Abstracts

Rationale: Although the FDA has recommended approval of Epidiolex (a plant-derived cannabidiol) for prescription use, there are currently no FDA-approved forms of cannabinoids aside from dronabinol (Marinol). As of January 2018, 29 states have legalized medical marijuana (MM) programs and 10 have legalized recreational marijuana (MJ) sales, including Oregon as of October 2015. There is a need to understand MJ use among patients with epilepsy in states that have legalized its use. Objective: The aim of this study was to survey current access, methods of use, and attitudes regarding MJ among a population of patients with epilepsy. Methods: A one-time, nine-item IRB-approved survey was administered to 34 adult participants (18 women, 16 men, ages 21-66) at the Oregon Health & Science University Epilepsy Clinic between October 2017 and May 2018 who have epilepsy. Results: 85.3% of patients surveyed used MJ for the purpose of seizure treatment; 14.7% used it recreationally. The majority (82.4%) agreed/strongly agreed that cannabis improved seizure control. 82.8% reported improved access to cannabis products since recreational legalization, though taxes and high commercial prices were continued barriers to access. A greater proportion of patients (44.1%) selected strains with more CBD than THC; others reported using higher THC strains (29.4%), an equal ratio of CBD:THC (17.6%), and multiple types (32.3%). Patients who used marijuana without intending to treat seizures preferred high THC strains, accounting for 40%. Medical dispensaries were the main source (55.9%), followed by recreational shops (38.2%), homegrowers (29.4%) and friends/family (29.4%). Within these channels, homegrowers supplied high CBD products 80% of the time, whereas friends/family (40% high CBD) and recreational shops (6.5% high CBD) were more varied. Most (58.8%) used CBD several times daily and a minority (14.7%) reported once per week use or less. Administration modes included: smoking (70.6%), edibles (50.0%), bongs/waterpipes (44.1%), tinctures (35.3%), vaping (41.2%), and concentrates (44.1%). Edibles and tinctures were most common among patients accessing MJ through homegrowers and friends/family. Conclusions: This study illustrates that patients with epilepsy access MJ through varied channels and administration methods, recreationally and medically. Considering the frequent MJ administration, it is relevant that patients do not exclusively choose high CBD varieties supported in research. Despite this discrepancy, the overwhelming majority of patients believed MJ use had improved their seizure control, even in high-THC product use. Since neither MM or MJ are covered by insurance, the high cost of recreational taxes and MM cards creates an access barrier for those seeking to treat their condition. Edibles, tinctures and concentrates are popular formulations, especially for those accessing MJ through homegrowers and friends/family members who are more likely to provide high CBD strains. Smoking, vaping and bongs/waterpipes remain common due to their short activation period and ease of access. Funding: Work reported in this poster was supported by the National Institutes of Health Common Fund and Office of Scientific Workforce Diversity under three awards UL1GM118964, RL5GM118963, and TL4GM118965, administered by the National Institute of General Medical Sciences.