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Cannabis use prevalence, patterns, and reasons for use among patients with cancer and survivors in a state without legal cannabis access

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Abstract

Purpose

Cannabis use among patients with cancer is common, yet data are limited regarding use patterns, reasons for use, and degree of benefit, which represents an unmet need in cancer care delivery. This need is salient in states without legal cannabis programs, where perceptions and behavior among providers and patients may be affected.

Methods

A cross-sectional survey of patients with cancer and survivors at the Hollings Cancer Center at the Medical University of South Carolina (no legal cannabis marketplace in SC) was completed as part of the NCI Cannabis Supplement. Patients (ages 18 +) were recruited using probability sampling from patient lists (N = 7749 sampled; N = 1036 completers). Weight-adjusted Chi-square tests compared demographics and cancer details among patients using cannabis since diagnosis versus those not using cannabis, while weighted descriptives are presented for cannabis use prevalence, consumption, symptom management, and legalization beliefs.

Results

Weighted prevalence of cannabis use since diagnosis was 26%, while current cannabis use was 15%. The most common reasons for cannabis use after diagnosis were difficulty sleeping (50%), pain (46%), and mood changes and stress, anxiety, or depression (45%). Symptom improvement was endorsed for pain (57%), stress/anxiety/depression (64%), difficulty sleeping (64%), and loss of appetite (40%).

Conclusions

Among patients with cancer and survivors at a NCI-designated cancer center within SC, a state without legal access to medical cannabis, prevalence rates, and reasons for cannabis use are consistent with emerging literature in oncology populations. These findings have implications for care delivery, and work is needed to inform recommendations for providers and patients.

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Data Availability

The final dataset will be made available to qualified requestors in accordance with NIH Data Sharing Policies and with an executed data use agreeement between MUSC and the requestor. Requests for de-identified data access should be made directly to the corresponding author (Dr. Erin McClure).

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Acknowledgements

The authors would like to thank the research staff at the Medical University of South Carolina, Addiction Sciences Division, including Benjamin Laprise, Isabeau Burnett, Kemi Chukwuka-White, Emma Mandel, Patrick Cato, and Elizabeth Bradley. We thank ICF for providing technical support to the supplement grantees, including advising on sampling plans and computing survey weights, and in collaboration with NCI, developing a core set of survey questions. Finally, we would like to thank the patients at the Hollings Cancer Center at MUSC for their participation in this survey and sharing their experiences with the research team.

Funding

This research was funded by an administrative supplement to the Hollings Cancer Center at the Medical University of South Carolina (P30 CA138313, PI Dubois, Supplement PI, McClure) from the National Cancer Institute (NCI), NIH, DHHS. Additional funding and support came from the National Center for Advancing Translational Sciences (NCATS UL1TR001450, PI Brady), NIDA K24DA038240 (McRae-Clark), K23 DA045766 (Dahne), the National Institute on Alcohol Abuse and Alcoholism (T32AA007474; PI: Woodward), and in part by the Biostatistics Shared Resource, Hollings Cancer Center, Medical University of South Carolina (P30 CA138313).

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA

    Erin A. McClure, Kyle J. Walters, Rachel L. Tomko, Jennifer Dahne & Aimee L. McRae-Clark

  2. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA

    Erin A. McClure, Jennifer Dahne & Elizabeth G. Hill

  3. Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA

    Elizabeth G. Hill

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Contributions

EM, RT, JD, and AMC were involved in the conception and design of this study. EM and KW drafted the original manuscript. KW, RT, and EH provided statistical guidance and conducted data analyses. All authors were involved in the interpretation of results, as well as writing and editing the manuscript and all approve the final version of this manuscript.

Corresponding author

Correspondence to Erin A. McClure.

Ethics declarations

Ethical approval

All study procedures were approved by the Institutional Review Board (IRB) at the Medical University of South Carolina (MUSC). All procedures were conducted in accordance with the Declaration of Helsinki.

Competing interests

Rachel Tomko provided consultation to the American Society of Addiction Medicine. No other authors have conflicts of interest to disclose.

Conflict of interest

Rachel Tomko provided consultation to the American Society of Addiction Medicine. Other authors declare no competing interests.

Disclosures

The contents of this manuscript are the sole responsibility of the authors and do not necessarily represent the official views of the NCI.

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McClure, E.A., Walters, K.J., Tomko, R.L. et al. Cannabis use prevalence, patterns, and reasons for use among patients with cancer and survivors in a state without legal cannabis access. Support Care Cancer 31, 429 (2023). https://doi.org/10.1007/s00520-023-07881-6

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