B0403 - Survey on Medical Marijuana Use in IBD Patients in Oklahoma Before and After Legalization

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

Mahum Nadeem, MD

University of Oklahoma Health Sciences Center
Oklahoma City, OK

Mahum Nadeem, MD, Andrea Fernandez, MD, Evgeny Idrisov, MD, Ijlal Ali, MD, Mohammad Madhoun, MD, MS, Hussein Bitar, MD
University of Oklahoma Health Sciences Center, Oklahoma City, OK

Introduction: There is an increasing interest among patients and providers in the use of cannabis and its derivatives to treat several chronic illnesses, including Inflammatory Bowel Disease (IBD) and its symptoms. In this study, we aimed to evaluate the prevalence and patterns of cannabis use for IBD in the state of Oklahoma. In addition, we examined patient’s experiences and attitudes towards cannabis since its legalization in 2018.

Methods: An anonymous cross-sectional survey was conducted, evaluating current and previous cannabis use in adult patients with confirmed diagnosis of Crohn’s Disease (CD) and Ulcerative Colitis (UC) who were followed at the University of Oklahoma Gastroenterology Clinics. Data was captured between August 1, 2021 and March 4, 2022.

Results: A total of 49 patients were included in the final analysis. Among those, 30 patients (61.2 %) reported history of cannabis use. Nonwhite patients (89.5% vs 72.4%, p=0.16), patients from a lower socioeconomic status (79.3% vs 57.9%, p=0.11) and patients with a history of psychiatric disorder, most commonly anxiety, (46.7% vs 21.1%, p=0.07) were more likely to report cannabis use. Nearly 48% (12/25) reported cannabis use daily. About half the patients (53.6%, 14/26) obtained cannabis from medical dispensaries. Cannabis was used for relief of IBD symptoms in 46.4 % (13/28) and 63.6% (14/22) reported at least some relief of their symptoms, especially abdominal pain. When asked how legalization affected their use of cannabis, 44% (11/25) reported no change in the amount used and 24% (6/25) reported increased use. Hyperemesis (24.0%, 6/25) and anxiety (12.0%, 3/25) were the most commonly reported side effects among users.

Discussion: Our study assessing cannabis use for IBD is the first of its kind in the state of Oklahoma. It shows that cannabis use is common among patients with IBD and many patients perceive medical benefit for IBD related symptoms. It also highlights the persistent social, religious and cultural stigma associated with cannabis use. Further studies are needed to validate these perceived benefits of medical cannabis use in patients with IBD and assess its safety profile.

	Reported history of marijuana use (n=30)	No reported history of marijuana use (n=19)	P-value
Age, mean ± SD	48.2±38	49.2±20.1	0.92
Female Sex, n (%)	18/29 (62.2)	13/19 (68.4)	0.65
White race, n (%)	21/29 (72.4)	17/19 (89.5)	0.16
High school degree, n (%)	22/29 (75.9)	14/19 (73.7)	0.71
Unemployed or Income < 30K/yr, n(%)	23/29 (79.3)	11/19 (57.9)	0.11
History of psychiatric illnesses, n (%)	14/30 (46.7)	4/19 (21.1)	0.07
Smoking history, n (%)	7/28 (25.0)	4/17 (23.5)	0.91
Alcohol, n (%)	20/30 (66.7)	10/19 (52.6)	0.33
Illicit drug, n (%)	1/30 (3.3)	0/19 (0)	0.42
IBD diagnosis			0.89
UC, n (%)	10/30(33.3)	6/19 (31.6)
Crohn's, n(%)	18/30 (60.0)	11/19 (57.9)
Non-specificed n (%)	2/30 (6.7)	2/19 (10.5)
Duration of IBD			0.21
< 5 years	10/30 (33.3)	9/19 (47.4)
5-10 years	10/30 (33.3)	2/19 (10.5)
> 10 years	5/30 (16.7)	2/19 (10.5)
> 15 years	4/30 (13.3)	6/19 (31.6)
Extra intestinal manifestation, n (%)	22/30 (73.3)	15/17 (88.2)	0.23
Hx of resection, n (%)	4/29 (13.0)	6/19 (31.6)	0.23
IBD activity			0.41
Clinical remission, n (%)	6/29 (20.7)	6/18 (33.3)
Mild, n (%)	12/29 (41.4)	6/18 (33.3)
Moderate, n (%)	8/29 (27.6)	6/18 (33.3)
Severe, n (%)	3/29 (10.3)	0/18 (0)
IBD hospitalizations			0.64
1-2, n (%)	17/30 (56.7)	11/17 (64.7)
3-4, n (%)	1/30 (3.3)	0/17 (0)
4-5, n (%)	1/30 (3.3)	0/17 (0)
5-6, n (%)	2/30 (6.7)	0/17 (0)
No hospitalizations, n (%)	9/30 (30.0)	6/17 (35.3)
Stool frequency			0.45
Normal, n (%)	11/30 (36.7)	7/19 (36.8)
1-2/day, n (%)	9/30 (30.0)	3/19 (15.8)
2-5/day, n (%)	7/30 (23.3)	8/19 (42.1)
5/day, n (%)	3/30 (10.0)	1/19 (5.3)
Abdominal pain			0.63
< 1/week, n (%)	10/30 (33.3)	4/19 (21.1)
2-3 times/week, n (%)	7/30 (23.3)	4/19 (21.1)
Daily, n (%)	9/30 (30.0)	6/19 (31.6)
Never, n (%)	4/30 (13.3)	5/19 (26.3)
Appetite			0.42
Normal, n (%)	17/30 (56.7)	11/19 (57.9)
Reduced, n (%)	13/30 (43.3)	7/19 (36.8)
Increased, n (%)	0/30 (0)	1/19 (5.3)
Weight loss			0.83
> 5 pounds, n (%)	7/30 (23.3)	3/19 (15.8)
< 5 pounds, n (%)	3/30 (10.0)	2/19 (5.3)
No weight loss, n (%)	15/30 (50.0)	11/19 (57.9)
Subjective weight loss, n (%)	5/30 (16.7)	4/19 (21.1)

Table: Demographic, socioeconomic, IBD characteristics grouped by history of cannabis use.

Disclosures:

Mahum Nadeem indicated no relevant financial relationships.

Andrea Fernandez indicated no relevant financial relationships.

Evgeny Idrisov indicated no relevant financial relationships.

Ijlal Ali indicated no relevant financial relationships.

Mohammad Madhoun indicated no relevant financial relationships.

Hussein Bitar indicated no relevant financial relationships.

Mahum Nadeem, MD, Andrea Fernandez, MD, Evgeny Idrisov, MD, Ijlal Ali, MD, Mohammad Madhoun, MD, MS, Hussein Bitar, MD. B0403 - Survey on Medical Marijuana Use in IBD Patients in Oklahoma Before and After Legalization, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.