Medical cannabis has been legally available in Canada since 2001, and the number of registered users has been steadily increasing.
As of March 2021, there were approximately 300,000 active client registrations, representing almost 1% of the Canadian population.
The Canadian Cannabis Patient Survey (CCPS) is a large cross-sectional survey that has been administered every two years since 2015 to gather valuable data on patient demographics, patterns of use, and self-reported effectiveness of medical cannabis.
The 2021 CCPS – Key Findings
The 2021 CCPS was completed by 2,697 participants, with a mean age of 54.3 years and a nearly equal proportion of male (50.1%) and female (49.1%) respondents.
This represents a significant shift from previous surveys, which had a lower proportion of female participants.
The survey also revealed an increasing trend in the age of respondents, with the mean age rising from 40 years in 2015 and 2017 to 48 years in 2019 and 54.3 years in 2021.
Reasons for Medical Cannabis Use
Chronic pain (27.8%) and arthritis (14.9%) were the two most common primary illnesses for which medical cannabis was used, while pain (66.6%) and anxiety (35.7%) were the most common primary symptoms.
Interestingly, the reasons for use varied by age group. Patients aged 41 to 60 were more likely to use medical cannabis for chronic pain, while those over 60 primarily used it for arthritis.
In contrast, patients aged 40 and under were more likely to use medical cannabis for anxiety, insomnia, stress, and depression.
Preferred Formulations and Modes of Use
The majority of respondents (54.4%) used oral extracts/drops as their primary formulation, followed by dried flower via vaporizer (12.4%). Oral administration was preferred by 63.3% of respondents, while 34.8% favored inhalation.
Age-related patterns emerged, with oral administration increasing significantly with age. Older patients also showed a preference for high CBD/low THC oral formulations, while younger patients preferred high THC/low CBD inhalational formulations (flower and vape products, i.e provape).
Impact on Prescription Drug Use Among respondents who reported using prescription opioids (most of whom were older patients), a majority (59.7%) reported an intention to reduce opioid use with medical cannabis, either self-guided (45.1%) or under the guidance of their healthcare provider (14.6%).
Also, 32.4% of patients taking prescription non-opioid pain medications reported a decrease in use concurrent with medical cannabis use.
Reductions in Alcohol, Tobacco, and Unregulated Substance Use
Over half of the respondents (53.8%) reported using alcohol concurrent with medical cannabis, and 38% of these reported a decrease in alcohol consumption. Approximately one-third of patients reported using tobacco and/or nicotine, with 24% reporting a decrease in use.
Notably, decreases in both alcohol and tobacco/nicotine use were significantly more prominent in the youngest group of patients. Only a small percentage (4.1%) reported using unregulated substances, with almost half of these patients reporting a reduction in use post medical cannabis initiation.
Oral Consumption with High CBD Preferred
The 2021 CCPS highlights the evolving landscape of medical cannabis use in Canada, with an increasing proportion of older patients and females.
Older patients represent a growing subset of this population, exhibiting different patterns of use compared to their younger counterparts.
They are more likely to use medical cannabis for chronic pain and arthritis, prefer oral routes of administration with high CBD/low THC concentrations, and report reductions in prescription opioid and non-opioid use.
As cannabis becomes more normalized as a treatment option, it is essential to track changes in patient characteristics and associated patterns of use.
The findings from the 2021 CCPS can help inform treatment decisions by patients and healthcare providers, suggesting that patient characteristics such as age and gender may impact patterns of use, treatment adherence, and outcomes.
