“There is a big discrepancy between what the empirical evidence is saying and what people believe,” says lead author Daniel Kruger, a research associate professor of community health and health behavior in the University at Buffalo’s School of Public Health and Health Professions as well as a research investigator with the Population Studies Center at the University of Michigan.
“We’ve gone back to the 19th century miracle cure. People are using cannabis and cannabinoids for everything and anything, and we don’t have enough systematic research on whether it’s effective for these conditions. People are stopping or reducing prescription drugs to use medical cannabis. It’s a serious issue.”
And that’s exactly why researchers felt it was important to survey marijuana users.
WHAT 500 HASH BASHERS GOT WRONG
Researchers set up a table during Hash Bash, an annual marijuana advocacy event that has taken place on the campus of the University of Michigan for the past several decades.
The research team—which includes Jessica Kruger, a clinical assistant professor at the University at Buffalo’s School of Public Health and Health Professions—has conducted several previous studies with data collected at Hash Bash, including a paper published last spring that showed that the munchiesexist, and that there’s a need for tailored nutrition education as the population of marijuana users grows.
For the current study, nearly 500 Hash Bash participants completed surveys that asked about their cannabis use and where they obtained their information about marijuana.
Researchers also asked them to respond to questions such as, “Which of the following conditions do you think marijuana is effective in treating (check all that apply)?” and “Which of the following conditions/events do you think marijuana use increases the risk for (check all that apply)?”
Researchers then compared participants’ knowledge with National Academies of Sciences, Engineering and Medicine (NASEM) conclusions regarding medical effectiveness and risk related to cannabis use.
In addition to revealing a disconnect between mainstream health and medicine and the medicinal use of marijuana, the study results also identified a lack of awareness of the potential risks involved.
For example, only 22% of respondents thought that cannabis use during pregnancy could be risky. “That was really striking,” Daniel Kruger says, “there is evidence that marijuana use could lead to lower birth weights.”
CANNABIS KNOWLEDGE GAP
Further, the majority of survey respondents said cannabis was effective in treating cancer, depressive symptoms, and epilepsy. The NASEM assessment, however, concludes there is limited evidence that cannabis or cannabinoids effectively reduce depressive symptoms, and no or insufficient evidence that it works for cancer and epilepsy.
Participants also said marijuana can treat irritable bowel syndrome, despite a lack of empirical data supporting that conclusion.
Daniel Kruger is quick to note the following caveat: Marijuana remains a Schedule I substance, which prohibits scientists from conducting the clinical trials necessary for properly informing NASEM conclusions.
The majority of study participants reported using marijuana every day, and 85% said they use it for health or medical reasons. About 78% said their knowledge of cannabis stemmed from personal experience, compared to just 23% from a medical cannabis caregiver or dispensary, and 18% from a primary care provider.
The knowledge gap identified in the study is significant from a public health perspective, researchers say, adding that as a growing number of states legalize—or consider legalizing—adult recreational marijuana use, the conversation needs to shift.
“These results highlight the disconnect between marijuana advocacy and policies and the lack of scientific evidence,” says coauthor R. Lorraine Collins, associate dean for research at the University at Buffalo’s School of Public Health and Health Professions and a contributor to the NASEM report.
“We need more scientifically rigorous research to inform health messages that provide guidance about the use and effectiveness of cannabis and cannabinoids for a wide range of medical conditions.”
The issue is moving at a rapid pace due to citizen-driven ballot initiatives and pushes from public officials, Kruger says. For example, New York Governor Andrew M. Cuomo in his recent State of the State Address again called for legalizing marijuana for adult recreational use. Michigan voters passed a bill in 2018 approving legalizing, regulating, and taxing marijuana there.
Given these efforts, it’s time for public health to get up to speed, Daniel Kruger says. “Abstinence won’t work as the only goal anymore. We need to maximize the benefits and minimize the costs, risks, and harms to individuals and society. We hope our study broadens the conversation.”
The paper appears in the American Journal of Health Promotion.