E. C. Amoah1, W. F. Mourad2, B. J. Shelton1, E. S. Yang3, and A. Kaushal1; 1University of Kentucky, Lexington, KY, 2University of Kentucky Department of Radiation Medicine, Lexington, KY, 3University of Kentucky, Department of Radiation Medicine, Lexington, KY
Purpose/Objective(s): Research into cannabis has been severely restricted due to the tenuous federal legal status of cannabinoids in the US. As a result, there is a paucity of studies to better understand the self-prescribed patterns of cannabis usage. To start addressing this deficit, we performed the first app driven survey at a rural satellite. An IRB approved survey was generated to collect broad data regarding demographics and the patterns of use of cannabis in both an urban and a rural oncology practice based in a geographical area with high endemic use of narcotics. This study aimed to start to 1) understand the symptomatology motivating radiation medicine patients to self-prescribe with cannabis, 2) compare patterns related to cannabis use among patients in an urban versus rural oncology practice, 3) collect information on the incidence of co-usage of cannabis with opioids and gabapentin in a geographic area of the initial opioid overuse epidemic, and 4) understand cannabinoids and its interactions with quality-of-life metrics and radiotherapy. Materials/
Methods: We surveyed 200 US adults (89% Caucasian, 3% Black/African American, 3% Native American, 1% Hispanic, 3% Other) age =20 years who received radiation as part of their oncologic care from July 2023 to February 2024. One hundred patients were from an urban oncology practice and 100 patients were from a rural oncology practice. Questions ranged from symptomatology, quality of life, financial toxicity, and means to obtaining cannabis products. Fisher’s exact test and Cochran-Mantel-Haenszel test were used to assess associations. Results: In preliminary analysis, among 200 study participants, 98 (49%) admitted to ever using cannabis and 28 (14%) acknowledged cannabis use in the last 30 days. There was no association between cannabis use and patient attributes such as income (p=0.55), education (p=0.39), cancer type (p=0.12) or locale (p=0.18). Among patients with active cannabis use, most reported cannabis use as an attempt to ameliorate symptomatology including pain (21%), nausea (14%), depression (14%), poor appetite (11%), and anxiety (7%) and, 85% noticed positive change in their overall quality of life. Interestingly, pain score was higher among patients with cannabis use compared to patients without cannabis use (mean pain score 4.4 vs 2.9 on a scale of 1-10, p=0.01). Among active cannabis users, 40% preferred to have the radiation oncologist be the primary healthcare member to discuss cannabis use and issues related to it. Conclusion: A diverse population of patients in radiation medicine use cannabis regardless of diagnosis, income, education, or locale with many patients reporting cannabis use for symptom relief and also express a desire to discuss cannabis use with their radiation oncologist. This will be the first peer-reviewed study specifically with the objective of examining rural cannabis use in an opioid-endemic radiation populace and serve as a major step forward to gathering knowledge to promote health equity in these regions.
