Cannabis use of patients with inflammatory bowel disease in Germany: a cross-sectional survey

Abstract

Background and Aims Progressive legalization and increasing utilization of medical cannabis open up potential new applications, including for inflammatory bowel disease (IBD). This study aimed to collect current figures on the use of and experience with cannabis among IBD patients in Germany. Methods A 71-item questionnaire was mailed to a randomly selected representative sample of 1000 IBD patients. Results Questionnaires were returned by 417 patients (mean age 49.1 ± 17.0 years; 55.8 % women; 43.4 % ulcerative colitis and 54.7 % Crohn’s disease). Seventy-three respondents (17.5 %) stated past cannabis use for recreational purposes, while 12 users mentioned usage at the time the questionnaire was completed (2.9 %). Seventeen patients (4.1 %) indicated past use of cannabis, and 18 participants (4.3 %) reported current use of cannabis to treat IBD. Perceived benefits of cannabis use by its users included reduced abdominal pain, improved sleep quality, and relief of unease and worry. They reported lower quality of life and higher levels of anxiety or depression than non-users. Of notice, 52.9 % of cannabis users obtained their cannabis from the black market. A total of 76.5 % of former and 50 % of current users did not report their cannabis use to the physician. Conclusion This survey reveals the largest data set on cannabis use among IBD patients in Germany, with the potential for further research. Cannabis is mainly procured from the black market, with unknown quality.

Medical Cannabis Increases Appetite but Not Body Weight in Patients with Inflammatory Bowel Diseases

“…More than 50% of the patients reported prior cannabis use for symptom control. This rate is in line with previous reports of cannabis use among patients with IBD, reported by 15–60% of patients in multiple surveys [ 26 , 27 , 28 ]. Patients treated with MC in our study for appetite improvement had lower appetite scores at enrollment, higher rates of pre-treatment weight loss, higher rates of underweight, and were more experienced with biologic therapy compared to patients treated for other indications.…”

Management of Pelvic Pain in Patients with Crohn’s Disease—Current Overview

“…Nevertheless, in comparison with non-users, they also reported higher levels of anxiety and decreased quality of life. More than half of the patients received the cannabis from the black market [ 59 ]. In New Zealand, 334 surveyed IBD patients reported improvement in loss of appetite, and alleviation of abdominal pain, nausea and vomiting [ 60 ].…”

Herb–Drug Interaction in Inflammatory Diseases: Review of Phytomedicine and Herbal Supplements

“…Cannabis flowers have been used by patients with various diseases to treat pain, appetite loss, and muscle spasms. The drug and preparations of it (e.g., oil extracts) gain popularity among RA [ 43 ], osteoarthritis [ 44 ], and IBD [ 45 ] patients. Animal studies and in vitro experiments suggest immune modulatory and anti-inflammatory properties of cannabinoids, which makes them possible candidates for therapy of autoimmune diseases (reviewed in [ 46 ]).…”

“…With the legalization of medical cannabis products in a growing number of countries, the use of this plant and its extracts to treat symptoms of chronic diseases increases. Still, a significant proportion of patients obtains the marijuana they intend to use medically from illegal sources with unknown quality (e.g., 52.9% of cannabis users among IBD patients in a survey conducted 2019 in Germany [ 45 ]). Besides, cannabidiol (CBD), a non-psychotropic cannabinoid, gained popularity and is used as an ingredient in cosmetics and marketed as a food supplement.…”