Illicit Cannabis Use to Self-Treat Chronic Health Conditions inthe United Kingdom: Cross-Sectional Study

Background: In 2019, it was estimated that approximately 1.4 million adults in the United Kingdom purchased illicitcannabis to self-treat chronic physical and mental health conditions. This analysis was conducted following the rescheduling ofcannabis-based medicinal products (CBMPs) in the United Kingdom but before the first specialist clinics had started treatingpatients.Objective: The aim of this study was to assess the prevalence of illicit cannabis consumption to treat a medically diagnosedcondition following the introduction of specialist clinics that could prescribe legal CBMPs in the United Kingdom.Methods: Adults older than 18 years in the United Kingdom were invited to participate in a cross-sectional survey throughYouGov between September 22 and 29, 2022. A series of questions were asked about respondents' medical diagnoses, illicitcannabis use, the cost of purchasing illicit cannabis per month, and basic demographics. The responding sample was weightedto generate a sample representative of the adult population of the United Kingdom. Modeling of population size was conductedbased on an adult (18 years or older) population of 53,369,083 according to 2021 national census data.Results: There were 10,965 respondents to the questionnaire, to which weighting was applied. A total of 5700 (51.98%)respondents indicated that they were affected by a chronic health condition. The most reported condition was anxiety (n=1588,14.48%). Of those enduring health conditions, 364 (6.38%) purchased illicit cannabis to self-treat health conditions. Basedon survey responses, it was modeled that 1,770,627 (95% CI 1,073,791-2,467,001) individuals consume illicit cannabis forhealth conditions across the United Kingdom. In the multivariable logistic regression, the following were associated withan increased likelihood of reporting illicit cannabis use for health reasons-chronic pain, fibromyalgia, posttraumatic stressdisorder, multiple sclerosis, other mental health disorders, male sex, younger age, living in London, being unemployed or notworking for other reasons, and working part-time (P<.05).Conclusions: This study highlights the scale of illicit cannabis use for health reasons in the United Kingdom and the potentialbarriers to accessing legally prescribed CBMPs. This is an important step in developing harm reduction policies to transitionthese individuals, where appropriate, to CBMPs. Such policies are particularly important considering the potential risksfrom harmful contaminants of illicit cannabis and self-treating a medical condition without clinical oversight. Moreover, itemphasizes the need for further funding of randomized controlled trials and the use of novel methodologies to determine theefficacy of CBMPs and their use in common chronic conditions