Most IBD patients using marijuana reported benefits but also had worse symptoms and mental health than non-users

A survey of 1,666 IBD patients in legal-access states found that only 4.4% used prescription marijuana and 12.8% had asked their doctor about it, while users reported high perceived benefits (80.7%) but also more depression, anxiety, and pain than non-users.

Kerlin, Ann Marie et al.·Digestive diseases and sciences·2018·Moderate EvidenceCross-Sectional
RTHC-01716Cross SectionalModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=1,666

What This Study Found

Researchers surveyed 2,357 inflammatory bowel disease patients living in states where marijuana was legal, with 1,666 (71%) completing the survey.

Only 214 patients (12.8%) had asked their doctor about marijuana use, and just 73 (4.4%) used prescription marijuana.

Among 234 patients living where both medical and recreational marijuana was legal, 49 (20.9%) reported using recreational marijuana specifically for IBD.

Marijuana users reported high perceived benefits (80.7%). However, users also reported more depression, anxiety, pain interference, and lower social satisfaction than non-users.

Patients on prescription marijuana had more active disease and greater use of steroids, narcotics, and the sleep aid zolpidem, suggesting marijuana use was concentrated among those with harder-to-treat disease.

Key Numbers

1,666 respondents (71% response rate). 12.8% asked their doctor about marijuana. 4.4% used prescription marijuana. 20.9% recreational use in dual-legal states. 80.7% of users reported benefits. Users had more depression, anxiety, pain interference, and lower social satisfaction.

How They Did This

Cross-sectional internet-based survey through the CCFA Partners cohort. Surveyed IBD patients in states with legal marijuana access. Bivariate statistics and logistic regression to identify factors associated with marijuana use.

Why This Research Matters

This study reveals a common pattern in medical cannabis use: patients who use it tend to be sicker and more symptomatic, which complicates the interpretation of both perceived benefits and associated harms. The low rate of physician consultation (12.8%) suggests a disconnect between patient cannabis use and clinical care.

The Bigger Picture

The finding that marijuana users perceive benefits while also having worse symptoms likely reflects a selection effect: patients with the most difficult-to-manage IBD are more likely to try cannabis. This does not mean cannabis worsens symptoms, but it does mean the patient population using cannabis has greater disease burden.

What This Study Doesn't Tell Us

Cross-sectional design cannot determine whether cannabis helped, hurt, or had no effect on symptoms. Self-selected internet cohort may not represent all IBD patients. Self-reported cannabis use and perceived benefits are subject to recall and desirability bias.

Questions This Raises

  • ?Would controlled trials show cannabis actually improves IBD symptoms, or do users just perceive benefits due to psychoactive effects?
  • ?Why are so few patients discussing marijuana with their doctors?
  • ?Would physician-guided cannabis use improve outcomes?

Trust & Context

Key Stat:
80.7% of IBD marijuana users reported benefits, but only 12.8% had discussed it with their doctor
Evidence Grade:
Moderate. Large survey through an established IBD cohort, but cross-sectional design and self-report limitations prevent causal conclusions.
Study Age:
Published in 2018. Medical cannabis use among IBD patients has likely increased as legalization has expanded.
Original Title:
Profiles of Patients Who Use Marijuana for Inflammatory Bowel Disease.
Published In:
Digestive diseases and sciences, 63(6), 1600-1604 (2018)
Database ID:
RTHC-01716

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Does marijuana help with inflammatory bowel disease?

In this survey, 80.7% of users reported perceived benefits. However, users also had more symptoms and worse mental health than non-users, suggesting those with harder-to-manage disease are more likely to try cannabis. Controlled trials are needed to determine whether cannabis actually improves IBD outcomes.

Why did so few patients ask their doctor about marijuana?

Only 12.8% of respondents had asked their doctor about marijuana use for IBD. This may reflect stigma, concern about physician judgment, uncertainty about legality, or a belief that conventional medicine has nothing to offer on the topic. This gap between patient use and physician awareness is a common finding across medical cannabis research.

Read More on RethinkTHC

Cite This Study

RTHC-01716·https://rethinkthc.com/research/RTHC-01716

APA

Kerlin, Ann Marie; Long, Millie; Kappelman, Michael; Martin, Christopher; Sandler, Robert S. (2018). Profiles of Patients Who Use Marijuana for Inflammatory Bowel Disease.. Digestive diseases and sciences, 63(6), 1600-1604. https://doi.org/10.1007/s10620-018-5040-5

MLA

Kerlin, Ann Marie, et al. "Profiles of Patients Who Use Marijuana for Inflammatory Bowel Disease.." Digestive diseases and sciences, 2018. https://doi.org/10.1007/s10620-018-5040-5

RethinkTHC

RethinkTHC Research Database. "Profiles of Patients Who Use Marijuana for Inflammatory Bowe..." RTHC-01716. Retrieved from https://rethinkthc.com/research/kerlin-2018-profiles-of-patients-who

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.