70% of people with spinal cord or brain injuries used cannabis before injury, and about half continued after
A Colorado survey of 116 adults with spinal cord injury or traumatic brain injury found 70% used cannabis before their injury and 48% after, with top reasons being recreation, stress/anxiety reduction, and sleep improvement.
Quick Facts
What This Study Found
Researchers surveyed 116 Colorado adults who had sustained spinal cord injury (SCI) or moderate to severe traumatic brain injury (TBI), combining focus group data with a telephone survey.
70% reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI).
Reasons for use differed between groups. Among SCI respondents, the top reasons were reducing spasticity (70%), recreation (63%), and improving sleep (63%). Among TBI respondents, the top reasons were recreational (72%), reducing stress/anxiety (62%), and improving sleep (55%).
Overall, the most common reasons across both groups were recreational (67%), reducing stress/anxiety (62.5%), and improving sleep (59%). Smoking was the most common method of use.
Key Numbers
116 participants (SCI and TBI). Pre-injury use: 70% (67% SCI, 74% TBI). Post-injury use: 48% (53% SCI, 45% TBI). Top SCI reasons: spasticity 70%, recreation 63%, sleep 63%. Top TBI reasons: recreation 72%, stress/anxiety 62%, sleep 55%.
How They Did This
Mixed-methods observational study. Focus groups identified key issues, which informed telephone survey development. 116 Colorado adults with SCI or moderate-to-severe TBI from Craig Hospital participated.
Why This Research Matters
Cannabis use is highly prevalent in SCI and TBI populations, yet most rehabilitation clinicians have limited data on how these patients use cannabis and why. The finding that many continue using post-injury, particularly for symptom management, has implications for rehabilitation care planning and drug interaction awareness.
The Bigger Picture
The high rate of pre-injury cannabis use in this population raises questions about whether cannabis use contributes to injury risk, while the shift from recreational to symptom-management use post-injury suggests cannabis may fill gaps in standard medical treatment for these conditions.
What This Study Doesn't Tell Us
Single-site (Colorado, where cannabis is legal) limits generalizability. Self-reported data subject to bias. Convenience sample from one rehabilitation hospital. No comparison to non-cannabis-using patients on outcomes. Small sample size limits subgroup analyses.
Questions This Raises
- ?Does cannabis use affect recovery outcomes after SCI or TBI?
- ?Do SCI patients who use cannabis for spasticity have different outcomes than those using standard medications?
- ?Should rehabilitation programs systematically screen for and address cannabis use?
Trust & Context
- Key Stat:
- 70% used cannabis pre-injury; 48% continued post-injury
- Evidence Grade:
- Small cross-sectional survey from a single site provides preliminary evidence on cannabis use patterns in SCI/TBI populations.
- Study Age:
- Published in 2018. Cannabis has been legal in Colorado since 2012, which may influence higher use rates compared to other states.
- Original Title:
- Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.
- Published In:
- Archives of physical medicine and rehabilitation, 99(8), 1584-1590 (2018)
- Database ID:
- RTHC-01679
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why do people with spinal cord injuries use cannabis?
The top reason was reducing spasticity (70%), followed by recreation (63%) and improving sleep (63%). Spasticity is a common and often undertreated symptom after SCI.
Do fewer people use cannabis after their injury?
Yes. Pre-injury use was 70% but dropped to 48% after injury. This decrease may reflect changes in access, medical advice, or shifting priorities during rehabilitation.
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Cite This Study
https://rethinkthc.com/research/RTHC-01679APA
Hawley, Lenore A; Ketchum, Jessica M; Morey, Clare; Collins, Kathleen; Charlifue, Susan. (2018). Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.. Archives of physical medicine and rehabilitation, 99(8), 1584-1590. https://doi.org/10.1016/j.apmr.2018.02.003
MLA
Hawley, Lenore A, et al. "Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.." Archives of physical medicine and rehabilitation, 2018. https://doi.org/10.1016/j.apmr.2018.02.003
RethinkTHC
RethinkTHC Research Database. "Cannabis Use in Individuals With Spinal Cord Injury or Moder..." RTHC-01679. Retrieved from https://rethinkthc.com/research/hawley-2018-cannabis-use-in-individuals
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.