US adults with medical conditions like asthma or cancer more likely to smoke weed than those without
While a number of US states legalizing marijuana for medical and recreational purposes, new study throws light on how or why adults with medical conditions use it
Adults with medical conditions in the US are much more likely to use marijuana than those without such conditions, new research has revealed. The trend was observed particularly among those with health conditions such as asthma, chronic obstructive pulmonary disease (COPD), arthritis, cancer, and depression.
The analysis holds across age groups except those aged 65 years or older, with adults who reported any medical condition having higher odds of marijuana use than those who reported no medical conditions: 1.8 times more for adults aged 18-34 years, 1.4 for adults aged 35-54 years, and 1.6 for people 55 years and above. While the number of US states legalizing marijuana for medical and recreational use is increasing, little was known regarding how or why adults with medical conditions use it, till now.
The study was conducted by researchers from the College of Public Health, University of Nebraska Medical Center, Omaha; and the Department of
Population Health, University of Kansas Medical Center, Kansas City.
The study included 169,036 participants, and overall, 53.7% of adults said they had at least one medical condition. Those with medical conditions were more likely than those without medical conditions to report using marijuana for medical reasons only (45.5% versus 21.8%), and less likely to report using marijuana for recreational purposes (36.2% versus 57.7%).
"However, the findings show that most people with medical conditions were using marijuana recreationally - for only non-medical purposes (36.2%) and for both medical and non-medical reasons (18.3%)," says the study published in JAMA Network Open.
The highest prevalence was among young adults aged 18 to 24 years with medical conditions: 25.2% reported using marijuana, which was over 10 times higher than those aged 65 years and older (2.4%). Among those who used marijuana in the 18 to 24 age group for medical reasons, 11.2% reported using it on a daily basis.
"Among those with medical conditions, the prevalence of marijuana use decreased with increasing age, ranging from 25.2% for those aged 18 to 24 years to 2.4% for those aged 65 years or older for current marijuana use; and from 11.2% to 0.9%, respectively, for daily marijuana use," says the study.
The disparities could be due to differences in perceived harm and benefits of marijuana use across age groups, says the study. In earlier studies, for example, researchers have stated that adults - aged 65 years or older - are more likely to view marijuana as very addictive and harmful compared with adults in other age groups, partly because of the stigma in past decades that was associated with marijuana use. However, says the research team, public opinions on marijuana use have been softening, and fewer older adults are reporting disapproval of marijuana use. The increase in public acceptance of marijuana use could lead older adults to start using marijuana for medical conditions.
Most adults who used marijuana either with or without medical conditions reported smoking as their primary method of administration. According to the findings, in 2017, most current marijuana users (77.5) said they primarily smoked marijuana, followed by eating it (9%), vaporizing it (9%), dabbing it (3.1%), other ways (1.1%), and drinking it (0.4%).
"It is of concern that the great majority of current marijuana users with medical conditions consume marijuana by smoking it. Marijuana smoke contains many chemicals found in cigarette smoke (for example, carcinogens, carbon monoxide, tar, and bronchial irritants) and is associated with adverse outcomes on pulmonary function and increased respiratory symptoms," says the team.
The researchers used a "probability sample" of US adults aged 18 years and older from the 2016 and 2017 Behavioral Risk Factor Surveillance System, a survey that collects data from a representative sample of residents across the states regarding health-related risk behaviors, chronic health conditions, and use of preventive services.
The research team examined the associations between marijuana use and 11 chronic health conditions. The analysis shows that adults with respiratory diseases, such as asthma or COPD, reported a higher prevalence of current marijuana use than those without these conditions across all age groups.
The likelihood of reporting use of marijuana for medical purposes increased by the number of medical conditions (36.1%) for one medical condition versus 68.7%.
The reasons for using marijuana also varied by type of medical condition. Among those using marijuana for medical purposes, the prevalence ranged from 64.3% for those with arthritis to 43.7% for those with COPD.
"For instance, adults aged 18 to 34 years with COPD had almost three times higher odds of reporting current marijuana use than their peers without COPD. It is possible that long-term marijuana use was a contributing factor to their comorbid condition. It is also possible that these adults were using marijuana for relief from pain, anxiety, stress, or depression," says the study.
The team also identified a significant variation of marijuana use among adults with medical conditions across select US states and territories, with Alaska having the highest prevalence among those aged 18 to 34 years with medical conditions. This was more than four times higher than that in Guam (38% versus 9%). "The geographic variation in marijuana use could be attributable to the availability of marijuana products associated with legal status as well as variations in perceptions of the risks and benefits of marijuana," the findings state.
According to the research team, in situations where a drug has well-established health benefits, good manufacturing processes, and minimal risks, the reason that a patient takes a drug is immaterial.
"For example, it does not matter that a person with migraine headaches, who also has concerns about aging skin, derives both medical and cosmetic benefits from Botox therapy. Marijuana, however, can vary widely according to the mode of delivery and is associated with several known adverse health outcomes, including increased respiratory symptoms, impaired short-term memory, and increased risk of psychiatric illness and addiction," says the team.
The researchers suggest that it is crucial for healthcare professionals to understand whether patients are using marijuana for medical or recreational purposes, and how patients are consuming their marijuana, to better advise them about possible adverse health outcomes and potential benefits. “Clinicians should screen for marijuana use among patients, understand why and how patients are using marijuana, and work with patients to optimize outcomes and reduce marijuana-associated risks,” they recommend.