Risk for increased use in CF population
Similar to findings reported by Stephen and colleagues’6, we also found that approximately half of the subjects who had never used would try marijuana or CBD if given the opportunity or if marijuana was legal. This indicates a probable increase in substance usage among the CF community as societal stigma around marijuana decreases and legality continues to shift. In addition, we found that many pwCF used substances due to the influence of friends and family and seeking a sense of normalcy, as seen in a prior study20. As pwCF are leading longer lives with fewer significant health disruptions due to CFTR modulators, substance use prevalence may increase over time.
There is a great need to expand the current knowledge of and guidance regarding marijuana and CBD use in the CF patient population. Further research is warranted to counsel pwCF accurately, as many report experiencing therapeutic benefits. With the advancements in therapies that enhance the quality of life and increase life expectancy, coupled with evolving legal landscapes, pwCF will have more opportunities to explore these substances than previous generations.
In this study, we have identified several factors with respect to substance use in pwCF that merit further consideration in CF routine patient care and future research. Most importantly, CF care providers must screen for substance use starting in the patient’s early teenage years. Second, CF care providers should feel comfortable addressing the topics of marijuana, CBD, e-cigarettes, and cigarette use and potential risks with patients and families. Finally, more studies are needed to understand potential interactions between these substances, especially marijuana and CBD and the concomitant use of CFTR modulators.