Background/Purpose: Cannabis use has increased substantially in the general population over the past decade, driven by changing legal landscapes and expanding public interest in its therapeutic potential. Among individuals with rheumatic and musculoskeletal diseases (RMDs), pain management remains a persistent challenge, prompting interest in alternative therapies such as cannabis. Our prior work documented a dramatic rise in cannabis use among people with RMDs between 2014 and 2019.1 However, updated recent estimates are lacking, and the clinical landscape has evolved rapidly with changing laws and new formulations available. We aimed to describe trends in cannabis use from 2020 to 2024 among individuals with RMDs, including patterns of THC vs CBD product use, routes of administration, and reasons for use.

Methods: The study population included adults with RMDs in the FORWARD Databank who answered questions related to cannabis use between 2020 and 2024. Participants who reported use of cannabis or cannabis-derived products (hereafter “cannabis”) were categorized by whether the products they used contained THC or not (CBD only) and whether their use was past or current. Descriptive statistics were calculated for characteristics of these subgroups as well as for self-reported reason(s) for cannabis use and route(s) of administration. Temporal trends for cannabis use in general, for THC-containing products, and for use related to arthritic pain were examined.

Results: A total of 6,673 participants were included in the study, 2,969 (44%) of whom reported past or current cannabis use (Table 1). Among users, 1,725 (58%) reported use of a THC-containing cannabis product, while the remainder reported use of CBD-only products (Table 2). Most cannabis users (68%) reported use of cannabis products for the purpose of treating arthritis-related pain, particularly those who reported use of CBD-only products. Ingestion and topical use were the most common routes of administration in general, although smoking was more common among users of THC-containing products. From 2020 to 2024, frequency of cannabis use in this population doubled; “ever” use increased from 32% to 62%, while current use increased from 13% to 26% (Figure 1). Each year, most current users (57-77%) were using THC-containing products.

Conclusion: Cannabis use has increased substantially among individuals with RMDs since 2020. This finding underscores the need for clinician awareness and guidance in this area, as well as the need for an understanding of any therapeutic impact of cannabis use in this population. Ongoing work will explore associations between cannabis use and disease activity, physical function, and patient-reported outcomes, as well as perceived effectiveness of treatment with cannabis products and reasons for discontinuation. 1. Wipfler, K. et al. Arthritis Care & Research 74, 2091–2099 (2022)

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/recent-trends-in-cannabis-use-among-individuals-with-rheumatic-diseases/