Most endometriosis patients using cannabis obtained it illicitly despite legal access | Research

The takeaway

Among 237 endometriosis patients using cannabis in Australia and New Zealand, 72-88% obtained it illicitly, with many reporting over 50% reduction in pain medication use.

Endometriosis patients considering cannabis, policymakers designing medicinal cannabis access programs, and gynecologists.

66.1% reported reducing opioid use by over 50%

What the researchers found

72% of Australian and 88.2% of NZ endometriosis patients using cannabis obtained it illicitly rather than through legal medical channels. Substantial medication substitution effects were reported: 66.1% reduced opioids by over 50%, 63.1% reduced non-opioid pain medication by over 50%.

Why it matters

Despite legal medicinal cannabis being available in both countries, the vast majority of endometriosis patients using cannabis do so without medical supervision, creating potential safety risks from drug interactions and unsupervised medication changes.

The numbers in context

237 respondents. 72% Australian and 88.2% NZ respondents used illicit cannabis. Only 23.1% Australian and 5.9% NZ accessed through prescription. Over 50% reduction reported in: opioid use (66.1%), non-opioid analgesics (63.1%), antineuropathics (61.7%), antianxiety medications (47.9%). 18.8% Australian and 23.5% NZ respondents did not disclose cannabis use to doctors.

How the study worked

Anonymous cross-sectional online survey distributed through social media via endometriosis advocacy groups. 237 respondents with medical diagnosis of endometriosis who reported cannabis use. Assessed legal vs illicit usage, access pathways, and healthcare provider interactions.

What this study cannot tell us

Self-selected sample recruited through advocacy groups may overrepresent cannabis-favorable attitudes. Self-reported outcomes without clinical verification. Survey design cannot establish causal medication substitution.

How to read the evidence

Moderate: reasonable sample size with detailed survey data, but self-selected and self-reported outcomes.

When this study was published

Published in 2022.

The bigger picture

This study reveals a significant gap between the availability of legal medicinal cannabis and actual patient access, with cost, stigma, and prescriber reluctance driving patients to illicit sources.

Questions still open

Would subsidizing medicinal cannabis shift patients from illicit to legal supply? Are patients safely tapering other medications when adding cannabis? How do cannabis-related outcomes compare in supervised vs unsupervised use?

Common questions

Why are so many patients using illicit cannabis despite legal access?

Barriers included high cost of legal medicinal cannabis, difficulty finding willing prescribers, geographic isolation, and concern about legal repercussions and stigma.

Did cannabis help with endometriosis symptoms?

Respondents reported positive outcomes and substantial reductions in use of pain medications, hormonal therapies, antidepressants, and antianxiety medications.

Why is unsupervised use concerning?

Patients may be tapering or stopping prescribed medications without medical guidance, risking drug interactions, withdrawal effects, and suboptimal disease management.

Read the original research

Cannabis Use for Endometriosis: Clinical and Legal Challenges in Australia and New Zealand.

Cannabis and cannabinoid research, 7(4), 464-472

View on PubMed ↗Publisher’s paper ↗

Citation

Sinclair, Justin; Toufaili, Yasmine; Gock, Sarah; Pegorer, Amanda G; Wattle, Jordan; Franke, Martin; Alzwayid, Muayed A K M; Abbott, Jason; Pate, David W; Sarris, Jerome; Armour, Mike. (2022). Cannabis Use for Endometriosis: Clinical and Legal Challenges in Australia and New Zealand.. Cannabis and cannabinoid research, 7(4), 464-472. https://doi.org/10.1089/can.2021.0116