Clinical Studies and Case Reports

On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients.
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TitleCannabinoid concentrations in confiscated cannabis samples and in whole blood and urine after smoking CBD-rich cannabis as a "tobacco substitute".
Author(s)Hädener M, Gelmi TJ, Martin-Fabritius M, Weinmann W, Pfäffli M.
Journal, Volume, IssueInt J Legal Med. [Epub ahead of print]
Major outcome(s)CBD-rich cannabis legally available in Switzerland may cause positive THC tests on blood and urine

In Switzerland, only cannabis with a total Δ9-tetrahydrocannabinol (THC) content higher than 1% is controlled by the narcotics legislation. Cannabis products rich in cannabidiol (CBD) and low in THC can be legally sold as tobacco substitutes. In this paper, we address analytical and forensic toxicological issues related to the increasing availability and consumption of these products. Based on the analysis of 531 confiscated cannabis samples, we could establish classification thresholds: plant material with a ratio of total THC/total CBD ≥ 3 is graded as THC-rich/CBD-poor, whereas samples with a ratio ≤ 0.33 are categorized as CBD-rich/THC-poor cannabis. We also evaluated an on-site test kit as a rapid alternative to the laborious liquid or gas chromatography (LC or GC)-based techniques normally used for the differentiation between THC- and CBD-cannabis. Furthermore, we determined whole blood and urine cannabinoid levels after smoking different doses of legal CBD-cannabis. A male volunteer smoked one cigarette within 15 min and four cigarettes within 1 h and within 30 min, respectively. Cigarettes contained on average 42.7 mg CBD and 2.2 mg THC. Blood samples were collected up to 1.1 h and urine samples up to 27.3 h after the beginning of smoking. All urine samples tested negative by three immunochemical assays for detection of cannabis use. This is an important finding for abstinence monitoring. However, we found that the trace amounts of THC present in CBD-cannabis can produce THC blood levels above the Swiss legal limit for driving, and thus render the consumer unable to drive from a legal point of view.

Duration (days)
DesignControlled study
Type of publicationMedical journal
Address of author(s)
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