Rationale:
The increased availability of artisanal cannabis-based products may contribute to the growing interest among people with epilepsy (PWE) in using them for self-medication. This study aimed to compare the usage and perception of cannabis products among PWE, their caregivers, and the general public.
Methods:
Between April 25 and May 20, 2023, we conducted an anonymous internet-based survey in Lithuanian patient groups and social network communities. People with epilepsy, their caregivers, and healthy controls (HCs) were asked about their experiences and opinions regarding cannabis product use. Agreement with closed-ended statements was measured using Likert scales and analyzed through Chi-square, Kruskal-Wallis tests, and linear regression modeling.
Results:
The study included 344 respondents (56 PWE, 37 caregivers and 251 HCs) with an average age 42.0 ±12.4 years, of whom 237 (68.9%) were female. Approximately half of PWE (26, 46.4%) and HCs (148, 59.0%), and one-third of PWE caregivers (14, 37.8%), reported trying cannabis products at least once (χ
2(2)=7.632, p=0.022). People with epilepsy reported using cannabis products mostly for self-medication (13, 50.0%), recreation (11, 42.3%), or health benefits (11, 42.3%). Nine (34.6%) PWE disclosed their cannabis use to physicians (compared to 10 (6.8%) HCs).
Across all respondent groups, cannabis products were often perceived as safe (185, 53.8%) and effective for epilepsy (110, 32.0%). Most respondents (235, 68.3%), particularly PWE caregivers (H(2)=6.922, p=0.031), noted a favorable shift in societal views toward cannabis. PWE caregivers also expressed the highest interest in medical cannabis applications (28 (75.7%) caregivers) compared to PWE (31, 55.4%) and HCs (123, 49.0%), H(2)=9.579, p=0.008.
Respondents who had never tried cannabis products had a similar propensity across subgroups to try them for treatment or health-related purposes (H(2)=0.521, p=0.771), with a similar proportion of respondents leaning in both directions (64 [41.0%] not willing and 70 [44.8%] willing to try). The inclination to try cannabis products was associated with an interest in their medical applications (β=−0.436, p=0.010) and support for uncontrolled cannabis markets (β=−0.334, p=0.044), F(2,29)=8.995, p=0.001.
Most respondents across all subgroups agreed (230, 66.9%, H(2)=0.617, p=0.735) that cannabis products should be prescribed by certified physicians. They also indicated neurologists as their preferred source of information on this matter (237, 68.9%).
Conclusions:
Our findings indicate that approximately half of PWE have a history of cannabis product use and demonstrate an ongoing interest in these products. Caregivers of PWE show particular interest in their use. Importantly, neurology specialists were identified as the primary source of information on cannabis use in epilepsy, highlighting the need for their active involvement in discussing this topic with patients.
Funding: None