Survey Finds Interest in Marijuana for Symptom Control in Norwegian Patients With PD

In Norway, where cannabis is illegal, 1 in 20 patients with Parkinson disease (PD) use cannabis to help manage symptoms, according to a recent study.

The authors noted that interest in cannabis for motor and nonmotor symptom management has risen in recent years among patients with PD worldwide, as patients and researchers have described benefits, although due to a lack of randomized, double-blind, placebo-controlled trials, conclusive evidence does not exist. That does not stop actual usage, however, which reportedly ranges from 4% to 25% in the United States, Germany, and the Czech Republic.

To discover more about how patients and caregivers use or think about cannabis in Norway, researchers conducted an anonymous online survey. Participants who were members of the Norwegian Parkinson's Disease Association (N-PA) were invited to join between February and August 2021 via emails, social media, and podcasts and webinars. There was also an online invitation on the webpages of the Norwegian Centre for Movement Disorders. The N-PA has approximately 3500 members with PD and 1000 members who are caregivers. A total of 530 patients and 108 caregivers agreed to participate.

The Can-PD survey includes 24 items about the patients’ history of cannabis use, perceived benefits and adverse effects of cannabis use, as well as expectations toward health care providers. The caregivers completed a shorter survey of 3 to 7 items asking about their experience with cannabis.

Participants with PD were significantly older than caregivers (65.5 [8.6] vs 58.1 [15.9], P <.001) and more likely to be male (χ2 = 38.6, P <.001).

A total of 59 (11.3%) of patients reported previous or current use of cannabis; usage was linked with increased disease duration, but not age or gender. Only 7 (6.6%) of caregivers reported any current or previous usage.

Patient benefits were more frequently reported by current than previous users, and in addition, negative effects were rarely reported (4.8% of current users and 5.6% of previous users). Only 2 participants (1 in each group) reported interaction effects between cannabis and prescribed PD medication for PD.

The most frequently used form of cannabis was CBD oil, followed by street, or illicit, marijuana.

As for benefits, patients cited motor function improvements (69.5%), sleep (52.5%), and pain relief (37.3%).

While half of cannabis users had sought advice from a health care professional regarding cannabis use, only about 20% of non-users with an interest in cannabis had sought professional counsel. Barriers to seeking advice included low expectations, fear of negative consequences, not wanting to disclose nonprescri"bed treatments, and other reasons.

"These findings are important for clinical practice, as these barriers may hinder the identification of patients using these products," the authors wrote. "Also, the frequent interest in cannabis among PwP indicates a need for the development of novel effective treatment strategies for PwP."

Reference

Erga AH, Maple-Grødem J, Alves G. Cannabis use in Parkinson’s disease—a nationwide online survey study. Acta Neurol Scand. Published online February 17, 2022. doi:10.1111/ane.13602