Olena Litvinova ^1,2* Bikash Baral ³ Thomas Wochele-Thoma ² Maima Matin ⁴ Nikolay T. Tzvetkov ⁵ Olga Adamska ⁶ Agnieszka Kamińska ⁶ Marcin Łapiński ⁷ Artur Stolarczyk ⁷ Atanas G. Atanasov ^2,4*

• ¹ Department of Management, Marketing and Quality Assurance in Pharmacy, National University of Pharmacy of the Ministry of Health of Ukraine, Kharkiv, Ukraine
• ² Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
• ³ Organismal and Evolutionary Biology Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
• ⁴ Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Magdalenka, Poland
• ⁵ Department of Biochemical Pharmacology and Drug Design, Institute of Molecular Biology "RoumenTsanev", Bulgarian Academy of Sciences, Sofia, Bulgaria
• ⁶ Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński University in Warsaw, Warsaw, Poland
• ⁷ Orthopaedic and Rehabilitation Department, Medical University of Warsaw, Warsaw, Poland

Background: Cannabis and its derivatives show encouraging therapeutic effects in the treatment of various diseases. However, further studies are needed to better assess their efficacy and safety. A promising base for research in the field of medicine and additional pharmacovigilance is social networks. The aim of this study was to investigate the reported efficiency and safety of medical use of cannabinoids in patients using posts on the social media Instagram and analyze the observed trends.Methods: Social media listening platform Apify was used to collect data with hashtags as of June 4, 2024. The analysis of the data obtained from the research was conducted using the RStudio platform.The analysis covered 1466 posts containing hashtags related to cannabinoids. The posts studied were categorized as follows: 33.08% focused on advertising and commercialization, 25.58% on personal experience, 21.35% on other topics, and 19.99% contained educational content. An analysis of overall content relevance found that the majority of Instagram posts (81.79%) related to cannabis and cannabinoid hashtags are relevant. The analysis shows that English dominates the studied category (70.74% of posts), while German, French, Spanish, and other languages also occupy a significant place, emphasizing the importance of a multilingual approach in content analysis. Personal experience stories receive a significant number of "likes" indicating a strong emotional connection between audience and content. Instagram discussions about cannabinoid treatment support evidence from scientific studies about their effectiveness in treating a range of diseases, such as epilepsy with Lennox-Gastaut and Dravet syndromes, multiple sclerosis, cancer, and HIV-cachexia, nausea and vomiting caused by chemotherapy. At the same time, they emphasize the need for further clinical studies to better assess safety, side effects, and optimal dosages. Advertising and commercial posts can contribute to increased cannabis use, highlighting the need to raise awareness of risks and strengthen preventive measures.Analysis of content on the social media Instagram can complement traditional scientific research by providing information on the real use of cannabis and its derivatives, contributing to the development of safe and effective recommendations for its use.