Untreated symptoms
Mental health continues to be a major concern in
pwCF16,17. In our study, many subjects had abnormal
mental health screens; except for marijuana, poor mental health was
associated with current substance use. Notably, current e-cigarette and
cigarette users were associated with anxiety and depression, while
current CBD users were associated with depressive symptoms. Many
reported using substances to minimize the impact of their illness and
improve their mental well-being, often to address anxiety, depression,
and sleep issues. Current users frequently stated using CBD and
marijuana as mood stabilizers; however, hyperawareness and anxiety were
also reported as side effects. Approximately half of the subjects who
quit marijuana reported wanting to avoid psychoactive effects. Although
current users noted worsening mental health with e-cigarettes and
cigarettes and a desire to stop using, quitting rates were lower when
compared to marijuana and CBD, likely due to the highly addictive nature
of nicotine18. While the causal relationship between
substance use and mental health remains uncertain, it is crucial to
recognize that some substances can exacerbate pre-existing mental health
issues frequently observed in patients with chronic
diseases19. It is also worth noting that some patients
may experience neurocognitive, mood, and anxiety changes after
initiating CFTR modulator therapy. Our study did not explore the
relationship between modulator therapy initiation, substance use timing
and mood which may be a confounding factor.