Cannabis self-medication: a solution that may create problems

 (Image: Pixabay CC0)
(Image: Pixabay CC0)

Even if the evidence of the effectiveness of cannabis is still very scarce, Quebecers are self-prescribing products from this plant for health problems ranging from pain to shyness

Anxiety, depression, insomnia, shyness, migraines, muscle spasms, pain, loss of appetite, loss of libido. These are some of the health problems for which Quebecers self-prescribe cannabis, even though no reliable scientific study has yet demonstrated its effectiveness for these uses.

These observations come from a study that a team from the Faculty of Pharmacy of Laval University and the Centre de recherche du CHU de Québec-Université Laval has just published in the Journal of Cannabis Research. This is the first study in Quebec to provide a detailed picture of self-medication with cannabis since it became available.It is the first study in Quebec to provide a detailed picture of self-medication with cannabis since it became available without medical authorization in Canada," says Professor Arsène Zongo, who led the team.

The researchers conducted an online survey of 489 people who used cannabis, purchased from the Société québécoise du cannabis, to treat a health problem or problems. All were self-medicating and not prescribed by a health care professional.

Here are the main findings of the study:

  • the most commonly cited reasons for self-prescribing cannabis were anxiety (70%), insomnia (56%), pain (53%) and depression (37%);
  • the number of health problems ranged from 1 to 13, but most respondents (66%) reported between 2 and 5 health problems
  • 45% of respondents used cannabis daily;
  • 74% had been self-medicating with cannabis for over a year;
  • 56% of respondents were also taking prescription medication.

This does not bode well for these individuals or for the health care system," says Arsène Zongo. People who self-prescribe cannabis are at risk of short- and long-term adverse events. This risk would be greater for people who also take prescription drugs because cannabis interferes with the biological mechanisms responsible for the breakdown of many drugs. In addition, as the percentage of people who use cannabis for health reasons increases - from 23% of all cannabis users in 2019 to 40% in 2021 - the problems created by self-medication with cannabis are likely to create an additional burden on the health care system.

The reason so many people are turning to self-medication with cannabis is that current treatments for problems such as chronic pain, anxiety and depression are ineffective for many patients," says Zongo. Most of these people have health needs that are not being met by the health care system and they are looking outside the system for solutions.

What would be the solution? Even if the effectiveness of cannabis to treat these problems remains to be demonstrated, we must be pragmatic and work to facilitate access to it in the medical circuit in order to limit the damage. This would ensure a better supervised use of cannabis, reduce the risks of intoxication and prevent interactions with drugs, he argues.

Even if the effectiveness of cannabis to treat these problems remains to be demonstrated, it is necessary to be pragmatic and to work to facilitate the access of it in the medical circuit in order to limit the damage.

To achieve this, barriers that limit access to medical cannabis and drive people to self-medicate should be removed, he says. In addition, health care professionals need to be better trained to educate patients about the risks associated with the therapeutic use of cannabis.

Pharmacists, as drug specialists, should be at the heart of the therapeutic use of cannabis to help minimize the risks associated with potential drug interactions. Currently, they are out of the loop, he laments.

The study published in the Journal of Cannabis Research is signed by Antoine Asselin, Olivier Beauparlant Lamarre, Richard Chamberland, Sarah-Jeanne McNeil, Éric Demers and Arsène Zongo.