People With Inflammatory Bowel Disease Were More Likely to Have Used Cannabis and Started Younger | Research

The takeaway

A national survey found that people with IBD had higher rates of ever using cannabis (67.3% vs. 60%), started using at a younger age, and used more per session than matched controls.

People with IBD curious about how common cannabis use is among others with the condition.

67.3% of IBD patients had ever used cannabis vs. 60% of controls

What the researchers found

Using data from the NHANES national health survey, researchers compared cannabis use patterns between people with inflammatory bowel disease (IBD) and matched controls.

People with IBD were more likely to have ever used cannabis (67.3% vs. 60.0%) and started at a younger average age (15.7 years vs. 19.6 years). When they did use, IBD patients tended to use heavier amounts per session: 64.9% reported three or more joints per day compared to 80.5% of non-IBD subjects using two or fewer.

However, IBD patients were less likely to have used cannabis consistently every month for a year. In regression analysis, having IBD, being male, and being over 40 predicted cannabis use.

Why it matters

Cannabis use among IBD patients is common but poorly understood. These population-level data suggest that IBD patients may use cannabis differently than the general population, potentially as symptom management, and that older males with IBD are the most likely users.

The numbers in context

Weighted populations: ~2.08 million IBD subjects, ~2.01 million controls. Ever used cannabis: 67.3% (IBD) vs. 60.0% (controls). Age of first use: 15.7 years (IBD) vs. 19.6 years (controls). 20% of IBD patients had a history of drug or alcohol use disorder.

How the study worked

Cases were identified from the NHANES database (2009-2010) as having ulcerative colitis or Crohn's disease. They were matched with controls using propensity score matching based on age, gender, and sample weighting. After weighting, approximately 2 million subjects per group were represented.

What this study cannot tell us

NHANES relies on self-reported data, which may undercount cannabis use. The cross-sectional design cannot determine whether IBD drives cannabis use or whether cannabis use affects IBD. The 2009-2010 data predate widespread legalization. The study could not assess whether cannabis use improved or worsened IBD outcomes.

How to read the evidence

This is a large population-based cross-sectional study using NHANES data with propensity score matching, providing moderate-quality evidence on use patterns.

When this study was published

Published in 2015, using 2009-2010 data. Cannabis access and attitudes have changed substantially since then.

The bigger picture

As interest grows in cannabis as a potential therapy for IBD symptoms, understanding existing use patterns helps frame the conversation. The higher rates and heavier use among IBD patients suggest many are already self-medicating, which underscores the need for clinical research on efficacy and safety.

Questions still open

Are IBD patients using cannabis specifically for symptom relief? Does the earlier age of cannabis onset among IBD patients reflect a biological connection or simply correlation?

Common questions

Are people with IBD using cannabis to manage their symptoms?

The study documented use patterns but could not determine motivations. The heavier per-session use and higher overall rates suggest possible symptom management, but this was not directly measured.

Does cannabis help or hurt inflammatory bowel disease?

This study did not assess outcomes. Some other research suggests cannabis may help with IBD symptoms like pain and appetite, but whether it affects the underlying inflammation remains unclear and requires more clinical trials.

Read the original research

Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis.

Drug and alcohol dependence, 156, 84-89

View on PubMed ↗Publisher’s paper ↗

Citation

Weiss, Alexandra; Friedenberg, Frank. (2015). Patterns of cannabis use in patients with Inflammatory Bowel Disease: A population based analysis.. Drug and alcohol dependence, 156, 84-89. https://doi.org/10.1016/j.drugalcdep.2015.08.035