Table 1.
Patterns of cannabinoid use from observational studies.
| Author, Year | Study Type | Legalization (Location) | Number of Participants (SCI/Total) |
Inclusion
Criteria |
Exclusion Criteria |
Male/Female/
Transgender |
Mean Age | Tetraplegia/ Paraplegia/ Unknown | Mean Time Since Injury | Prevalence | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Dunn & Davis, 1974 [63] | Cross-sectional | Illegal (Florida, USA) | 10/10 | SCI patients using cannabis | - | 10/0/0 | NR | NR | NR | N/A- cannabis use was inclusion criteria | |||||||||||||||||
| Malec et al., 1982 [64] | Cross-sectional | Illegal (Wisconsin, USA) |
43/43 | SCI patients | - | 38/5/0 | NR | NR | NR | Within last yr: 56% | |||||||||||||||||
| Heinemann et al., 1991 [65] |
Case-series | Illegal (Illinois, USA) |
86/86 | 13-66 age, 2+ yr since tSCI, English language, no cognitive impairment | - | 59/27/0 | 39.5 (13-65) |
47/39 | 13.1 ± 10.2 | 6 mo pre-SCI: 31%; Post-SCI: 42% | |||||||||||||||||
| Rothstein et al., 1992 [66] |
Cross-sectional | MC legal (New York, USA) | 153/153 | Male veterans with SCI | - | 153/0/0 | 53 ± 1 (20-76) | NR | NR | Current (urinary cannabinoid test): 10% | |||||||||||||||||
| Young et al., 1995 [43] | Cross-sectional | Illegal (Texas, USA) | 123/123 | 17+ age, 9+ mo since tSCI, residual motor disability with assistive walking device if ambulatory | - | 82/41/0 | 36 ± 10.9 (19-76) | Complete tetra: 53, complete para: 53, incomplete: 17 | 9.7 ± 6.6 | Current (regular basis at time of study): 16% | |||||||||||||||||
| Kolakowsky-Hayner et al., 2002 [67] | Cross-sectional | Illegal (Virginia, USA) | 30/60 | SCI and brain injury patients treated in trauma centre | - | 56/4/0 | 35.0 ± 10.85 | NR | 1.4 | Past 6-12 mo: 50% among illicit drug users (n=6 SCI, n=1 TBI) | |||||||||||||||||
| Warms et al., 2002 [68] | Cross-sectional | MC legal starting Nov 1998, study V1 Feb 1997 – Jul 1998, V2 Aug 1998 – June 2000 (Washington, USA) | 471/471 | 18+ age, 6+ mo since SCI | - | 334/137/0 | 42.5 ± 13.2 (18-84) |
240/221, unknown: 9 | NR | Ever: 3% | |||||||||||||||||
| Grotenhermen & Schnellea, 2003 [51] | Cross-sectional | Dronabinol prescription and ∆9-THC special permit (Germany) and permit (Switzerland) |
4/165 | Members of Association for Cannabis as Medicine | No severe disease | 101/64/0 | Median age: 40.3 ± 12.4 (16-87) | NR | NR | Ever: 87% | |||||||||||||||||
| Gortera, 2005 [52] | Cross-sectional | MC legal (Netherlands) | ?/107 | Members of Multiple Sclerosis society | - | 48/59/0 | Median age: 58.0 | NR | NR | N/A- MC was inclusion criteria | |||||||||||||||||
| Cardenas & Jensen, 2006 [53] | Cross-sectional | MC legal (Washington, USA) | 117/117 | 18+ age, tSCI, chronic pain | Incomplete questionnaires | 85/32/0 | 48.8 ± 11.7 (21-79) |
56/61 | 17.3 ± 10.9 | Ever: 32%; Current: 20% | |||||||||||||||||
| Mahoney et al., 2007 [69] |
Interview | Illegal (Texas, USA) | 24/24 | 1+ yr since SCI, spasticity, English language | - | 17/7/0 | 45.1 (21-68) |
13/11 | 16 | NR | |||||||||||||||||
| Aggarwal et ala., 2009 [46] |
Retrospective chart review | MC legal (Washington, USA) | 5/139 | 18+ age, pain clinic patients, access to MC with valid doctor documentation | Cannabinoid receptor 1 blocker drug rimonabant | 88/51/0 | Median age: 48 (18-84) | NR | NR | N/A- MC was inclusion criteria | |||||||||||||||||
| Author, Year | Study Type | Legalization (Location) | Number of Participants (SCI/Total) |
Inclusion Criteria |
Exclusion Criteria |
Male/ Female/ Transgender |
Mean Age |
Tetraplegia/ Paraplegia/ Unknown |
Mean Time Since Injury | Prevalence | |||||||||||||||||
| Heutink et al., 2011 [70] | Cross-sectional | MC legal starting 2003, study 1990-2005 (the Netherlands) | 279/279 | 18+ age, SCI rehab patients, living in community | - | 173/106/0 | 51.3 ± 14.0 (25-81) | 103/165, unknown: 11 | 11.6 ± 10.7 | Past, discontinued: 6%; Current (at study): 3% | |||||||||||||||||
| Hwang et al., 2012 [48] | Cross-sectional | Illegal (Florida, USA) | 215/215 | SCI before age 19, current age 21-25, former hospital patient | - | 127/88/0 | 23.4 ± 0.9 | 112/101, unknown: 2 | 10.2 ± 4.9 | Current (at least mo): 11% | |||||||||||||||||
| Fekete et al., 2015 [42] | Cross-sectional | MC permit (Switzerland) | 511/511 | 16+ age, tSCI or non-tSCI; | New SCI with palliative care, neurodegenerative diseases or Guillain-Barre syndrome; congenital conditions leading to SCI | 373/138/0 | 52.9 ± 14.8 | 158/353 | 17.6 ± 13.0 | Current (last 30 d): 7% | |||||||||||||||||
| Shroff, 2015 [54] | Interview | MC legal (Canada) | 53/53 | 19-65 age, 1+ years since SCI, BC resident, member of paraplegic association | - | 42/11/0 | NR | NR | NR | NR | |||||||||||||||||
| Drossel et al., 2016 [45] | Cross-sectional | MC legal (Michigan & California, USA) | 244/244 | 18+ age, 5+ years since tSCI, English language, neurogenic bowel and/or bladder, no cognitive limitations | - | 181/63/0 | 49.7 | 134/110 | 18.6 | Ever: 23% | |||||||||||||||||
| Andresen et al., 2017 [44] | Cross-sectional | MC legal starting 2011, study 1990-2012 (Denmark) | 537/537 | Inclusion: 18+ age, acquired tSCI, rehab clinic patients | Incomplete questionnaires | 413/124/0 | 54.6 ± 14.6 (18-88) | 247/263, unknown: 27 | 18.2 ± 12.8 | Ever: 36%; Current (last 2 yrs): 9% | |||||||||||||||||
| Clark et al., 2017 [47] | Cross-sectional | MC illegal (Georgia & South Carolina, USA) | 1619/1619 | 18+ age, 1+ year since tSCI, some residual impairment | No painful condition, no prescription pain med | 1166/453/0 | 49.3 ± 14.2 | 453/1166 | 11.5 ± 9.2 | Current (mo): 16% | |||||||||||||||||
| Patel et al., 2017 [71] | Retrospective chart review | MC legal (Canada) | 19/19 | Patients of mobility clinic with documented SCI | - | 14/5/0 | 46.7 (18-89) | NR | NR | Current: 16% | |||||||||||||||||
| Bruce et al.a, 2018 [50] |
Interview | MC legal (Illinois, USA) | 6/30 | 18+ age, smoked MC in past 3 mo, qualifying health condition for MC | - | 19/11/0 | 44.6 ± 15.9 | NR | NR | N/A- MC was inclusion criteria | |||||||||||||||||
| Hawley et al., 2018 [49] |
Cross-sectional | MC and recreational legal (Colorado, USA) | 51/116 | SCI rehab patient | - | 95/21/0 | 47.1 ± 13.8 (22-74) | Tetra ABC: 38, para ABC: 31, tetra/para D: 41, unknown: 5 | 13.0 | Before injury: 67%; After injury: 53% | |||||||||||||||||
| Bourke et al., 2019 [72] |
Interview | Illegal (New Zealand) | 8/8 | 18+ age, SCI patients using cannabis for pain, residing in New Zealand, English speaking, | Comorbid conditions inhibiting communication and participation in interview | 6/2/0 | Age 20-39: n = 1, 40-59: n= 5, 60+: n=2 | Tetra: 6 Para: 2 |
NR | N/A- MC was inclusion criteria | |||||||||||||||||
| Author, Year | Study Type | Legalization (Location) | Number of Participants (SCI/Total) | Inclusion Criteria | Exclusion Criteria |
Male/ Female/ Transgender |
Mean Age |
Tetraplegia/ Paraplegia/ Unknown |
Mean Time Since Injury | Prevalence | |||||||||||||||||
| Eldridge et al., 2019 [73] |
Retrospective chart review | Illegal (Indiana, USA) |
20/20 | 18+ age, SCI patients received medical care at Eskenazi Medical Center | - | 17/3/0 | 45.05 ± 13.84 | NR | NR | Before injury: 25% | |||||||||||||||||
| Graupensperger et al., 2019 [74] | Retrospective chart review | MC legal starting 2016 and implemented Feb 2018, study Jan 1997-April 2018 (Pennsylvania, USA) | 6192/1466985 | 16+ age, patients at Penn State Hershey Medical Center | - | 3368/2824/0 | NR | NR | NR | Cannabis use disorder with SCI: 1% vs. non-SCI 0.2% | |||||||||||||||||
| Stillman et al., 2019 [75] | Cross-sectional | 39 states in USA, not disclosed; mixed legality | 353/353 | SCI patients included in mailing lists maintained by Thomas Jefferson University, University of Washington at Seattle, and Uni- versity of Alabama at Birmingham |
- | 183/107/3 | 52.74 (19-82) | NR | 17.49 | Current: 39% Past: 15% |
|||||||||||||||||
Abbreviations: d: days; freq: frequency; MC: medical cannabis; mo: monthly; N/A: not applicable; NR: not reported; qd: daily; SCI: spinal cord injury; TBI: traumatic brain injury; THC: tetrahydrocannabinol; tSCI: traumatic spinal cord injury, wk: weekly; yr: yearly. adata listed not limited to people with SCI.