Cannabis Use Reported by Patients Receiving Primary Care in a Large Health System

Gelberg, Lillian; Beck, Dana; Koerber, Julia; Akabike, Whitney N.; Dardick, Lawrence; Lin, Clara; Shoptaw, Steve; Javanbakht, Marjan

doi:10.1001/jamanetworkopen.2024.14809

Cited by 4 publications

References 44 publications

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Self-Medication Paths

Audet,

Bertrand,

Martel

et al. 2024

The Clinical Journal of Pain

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Objectives: Cannabis is used by one-third of people living with chronic pain to alleviate their symptoms despite warnings from several organizations regarding its efficacy and safety. We currently know little about self-medication practices (use of cannabis for therapeutic purposes without guidance), mainly since the legalization of recreational cannabis in countries such as Canada has expanded the scope of this phenomenon. This study aimed to describe legal cannabis self-medication for pain relief in people living with chronic pain and to explore perceptions of the effectiveness and safety of cannabis. Methods: A cross-sectional descriptive study was performed among 73 individuals living with chronic pain and using cannabis (Quebec, Canada). Data collection using telephone interviews occurred in early 2023. Results: Results indicated that 61.6% of participants reported using cannabis without the guidance of a healthcare professional (self-medication). Surprisingly, among those, 40.0% held a medical authorization. Overall, 20.6% of study participants were using both medical and legal non-medical cannabis. Different pathways to self-medication were revealed. Proportion of women vs. men participants self-medicating were 58.2% vs. 70.6% (P=0.284). In terms of perceptions, 90.4% of the sample perceived cannabis to be effective for pain management; 72.6% estimated that it posed no or minimal health risk. Discussion: Cannabis research is often organized around medical vs. non-medical cannabis but in the real-world, those two vessels are connected. Interested parties, including researchers, healthcare professionals and funding agencies, need to consider this. Patients using cannabis feel confident in the safety of cannabis, and many of them self-medicate, which calls for action.

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Self-Medication Paths

Audet,

Bertrand,

Martel

et al. 2024

The Clinical Journal of Pain

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Exploratory survey study on adjunctive use of medical cannabis for Gaucher disease

Berman,

Ely,

Scher

et al. 2024

Rare Dis Orphan Drugs J

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Aims : Using an investigator-designed survey tool to confirm that adult patients with type 1 Gaucher disease (GD1) often self-prescribe cannabis products to try to alleviate symptoms such as lingering fatigue, chronic bone and joint pain, loss of energy, anxiety, and depression that persist despite enzyme replacement therapy (ERT) or substrate restriction therapy (SRT). Additionally, to explore whether patient reports of symptom relief and adverse side effects relate to frequency and duration of cannabis use. Methods : We conducted an anonymous, cross-sectional questionnaire study to elicit GD1 patient-reported experiences with cannabis used to alleviate symptoms they attributed to their underlying disease. Eligible participants included individuals with GD1 aged ≥ 18 years, regardless of sex, gender, country of residence, ethnicity, state of health or GD1 treatment status. The questions included basic socio-demography (n = 9), GD diagnosis and pre-treatment signs and symptoms (n = 16), GD treatment information (n = 9), current GD symptoms (n = 12), concurrent manifestations of Parkinson’s disease (n = 6), details of cannabis use (n = 24), perceived effect of cannabis on symptoms (n = 13), and interest in participating in future studies (n = 2). Results: 159 GD1 adults (81.5% US) responded to advertisements on patient online sites or to informational posts in advocacy group newsletters. The most frequent pre-treatment symptoms were fatigue (83.8%), bone or joint pain (79.7%), and bleeding problems (73.0%). Hemostasis substantially improved, but pain, achiness, fatigue, and anxiety often persisted. Sixty-two respondents (39%) reported very heterogeneous cannabis use. There was a positive association between the severity of persistent symptoms and the likelihood of cannabis use. Cannabis users reported improvements in muscle pain (84.3%), bone pain (82.4%), joint pain (82.4%), anxiety (70.6%), and general achiness (66.7%). However, moderate and extreme bone manifestations, fatigue, breathing problems, memory loss, and episodic dyscoordination were more prevalent among frequent users of inhaled cannabis than among non-users. Conclusion: Our results justify further investigations to determine the efficacy and safety of cannabis specifically for GD1 patients. Although randomized controlled trials would be optimal, well-designed observational GD registry studies may be a more practical approach. Although some patients may be reluctant to talk openly with their doctors about cannabis, they should routinely be queried about such use by primary care physicians and GD specialists who, in turn, must be able to provide informed guidance on safety, dosage, and potential interactions with other medications the patient is using.

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What proportion of cannabis users in Germany have spoken with their general practitioner about their consumption? A repeated cross-sectional representative population survey

Borchardt,

Klosterhalfen,

Kotz

2024

Preprint

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Introduction: On 1st of April 2024 a law on cannabis legislation entered into force in Germany. Henceforth, a rise in cannabis consumption rates and consequently cannabis related health impacts is expected. Preventive measures are only possible if harmful use is recognised and addressed at an early stage. We set up to estimate the proportion of cannabis users in Germany that discussed their cannabis consumption with their general practitioner (GP), either on the initiative of the GP or the patient, and how these varied according to person characteristics. Methods We used data from the German Study on Tobacco Use (DEBRA). This is a repeated ongoing representative cross-sectional household survey on use of tobacco and alternative nicotine delivery systems in Germany in people aged 14 years and older. During bimonthly study waves we asked all respondents who stated that they had consumed cannabis before whether they had ever spoken with their GP about their cannabis use or received advice about it. We estimated the proportion including 95% confidence intervals and assessed possible associations with person characteristics by using univariate logistic regression models. Results Of 2,057 ever users of cannabis, 7.0% [95%CI = 5.9; 8.2%] (n = 139) answered “Yes, I have ever spoken to my general practitioner about my cannabis use or sought advice in this regard”. This response was associated with older age (65+), low educational attainment, low income, and frequent cannabis use. Conversation with a GP was also more common in past-year cannabis users (16.2% [95%CI = 13.5; 19.6%], n = 591). Conclusions Around one in fifteen cannabis users has ever spoken with his or her GP, or received advice, about his or her cannabis consumption. In past-year and frequent users, the proportions are highest, between 16 to 26%. The awareness of this topic among GPs needs to be increased. Furthermore, a future re-evaluation on what impact the legislation of cannabis will have on the frequency of consultation about cannabis consumption in primary care is necessary.

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Cannabis Use Reported by Patients Receiving Primary Care in a Large Health System

Cited by 4 publications

References 44 publications

Self-Medication Paths

Self-Medication Paths

Exploratory survey study on adjunctive use of medical cannabis for Gaucher disease

What proportion of cannabis users in Germany have spoken with their general practitioner about their consumption? A repeated cross-sectional representative population survey

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