A Comparative Analysis of the Frequency and Motivations for Cannabis Use in College Students With & Without an Autoimmune Disease
Main Article Content
Abstract
The therapeutic effects of cannabis and its derivatives have been well established for a narrow number of conditions, including syndrome-related seizures, cancer-related nausea, and AIDS-related anorexia. Research progress in the United States has been slowed by restrictions related to cannabis’ status as a highly controlled substance. Despite the sluggish pace of empirical research, there is a high level of interest among both scientists and patients regarding cannabis’ possible efficacy for a much wider range of diseases and conditions. Studies indicate that many people are self-medicating with cannabis for both physical and psychological ailments. New evidence suggests that cannabinoids may be beneficial to those who have an autoimmune disease; this may be due to cannabis’ modulatory effects on the immune system. The current study, in an attempt to determine if college students with autoimmune diseases are self-medicating their symptoms with cannabis, surveyed students (5.8% of whom reported a diagnosed autoimmune disease) about their frequency, route of administration, and motivations for cannabis use. Independent samples t-tests and chi-squared tests revealed that while those with an autoimmune disease were significantly more likely to report having used cannabis in the past 30 days than their peers without an autoimmune disease, the frequency of use in the past 30 days did not differ. Participants with autoimmune disease were significantly more likely to endorse therapeutic motives for cannabis consumption, including pain and nausea control and to improve sleep and appetite. This study is one of the first to investigate self-medication motives for cannabis use in young adults with an autoimmune disease. Potential mechanisms, as well as benefits and drawbacks of cannabis use as medicine in this population are discussed.
Article Details
How to Cite
MILLIN, Paula M.; KLACE, Flynn; KRIEG, Dana Balsink.
A Comparative Analysis of the Frequency and Motivations for Cannabis Use in College Students With & Without an Autoimmune Disease.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4674>. Date accessed: 09 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4674.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022; 20: 259. https://doi.org/10.1186/s12916-022-02459-1
2. FDA and Cannabis: Research and Drug Approval Process. US Food & Drug Administration. Updated February 2023. Accessed September 2023. https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
3. Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry. 2020; 19(2):179-186. doi: 10.1002/wps.20735.
4. Jacobs, P. Researchers applaud health officials’ push to ease cannabis restrictions. Science. September 2023. Accessed September 2023. doi: 10.1126/science.adk6391. https://www.science.org/content/article/researchers-applaud-hhs-push-ease-cannabis-restrictions#:~:text=A%202022%20law%20increased%20access,Rescheduling%20would%20streamline%20the%20process.
5. Autoimmune Diseases. National Institute of Health National Institute of Environmental Health Science. May 2022. Accessed September 2023. https://www.niehs.nih.gov/health/topics/conditions/autoimmune/index.cfm#:~:text=A%20healthy%20immune%20system%20defends,and%20even%20turning%20life%2Dthreatening.
6. Conrad N. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet. 2022;400(10354):733-743. doi: 10.1016/S0140-6736(22)01349-6.
7. Lerner A, Jeremias P, Matthias T. (2016). The world incidence and prevalence of autoimmune diseases is increasing. Int. J. Celiac Dis. 2016;3(4):151–155. https://doi.org/10.12691/ijcd-3-4-8
8. Mayer M. Autoimmunity on the rise. Global Autoimmune Institute. August 2022. Accessed September 2023. https://www.autoimmuneinstitute.org/articles/about-autoimmune/autoimmunity-on-the-rise/
9. Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi: 10.1038/s41591-019-0675-0.
10. Mifflin KA, Kerr BJ. Pain in autoimmune disorders. J Neurosci Res. 2016; 95(6): 1282-1294. https://doi.org/10.1002/jnr.23844
11. Pisetsky D. Pathogenesis of autoimmune disease. Nat Rev Neph. 2013;19:| 509-524. https://doi.org/10.1038/s41581-023-00720-1
12. Orbai A. What are common symptoms of autoimmune disease? Johns Hopkins. 2023. Accessed September 2023). https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease
13. Khan, MF, Wang, H. Environmental exposures and autoimmune diseases: contribution of gut microbiome. Front Immunol. 2020.;10. https://doi.org/10.3389/fimmu.2019.03094
14. Mehta D. The genetic double whammy – autoimmune and mental health disorders. Brain Behav Immun. 2020;89,7-8. https://doi.org/10.1016/j.bbi.2020.08.014
15. Parry W. The immunotherapy revolution for autoimmune diseases. Penn Medicine News. August 12 2023. Accessed September 2023. https://www.pennmedicine.org/news/publications-and-special-projects/penn-medicine-magazine/immune-health/the-immunotherapy-revolution-for-autoimmune-diseases
16. Rosenblum MD, Gratz IK, Paw JS, & Abbas AK. Treating human autoimmunity: current practice and future prospects. Sci Transl Med. 2012;4(125). https://doi.org/10.1126/scitranslmed.3003504
17. Immunosuppressive medication for the treatment of autoimmune disease. American Academy of Allergy Asthma & Immunology. September 28, 2020. Accessed May 2, 2023.https://www.aaaai.org/Conditions-Treatments/Related-Conditions/immunosuppressive
18. Brune K, Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015;105. https://doi.org/10.2147/jpr.s75160
19. Marcum ZA, Hanlon JT. Recognizing the risks of chronic nonsteroidal anti-inflammatory drug use in older adults. Ann Longterm Care. 2010;18(9):24-27. PMID: 21857795; PMCID: PMC3158445.
20. Mercadante S, Arcuri E, Santoni A. Opioid-induced tolerance and hyperalgesia. CNS Drugs. 2019;33(10):943-955. doi: 10.1007/s40263-019-00660-0.
21. Jensen B, Chen J, Furnish T, Wallace M. Medical marijuana and chronic pain: a review of basic science and clinical evidence. Curr Pain and Headache Rep. 2015;19(10). https://doi.org/10.1007/s11916-015-0524-x
22. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022;20,259. https://doi.org/10.1186/s12916-022-02459-1
23. Bicket MC, Stone EM, McGinty EE. Use of cannabis and other pain treatments among adults with chronic pain in US states with medical cannabis programs. JAMA Netw Open. 2023;6(1):e2249797. doi:10.1001/jamanetworkopen.2022.49797
24. Wallis D, Coatsworth JD, Mennis J, et al. Predicting self-medication with cannabis in young adults with hazardous cannabis use. Int J Environ Res Public Health. 2022;19(3):1850. doi: 10.3390/ijerph19031850.
25. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and nonpsychoactive cannabinoids: their chemistry and role against oxidative stress, inflammation, and cancer. BioMed research international, 2018, 1691428. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/
26. Katchan V, David P, Shoenfeld Y. Cannabinoids and autoimmune diseases: a systematic review. Autoimmun Rev. 2016;15(6), 513-528. doi:10.1016/J.AUTREV.2016.02.008
27. Okafor CN, Li M, Paltzer J. Self-reported cannabis use and biomarkers of inflammation among adults in the United States. BBI-Health. 2020;7,100-109. https://www.sciencedirect.com/science/article/pii/S2666354620300740
28. Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-49. doi:10.4155/fmc.09.93. PMID: 20191092; PMCID: PMC2828614.
29. Anil SM, Peeri H, Koltai H. Medical Cannabis activity against inflammation: active compounds and modes of action. Front Pharmacol. 2022 May 9;13:908198. doi: 10.3389/fphar.2022.908198. PMID: 35614947; PMCID: PMC9124761.
30. Marijuana shows potential in treating autoimmune disease. University of South Carolina. ScienceDaily. 2014. Retrieved November 29, 2022 www.sciencedaily.com/releases/2014/06/140602150914.htm
31. Kozela E, Juknat A, Gao F, Kaushansky N, Coppola G, Vogel Z. Pathways and gene networks mediating the regulatory effects of Cannabidiol, a nonpsychoactive cannabinoid, in autoimmune T cells. Journal of Neuroinflammation. 2016;13(1). https://doi.org/10.1186/s12974-016-0603-x
32. Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Substance Abuse and Mental Health Services Administration. 2022. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
33. Smith DA, Germolec DR. Introduction to immunology and autoimmunity. Environ Health Perspect. 1999;107,661. https://doi.org/10.2307/3434323
34. Brogan PA, Dillon MJ. Autoimmune diseases in children. Curr Paediat. 2005;15(1), 23–31. https://doi.org/10.1016/j.cupe.2004.10.011
35. Wang L, Wang FS, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Internal Med. 2015; 278(4),369-395. https://doi.org/10.1111/joim.12395
36. Feingold D, Brill S, Goor-Aryeh I, Delayahu Y, Lev-Ran S. Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana. Journal of Affective Disorders. 2017;218, 1–7. https://doi.org/10.1016/j.jad.2017.04.026
37. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27. doi: 10.1056/NEJMra1402309.
38. Pryce CR, Fontana A. Depression in autoimmune diseases. Inflammation-Associated Depression: Evidence, Mechanisms and Implications. 2016;139–154. https://doi.org/10.1007/7854_2016_7
39. Kelley KW, Dantzer R. Alcoholism and inflammation: Neuroimmunology of behavioral and mood disorders. Brain, Behav, Immun. 2011;25. https://doi.org/10.1016/j.bbi.2010.12.013
2. FDA and Cannabis: Research and Drug Approval Process. US Food & Drug Administration. Updated February 2023. Accessed September 2023. https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
3. Hall W, Lynskey M. Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World Psychiatry. 2020; 19(2):179-186. doi: 10.1002/wps.20735.
4. Jacobs, P. Researchers applaud health officials’ push to ease cannabis restrictions. Science. September 2023. Accessed September 2023. doi: 10.1126/science.adk6391. https://www.science.org/content/article/researchers-applaud-hhs-push-ease-cannabis-restrictions#:~:text=A%202022%20law%20increased%20access,Rescheduling%20would%20streamline%20the%20process.
5. Autoimmune Diseases. National Institute of Health National Institute of Environmental Health Science. May 2022. Accessed September 2023. https://www.niehs.nih.gov/health/topics/conditions/autoimmune/index.cfm#:~:text=A%20healthy%20immune%20system%20defends,and%20even%20turning%20life%2Dthreatening.
6. Conrad N. Autoimmune diseases and cardiovascular risk: a population-based study on 19 autoimmune diseases and 12 cardiovascular diseases in 22 million individuals in the UK. Lancet. 2022;400(10354):733-743. doi: 10.1016/S0140-6736(22)01349-6.
7. Lerner A, Jeremias P, Matthias T. (2016). The world incidence and prevalence of autoimmune diseases is increasing. Int. J. Celiac Dis. 2016;3(4):151–155. https://doi.org/10.12691/ijcd-3-4-8
8. Mayer M. Autoimmunity on the rise. Global Autoimmune Institute. August 2022. Accessed September 2023. https://www.autoimmuneinstitute.org/articles/about-autoimmune/autoimmunity-on-the-rise/
9. Furman D, Campisi J, Verdin E, et al. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019;25(12):1822-1832. doi: 10.1038/s41591-019-0675-0.
10. Mifflin KA, Kerr BJ. Pain in autoimmune disorders. J Neurosci Res. 2016; 95(6): 1282-1294. https://doi.org/10.1002/jnr.23844
11. Pisetsky D. Pathogenesis of autoimmune disease. Nat Rev Neph. 2013;19:| 509-524. https://doi.org/10.1038/s41581-023-00720-1
12. Orbai A. What are common symptoms of autoimmune disease? Johns Hopkins. 2023. Accessed September 2023). https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease
13. Khan, MF, Wang, H. Environmental exposures and autoimmune diseases: contribution of gut microbiome. Front Immunol. 2020.;10. https://doi.org/10.3389/fimmu.2019.03094
14. Mehta D. The genetic double whammy – autoimmune and mental health disorders. Brain Behav Immun. 2020;89,7-8. https://doi.org/10.1016/j.bbi.2020.08.014
15. Parry W. The immunotherapy revolution for autoimmune diseases. Penn Medicine News. August 12 2023. Accessed September 2023. https://www.pennmedicine.org/news/publications-and-special-projects/penn-medicine-magazine/immune-health/the-immunotherapy-revolution-for-autoimmune-diseases
16. Rosenblum MD, Gratz IK, Paw JS, & Abbas AK. Treating human autoimmunity: current practice and future prospects. Sci Transl Med. 2012;4(125). https://doi.org/10.1126/scitranslmed.3003504
17. Immunosuppressive medication for the treatment of autoimmune disease. American Academy of Allergy Asthma & Immunology. September 28, 2020. Accessed May 2, 2023.https://www.aaaai.org/Conditions-Treatments/Related-Conditions/immunosuppressive
18. Brune K, Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res. 2015;105. https://doi.org/10.2147/jpr.s75160
19. Marcum ZA, Hanlon JT. Recognizing the risks of chronic nonsteroidal anti-inflammatory drug use in older adults. Ann Longterm Care. 2010;18(9):24-27. PMID: 21857795; PMCID: PMC3158445.
20. Mercadante S, Arcuri E, Santoni A. Opioid-induced tolerance and hyperalgesia. CNS Drugs. 2019;33(10):943-955. doi: 10.1007/s40263-019-00660-0.
21. Jensen B, Chen J, Furnish T, Wallace M. Medical marijuana and chronic pain: a review of basic science and clinical evidence. Curr Pain and Headache Rep. 2015;19(10). https://doi.org/10.1007/s11916-015-0524-x
22. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022;20,259. https://doi.org/10.1186/s12916-022-02459-1
23. Bicket MC, Stone EM, McGinty EE. Use of cannabis and other pain treatments among adults with chronic pain in US states with medical cannabis programs. JAMA Netw Open. 2023;6(1):e2249797. doi:10.1001/jamanetworkopen.2022.49797
24. Wallis D, Coatsworth JD, Mennis J, et al. Predicting self-medication with cannabis in young adults with hazardous cannabis use. Int J Environ Res Public Health. 2022;19(3):1850. doi: 10.3390/ijerph19031850.
25. Pellati F, Borgonetti V, Brighenti V, Biagi M, Benvenuti S, Corsi L. Cannabis sativa L. and nonpsychoactive cannabinoids: their chemistry and role against oxidative stress, inflammation, and cancer. BioMed research international, 2018, 1691428. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/
26. Katchan V, David P, Shoenfeld Y. Cannabinoids and autoimmune diseases: a systematic review. Autoimmun Rev. 2016;15(6), 513-528. doi:10.1016/J.AUTREV.2016.02.008
27. Okafor CN, Li M, Paltzer J. Self-reported cannabis use and biomarkers of inflammation among adults in the United States. BBI-Health. 2020;7,100-109. https://www.sciencedirect.com/science/article/pii/S2666354620300740
28. Nagarkatti P, Pandey R, Rieder SA, Hegde VL, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-49. doi:10.4155/fmc.09.93. PMID: 20191092; PMCID: PMC2828614.
29. Anil SM, Peeri H, Koltai H. Medical Cannabis activity against inflammation: active compounds and modes of action. Front Pharmacol. 2022 May 9;13:908198. doi: 10.3389/fphar.2022.908198. PMID: 35614947; PMCID: PMC9124761.
30. Marijuana shows potential in treating autoimmune disease. University of South Carolina. ScienceDaily. 2014. Retrieved November 29, 2022 www.sciencedaily.com/releases/2014/06/140602150914.htm
31. Kozela E, Juknat A, Gao F, Kaushansky N, Coppola G, Vogel Z. Pathways and gene networks mediating the regulatory effects of Cannabidiol, a nonpsychoactive cannabinoid, in autoimmune T cells. Journal of Neuroinflammation. 2016;13(1). https://doi.org/10.1186/s12974-016-0603-x
32. Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health (HHS Publication No. PEP22-07-01-005, NSDUH Series H-57). Substance Abuse and Mental Health Services Administration. 2022. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-annual-national-report
33. Smith DA, Germolec DR. Introduction to immunology and autoimmunity. Environ Health Perspect. 1999;107,661. https://doi.org/10.2307/3434323
34. Brogan PA, Dillon MJ. Autoimmune diseases in children. Curr Paediat. 2005;15(1), 23–31. https://doi.org/10.1016/j.cupe.2004.10.011
35. Wang L, Wang FS, Gershwin ME. Human autoimmune diseases: a comprehensive update. J Internal Med. 2015; 278(4),369-395. https://doi.org/10.1111/joim.12395
36. Feingold D, Brill S, Goor-Aryeh I, Delayahu Y, Lev-Ran S. Depression and anxiety among chronic pain patients receiving prescription opioids and medical marijuana. Journal of Affective Disorders. 2017;218, 1–7. https://doi.org/10.1016/j.jad.2017.04.026
37. Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27. doi: 10.1056/NEJMra1402309.
38. Pryce CR, Fontana A. Depression in autoimmune diseases. Inflammation-Associated Depression: Evidence, Mechanisms and Implications. 2016;139–154. https://doi.org/10.1007/7854_2016_7
39. Kelley KW, Dantzer R. Alcoholism and inflammation: Neuroimmunology of behavioral and mood disorders. Brain, Behav, Immun. 2011;25. https://doi.org/10.1016/j.bbi.2010.12.013