German IBD patients using cannabis reported benefits but most obtained it from the black market

Among 417 German IBD patients surveyed, 4.3% currently used cannabis for their condition, reporting benefits like reduced pain and improved sleep, but 52.9% obtained cannabis from the black market and users had lower quality of life and more anxiety/depression than non-users.

Neufeld, Tanja et al.·Zeitschrift fur Gastroenterologie·2021·Moderate EvidenceCross-Sectional
RTHC-03378Cross SectionalModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=417

What This Study Found

17.5% had used cannabis recreationally; 4.3% currently used cannabis to treat IBD. Users reported reduced abdominal pain, improved sleep, and relief of anxiety. However, users had lower quality of life and more anxiety/depression than non-users. 52.9% obtained cannabis from the black market. 76.5% of former and 50% of current users did not report cannabis use to their physician.

Key Numbers

417 respondents; 4.3% current medical use; 17.5% recreational history; 52.9% black market; 76.5% former users and 50% current users did not tell physician

How They Did This

Cross-sectional survey mailed to a randomly selected representative sample of 1,000 IBD patients in Germany, with 417 responses (55.8% women; 43.4% ulcerative colitis, 54.7% Crohn's disease).

Why This Research Matters

Even in Germany, where medical cannabis is available by prescription, more than half of IBD patients using cannabis obtain it from unregulated sources. The physician communication gap is also striking, mirroring findings from other countries.

The Bigger Picture

The finding that cannabis users had lower quality of life and more anxiety/depression than non-users raises the chicken-and-egg question: are sicker patients turning to cannabis, or does cannabis use worsen outcomes? The black market procurement is a quality and safety concern.

What This Study Doesn't Tell Us

Response rate of 41.7% may introduce selection bias. Self-reported data. Cross-sectional design. German healthcare context may not generalize.

Questions This Raises

  • ?Why do patients use the black market when medical cannabis is legally available in Germany?
  • ?Would physician-guided cannabis use produce better outcomes than self-directed use?
  • ?Are patients with more severe disease more likely to try cannabis?

Trust & Context

Key Stat:
52.9% of cannabis-using IBD patients obtained it from the black market
Evidence Grade:
Representative random sample with reasonable response rate, though cross-sectional self-report design.
Study Age:
Published in 2021.
Original Title:
Cannabis use of patients with inflammatory bowel disease in Germany: a cross-sectional survey.
Published In:
Zeitschrift fur Gastroenterologie, 59(10), 1068-1077 (2021)
Database ID:
RTHC-03378

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

Do IBD patients find cannabis helpful?

Users reported reduced abdominal pain, improved sleep, and less anxiety. However, cannabis users overall had lower quality of life and more anxiety/depression than non-users, making it hard to separate cause from effect.

Do patients tell their doctors about cannabis use?

No, often not. 76.5% of former and 50% of current cannabis users in this German IBD sample did not disclose use to their physician.

Read More on RethinkTHC

Cite This Study

RTHC-03378·https://rethinkthc.com/research/RTHC-03378

APA

Neufeld, Tanja; Pfuhlmann, Katrin; Stock-Schröer, Beate; Kairey, Lana; Bauer, Nina; Häuser, Winfried; Langhorst, Jost. (2021). Cannabis use of patients with inflammatory bowel disease in Germany: a cross-sectional survey.. Zeitschrift fur Gastroenterologie, 59(10), 1068-1077. https://doi.org/10.1055/a-1400-2768

MLA

Neufeld, Tanja, et al. "Cannabis use of patients with inflammatory bowel disease in Germany: a cross-sectional survey.." Zeitschrift fur Gastroenterologie, 2021. https://doi.org/10.1055/a-1400-2768

RethinkTHC

RethinkTHC Research Database. "Cannabis use of patients with inflammatory bowel disease in ..." RTHC-03378. Retrieved from https://rethinkthc.com/research/neufeld-2021-cannabis-use-of-patients

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.