Cannabis Use Disorder in Multiple Sclerosis: Characterization of a National Sample of Patients Seeking Treatment
Shayna Pehel1, Timothy Ko1, Luis Fernandez1, Erica Kreisberg1, Matthew Lustberg1, Giuseppina Pilloni1, Leigh Charvet1
1NYU Grossman School of Medicine
Objective:
To characterize a national sample of patients with multiple sclerosis (MS) seeking to enroll in a clinical trial of a telehealth intervention for cannabis use disorder (CUD).
Background:
Cannabis products are used by up to half of all patients living with MS, with only limited symptom benefit, and growing association with the worsening of symptoms such as cognitive dysfunction and depression. Approximately one-fifth develop CUD, without any options for intervention.
Design/Methods:
We recruited women with MS seeking to reduce their cannabis use for a nationally-enrolling pilot RCT of a home-based telehealth intervention. Demographic and clinical features were characterized for potential participants and those who met trial enrollment criteria.
Results:
A total of n=389 women with MS responded to study advertisements seeking intervention for their cannabis use, ranging in age 22 to 64 years (40.7 ± 8.4 years); 50% White, 35% Black, 15% Other; 12% Hispanic. A subset of n=42 met full eligibility criteria (CUD in the context of MS, confirmed with urine screen and without other substance use disorder or currently elevated Kessler Psychological Distress Scale (K10) score). The enrolled sample had a mean age of 42 ± 11 years, were 46% White, 34% Black, 20% Mixed Race/Other; 39% Hispanic. They had a mean MS disease duration of 9.7 ± 8.1 years, and mean K10 score of 22.1 ± 6.4. The most commonly used cannabis products were joints (31%), hand pipes (20%), edibles (20%), blunts (11%), vapes (9%), bongs (6%), and dabs (3%). The majority (66%) started using cannabis after their MS diagnosis and used for 11.6 ± 9.3 years.
Conclusions:
There is a large subpopulation of people living with MS who use cannabis products and are at risk for CUD. With growing evidence of the potential of cannabis to worsen MS symptom burden, characterizing those with CUD will lead to treatment options.