interactions—including insights from split biosensors, allosteric modulation, and structure–function relationships relevant to therapeutic development.

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Cannabinoid Use in Special Populations

The expanding availability of medical and recreational cannabinoid products has led to their use across diverse populations, including older adults, pregnant/lactating women, and adolescents. These populations require special considerations such as polypharmacy and comorbidities among older adults, altered fetal development in pregnant women, and neurocognitive changes and substance use disorder in adolescents. Unfortunately, the safety, pharmacokinetics, efficacy, and long-term outcomes of cannabinoid exposure remain insufficiently characterized in these special populations. This session will provide an evidence-based examination of cannabinoid use in these populations, drawing on basic and translational research, epidemiologic data, and clinical trials where available. 
 

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Cannabis Impairment and Driving Safety   

In 2026, cannabis-impaired driving research has shifted from basic impairment confirmation to the development of standardized metrics and advanced behavioral detection tools. Because THC concentrations in blood and saliva correlate poorly with functional intoxication, federal and state agencies have pivoted toward four high-priority research pillars.
First, researchers are untangling the relationship between individual variability and tolerance. While frequent users may exhibit fewer overt symptoms, they often lack awareness of persistent deficits; ongoing studies examine whether ""compensatory behaviors,"" like reduced speed, truly mitigate risk or merely mask underlying degradation.
Second, the ""deadly trio"" of polysubstance use remains a critical safety concern. Evidence from trauma centers indicates that combining THC with alcohol or other drugs produce additive or even synergistic effects that significantly amplify crash risk. Finally, the search for acute biomarkers is being supplemented by enabled intelligent vehicle applications that understand both the outside scene and the driver's state to improve safety outcomes. These systems record objective behavioral data—such as millimeter-level lane weaving and reaction-time delays—to identify impairment in real time, with a specific focus on the unique profiles of high-potency concentrates and edibles. Collectively, these advancements represent a transition toward a more nuanced, behavior-based framework for ensuring roadway safety in a legalized landscape.

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Cannabis Worker Health: Emerging Occupational Hazards, Exposure Science, and Clinical Implications

As legal cannabis markets expand across the United States, occupational exposures in cultivation, processing, and manufacturing settings are increasing, yet systematic research on cannabis worker health remains limited. Workers may be exposed to unique and common biological, chemical, and physical hazards during their workplace activities. Reports of respiratory symptoms, occupational asthma, dermal sensitization, and other adverse outcomes are emerging, but exposure characterization and clinical surveillance frameworks remain underdeveloped. This interdisciplinary session will convene subject matter experts in occupational exposure science, inhalation toxicology, immunology, and occupational medicine to examine the current state of evidence and identify top research priorities. Topics will include: bioaerosol and allergen exposure assessment in cultivation and processing facilities; inhalation toxicology of cannabis-derived particulate matter and co-contaminants; regulatory discussion on the biggest worker compensation claims and documented health issues in cannabis; clinical recognition of cannabis-associated occupational asthma and hypersensitivity; and gaps in regulatory standards, worker protections, and surveillance systems. The panel will emphasize translational connections between exposure measurement, mechanistic research, and clinical practice, with the goal of fostering collaboration among occupational medicine physicians, industrial hygienists, toxicologists, epidemiologists, and academic researchers. This session will provide a platform to identify critical knowledge gaps, align research approaches, and build a coordinated framework to protect cannabis workers as the industry continues to evolve.

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Cannabis, Cannabinoids, and Cancer: Mechanisms, Symptom Management, and Emerging Therapies

This session will explore the therapeutic potential of cannabinoids across the cancer continuum, integrating both preclinical and clinical perspectives. We will highlight mechanistic and behavioral studies in animal models that evaluate cannabinoid modulation of cancer-related symptoms, with a particular emphasis on pain, neuropathy, and treatment-associated toxicities. These data will be linked to early- and late-phase clinical trials testing cannabinoids for symptom management in people with cancer, including outcomes related to analgesia, quality of life, and functional status. In parallel, the session will examine emerging evidence that components of the endocannabinoid system may be directly targetable in cancer itself. We will review studies investigating anti-proliferative, pro-apoptotic, anti-metastatic, and immunomodulatory effects of cannabinoids in tumor models, and discuss how these findings are being translated into clinical research. A key focus will be the diversity of cannabinoid agents under investigation, including hemp-derived products, defined phytocannabinoids (such as cannabidiol and Δ9-tetrahydrocannabinol), minor cannabinoids, and synthetic analogues and modulators. Across talks, presenters will address pharmacology, dosing considerations, and safety, as well as regulatory and methodological challenges in studying complex botanical preparations versus single-molecule therapeutics. Collectively, the session aims to provide a balanced, state-of-the-science overview of how cannabinoids may be leveraged both to alleviate cancer-related symptoms and to modify the underlying disease process, highlighting critical knowledge gaps and priorities for future translational research.

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Exploring the Therapeutic Potential of Cannabinoids for Pain    

Over the past two decades, cannabinoids have become increasingly recognized as a potential alternative to traditional analgesics for a variety of pain conditions. This session will provide an integrated perspective on the efficacy of cannabinoids for diverse acute and chronic pain conditions, bridging evidence from preclinical models with emerging clinical data, including surveys, registry data, observational designs, and clinical trials. Evidence-supported perspectives and reviews of the literature will also be considered. Presentations will provide current information on the utility of particular cannabinoids/ratios (chemovars), routes and frequency of administration, doses, etc., as well as a discussion of adverse effects. This session will highlight strengths and weaknesses in the currently available scientific data and will identify future research areas needed in this field.

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Leveraging NCI Collaborative Efforts to Assess Benefits and Harms of Cannabis Use among Individuals with Cancer: Overview of Five U01 Studies

Cannabis use for symptom management among patients with cancer has increased significantly in recent years, with many reporting benefits for pain, anxiety, sleep, nausea, appetite as well as other symptoms. Rigorous prospective data on the potential benefits and harms of cannabis use among those with cancer are lacking. This National-Cancer Institute (NCI) funded multi-site Research Project Cooperative Agreement (U01) leverages a robust infrastructure across five diverse cancer centers to ensure standardized data collection and harmonized protocols to address this research gap. The prospective observational studies evaluate the benefits and harms of cannabis use among a large, heterogeneous samples of patients with cancer undergoing active systemic treatment. In this symposium, we will provide an overview of each study, including cancer type, treatment modalities, inclusion/exclusion criteria, data collection methods, and both patient-reported and cancer-related outcomes. We will also discuss important aspects of this collaboration including data harmonization on core cannabis use, biological and patient-reported outcomes across studies. Finally, we will discuss the clinical implications of this effort such as informing clinical guidelines for cannabis use in cancer patients and laying the groundwork for future randomized controlled clinical trials.

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Linking Cannabis Use, Neuroinflammation, Blood–Brain Barrier Function, and Clinical Outcomes: Translational Insights from HIV

Neuroinflammation and blood brain barrier (BBB) dysfunction are central features of neurodegenerative, autoimmune, and mood disorders and contribute to adverse outcomes such as neurocognitive impairment. These processes are particularly relevant in HIV infection, where chronic systemic and central nervous system inflammation persist despite suppressive antiretroviral therapy. Cannabis use is disproportionately high among people with HIV and may influence inflammatory signaling, BBB-related neurobiological processes, and downstream neurobehavioral outcomes. Prior research has reported both potentially beneficial and harmful associations of cannabis use, yet findings remain inconsistent, underscoring the importance of considering multidimensional contextual factors, including exposure patterns, cannabinoid composition, inflammatory milieu, and related biological modifiers. This symposium will present novel findings from ongoing studies of cannabis and HIV that span the translational spectrum from animal models to human observational and clinical research and integrate advanced neuroimaging, inflammatory biomarkers, neurobehavioral assessment, and mechanistic in vitro platforms, including BBB models and personalized assays using participant-derived samples to examine immune activation and endocannabinoid and inflammatory signaling pathways. Together, this work examines how cannabis exposure interacts with chronic inflammation to influence BBB integrity, neuroimmune signaling, and brain and behavioral outcomes in people with and without HIV. By linking mechanistic models, in vivo biomarkers, and clinical phenotypes within a unified translational framework, this work addresses critical gaps in understanding the context-dependent and potentially beneficial or harmful effects of cannabis use, including identification of exposure thresholds that may inform risk stratification and therapeutic development in inflammatory conditions such as HIV.
 

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Medical Cannabis Use in the Real World: Epidemiology, Public Health, and Patient Outcomes

As medical cannabis use continues to expand, understanding real-world patterns of use and health outcomes is critical for clinicians, researchers, and policymakers. This session highlights epidemiologic and public health research focused specifically on medical cannabis populations, including indications for use, dosing patterns, modes of administration, and patient-reported benefits and adverse effects. Speakers will discuss methodological challenges in studying medical cannabis, including misclassification bias, stigma-driven underreporting, and limitations of existing surveillance systems. Emphasis will be placed on how epidemiologic evidence can inform clinical decision-making, harm reduction strategies, and the design of patient-centered medical cannabis research.

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Novel Biomarkers and Integrative Methods for Understanding the Metabolic and Neurobiological Mechanisms of Cannabis Use and Disorder

Understanding the biological mechanisms associated with cannabis use and cannabis use disorder (CUD) remains a major challenge in the field. While research has increasingly characterized behavioral and clinical outcomes, far less is known about the metabolic, endocannabinoid, and lipid signaling processes that may drive risk, benefits, acute effects, and disorder progression. Emerging biomarker approaches, particularly those emphasizing metabolic hormones, immune and endocannabinoid signaling, and advanced analytic methods, offer new opportunities to identify mechanistic pathways and improve prediction of clinically meaningful outcomes. This session will present novel biomarker and computational approaches aimed at advancing mechanistic understanding of cannabis exposure and CUD risk. Presentations will highlight experimental and analytic work examining metabolic hormone (e.g., GLP-1) responses to acute THC exposure, multi-system immune and lipid signaling profiles, and novel analytic approaches for integrating complex biological data. Together, these talks will provide a translational perspective linking acute pharmacological effects, circulating biomarkers, and behavioral phenotypes relevant to cannabis use and disorder.

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Pharmacokinetics and Toxicology of Cannabinoids   

As cannabis legalization has expanded, many novel cannabis product types have emerged, and the co-use of cannabis with other intoxicating substances has increased. Simultaneously, the incidence of driving under the influence of cannabis has increased. Thus, controlled research to quantify cannabinoids across various biological matrices (e.g., blood, oral fluid, urine), product formulations/routes of administration, and under solo versus co-use conditions, is vital to public safety, as it can inform policies related to workplace drug testing and impairment detection. This symposium brings together leading researchers studying these critical issues using controlled human laboratory procedures. Specific research in this symposium will include: 1) studies on the impact of cannabis product formulation/route of administration on cannabinoid pharmacokinetics in blood, urine, and oral fluid, 2) innovative research quantifying cannabinoids in exhaled breath, and 3) research elucidating how other potentially intoxicating drugs, measured via broad spectrum drug screening and quantitative analysis, influence the pharmacokinetics and toxicology of cannabinoids. The session will conclude with a panel discussion summarizing how cannabis toxicology data is currently used in the US, the current state of science on this subject, including current limitations to using toxicology data to infer impairment, lessons learned from other countries with differing cannabis policies in this area, and possible future research directions and solutions to current limitations.

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Sex Determination and Sexual Plasticity in Cannabis: From Chromosomes to Commercial Applications

Cannabis sativa is a dioecious species with distinct male and female individuals. Male and female flowers differ markedly in structure; each comprises a reduced flower specialized for pollen or seed production. Sex determination is governed by an XY chromosomal system; however, sexual phenotype is remarkably plastic. Environmental and hormonal applications can induce male flowers on genetically female plants and vice versa, revealing an unusual flexibility between chromosomal sex and floral identity. The molecular mechanisms of sex determination remain elusive. Recent years have witnessed an explosion of interest in cannabis sex determination and the gene regulatory networks governing floral organ specification. Multiple laboratories have deployed cutting-edge genomics and transcriptomics approaches, including population-scale analyses and cross-species comparisons, generating transformative insights into Y-chromosome function, gene regulatory networks, hormonal signaling pathways, and the evolution of dioecy. Emerging data reveal complex interactions between environmental cues and chromatin-based regulation that collectively shape sexual fate. This topic holds exceptional scientific merit, addressing fundamental questions in plant developmental biology, sex chromosome evolution, and epigenetic inheritance, while carrying immediate commercial relevance. Understanding and manipulating sex expression is critical for controlling pollination and developing stable monoecious or feminized cultivars for industrial hemp and pharmaceutical applications. This session brings together researchers investigating sex determination in cannabis, covering sex chromosome biology, developmental regulation, environmental effects, and evolutionary perspectives. Understanding sex expression has direct commercial relevance for crop uniformity, cannabinoid production, and breeding strategies. By integrating fundamental and applied research, this session will attract a broad audience spanning plant biology, agriculture, and cannabis science.
 

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