GOLD stage III or IV COPD (i.e., post-β2-agonist FEV1 of 50% predicted or less)
Self-reported cigarette smoking history ≥10 pack yrs
Currently taking long-acting beta-2 agonists and long-acting antimuscarinic agents (LABA/LAMAs) with or without an inhaled corticosteroid
Willing to abstain from cannabis smoking for ≥15 days prior to study participation (if applicable)
Willing to abstain from non-study related cannabis smoking throughout the study period (if applicable)
No change in medication dosage or frequency of administration, with no exacerbations or hospitalizations in the preceding 4 weeks
You may not be if
Presence of active and/or uncontrolled cardiopulmonary and/or musculoskeletal disease other than COPD that could contribute to breathlessness and exercise intolerance
Hepatic or renal impairment
Psychiatric history (other than depression and/or anxiety)
History of epilepsy or convulsions;
Lung cancer
History of sensitivity to cannabis
Use of levodopa, sildenafil and/or fentanyl
Use of ketoconazole
Use of regular high dose opioids (i.e., 30 mg of oral morphine equivalents/day)
Known or suspected history of addiction/substance abuse based on CAGE-AID and SISAP scores (\*note, patients may be recruited if they have a history of smoking cannabis)
Positive urine toxicology for cannabinoids on screening
Positive pregnancy urine test
Subject cannot arrange to be accompanied home by a family member and/or friend during each treatment visit.
