About 90 million US adults have tried CBD, and one-third of users have taken it as a substitute or supplement to conventional medications — most commonly replacing over-the-counter pain relievers.
CBD consumers, physicians and pharmacists advising patients, public health officials, and CBD industry stakeholders
What the researchers found
35.2% of US adults (~90.8 million) have tried CBD; among users, 32% used it as a substitute or adjunct for medications, with adjunct use (24.2%) more common than substitution (11.0%); most commonly for pain, psychiatric conditions, and replacing ibuprofen/Tylenol.
Why it matters
Millions of Americans are making medication decisions involving CBD without adequate evidence or clinical guidance — this quantifies a major public health knowledge gap.
The numbers in context
35.2% ever used CBD (~90.8M); 21.8% used in past 12 months; 32% used as substitute/adjunct; most replaced: ibuprofen (4.8%), Tylenol (3.9%); only 2.4% reported CBD-related health problems.
How the study worked
Nationally representative cross-sectional survey via Ipsos KnowledgePanel of 2,880 US adults (1,523 qualifying, including 1,008 CBD ever-users), weighted for national estimates, with medications coded using MedDRA and RxNav.
What this study cannot tell us
Self-reported data with potential recall bias; survey doesn't capture CBD dose, product type, or quality; cannot assess whether substitution improved or worsened outcomes.
How to read the evidence
Nationally representative probability-based survey with validated medication coding, providing reliable prevalence estimates despite self-report limitations.
When this study was published
Published in 2026 with October-November 2023 survey data, reflecting current CBD consumer behavior.
The bigger picture
The scale of self-directed CBD-medication substitution reveals a disconnect between consumer behavior and clinical evidence — people are making treatment decisions in an evidence vacuum.
Questions still open
- Is CBD an effective substitute for OTC pain relievers? Are people who substitute CBD for medications achieving adequate symptom control? What clinical guidance framework is needed?
Common questions
How many Americans use CBD?
Are people replacing their medications with CBD?
Read the original research
Self-reported use of cannabidiol as a substitute or adjunct for approved medications.
Frontiers in public health, 14, 1720348
Citation
Austin, Emily A C; Berghammer, Lara; Ellis, Shannon E; Appolon, Giovanni; Brooks, Jenna; Rice, Nina M; Land, Prosperity; Ping, Siyuan; Satybaldiyeva, Nora; Grant, Igor; Leas, Eric C. (2026). Self-reported use of cannabidiol as a substitute or adjunct for approved medications.. Frontiers in public health, 14, 1720348. https://doi.org/10.3389/fpubh.2026.1720348
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