Medical Cannabis Is Poorly Integrated Into Rheumatic Disease Care

About one-fifth of US and one-third of Canadian participants reported seeking guidance from their health care providers on medical cannabis use.

Medical cannabis is poorly integrated into rheumatic disease care, despite being widely available, according to study results published in the ACR Open Rheumatology.

Investigators designed an online survey to characterize attitudes towards medical cannabis, medical cannabis use and associated behaviors, and patient interactions with health care providers regarding cannabis among individuals self-reporting a rheumatic condition in the United States (US) and Canada.

The 3406 participants included in the study were aged at least 18 years, resided in the US or Canada, were fluent in English or French, and reported being diagnosed with a rheumatic condition. The majority of study participants identified as White (84.4% in the US and 90.7% in Canada) and were women (88.4% in the US and 79.6% in Canada). The mean ages of participants from the US and Canada were 59.6 and 64.8 years, respectively.

Participants from both countries most commonly reported using medical cannabis due to inadequate relief from medications (US, 65.7%; Canada, 58.7%). Participants from the US were less likely to obtain a medical cannabis license, disclose use to their health care providers, and seek advice on how to use cannabis (all P <.001).

Our results suggest that medical cannabis legality may lower barriers to patient-physician communication about medical cannabis use, but that considerable education and clear clinical policy guidance is needed to appropriately integrate medical cannabis into health care in both the US and Canada.

Despite these participant differences, physicians from both countries reported similar comfort levels and knowledge regarding the use of medical cannabis. However, participants from Canada reported higher levels of physician guidance on medical cannabis dosing, route of administration, and product contents, while US participants reported receiving more guidance on general safety and interactions with other medications.

Participants from the US vs Canada were more likely to use delta-9-tetrahydrocannabinol-dominant products and to report using cannabis through smoking (16.4% vs 11.0%), vaporizing (14.9% vs 9.2%), consuming edibles (29.9% vs 19.9%), and using topical applications (15.7% vs 11.6%). In contrast, participants from Canada vs the US were more likely to use cannabis through tinctures and oils (45.4% vs 22.1%).

Medical cannabis users from the US were also more likely to rely on personal experiences, reviews, and recommendations from peers when purchasing cannabis rather than considering recommendations from health care professionals.

Participants from the US were more likely to disclose medical cannabis use to their physician if it was legal in their place of residence (odds ratio [OR], 2.49; 95% CI, 1.49-4.16; P <.001) and if they reported lower physical health outcome scores (OR, 0.96; 95% CI, 0.92-0.99; P =.02).

Study limitations included reduced generalizability and demographic and clinical differences between the US and Canadian study populations. Additionally, participant communication with health care providers, participant medical cannabis use patterns, and rheumatic disease diagnoses could not be verified.

The study authors concluded, “Our results suggest that [medical cannabis] legality may lower barriers to patient-physician communication about [medical cannabis] use, but that considerable education and clear clinical policy guidance is needed to appropriately integrate [medical cannabis] into health care in both the US and Canada.”

This article originally appeared on Rheumatology Advisor


Boehnke KF, Martel MO, Smith T, et al. Medicinal cannabis use for rheumatic conditions in the US versus Canada: rationale for use and patient-health care provider interactionsACR Open Rheumatol. Published online July 31, 2023. doi:10.1002/acr2.11592