Try out PMC Labs and tell us what you think. Learn More. Analyzed the data: JTM. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources.
Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as thre, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis. A total of separate forum thre were identified.
A final sample of posts in these forum thre received at least one endorsement on predetermined topics following qualitative coding procedures. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other non-ADHD psychiatric conditions, or overall domains of daily life. Additional themes emerged e. Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD—this is the first study Add and smoking pot identify such a trend.
This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care. Cannabis use disorder CUD refers to a problematic pattern of cannabis use leading to clinically ificant impairment or distress within a 12 month period and includes at least two symptoms occurring in this context e.
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In a large, multisite longitudinal study, individuals initially diagnosed with ADHD between the ages of 7—9 years were ificantly more likely than controls to report cannabis use at 8-year follow-up Even in non-clinical samples, ADHD symptoms are associated with increased cannabis use severity, craving, abuse, dependence, and earlier initiation of use [ 67 ]. This relationship between ADHD and cannabis use is relevant given the known adverse effects of use. For instance, short-term effects of cannabis use include impaired short-term memory and motor coordination, altered judgement, and in high doses paranoia and psychosis [ 8 ].
Real-world outcomes of such effects include higher rates of motor vehicle accidents. The effect of long-term or heavy use include altered brain development, poorer Add and smoking pot outcomes e. Cardiovascular disease, poorer mental health, use of other illicit substances, and a range of poorer neurocognitive outcomes e. Given that similar outcomes are associated with ADHD independent of cannabis useincluding neurocognitive deficits [ 1516 ] and poor driving [ 17 ], the maladaptive effects of cannabis use may be particularly pronounced in ADHD patients.
Indeed, heavier cannabis use in people with ADHD appears to have an additive effect on poor neurocognitive outcomes [ 18 ] and alters Add and smoking pot and cerebellar-dependent function [ 19 ], along with frontal and postcentral cortical thickness [ 20 ]. Further, this comorbidity will likely impact successful treatment of cannabis use since ADHD symptoms are correlated with cannabis craving [ 7 ] and such craving is associated with relapse [ 21 ].
Despite the increased risk for problematic cannabis use outcomes, anecdotal clinical observations suggest there is a growing popular perception that cannabis is therapeutic for ADHD. Even some medical professionals have advocated for cannabis as a treatment for ADHD, including before a congressional subcommittee on drug policy [ 22 ] also see [ 23 ].
Consistent with such observations, the perceived risk associated with regular cannabis use in the general population has decreased among adolescents and young adults to its lowest point since Add and smoking pot late s [ 24 ], which is paralleled by patients and caregivers increasingly inquiring about the therapeutic effects of cannabis for developmental and behavioral disorders [ 25 ]. It is particularly relevant to address factors that may influence perceptions about the effects of cannabis on ADHD given that substance use perceptions can influence use [ 2627 ] and, as noted above, cannabis has adverse effects, especially for at-risk populations such as those with ADHD.
As legalized recreational use among adults could ificantly increase access to cannabis among youth and is a growing concern for pediatric health in the US [ 28 ], identifying factors that may impact perceptions promoting cannabis use is a timely issue that is likely to become increasingly important.
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The overall aim of this study was to systematically characterize one source of information that patients and caregivers may use to inform their opinions about ADHD and cannabis: the Internet. Analysis of online information has been increasingly used to identify emerging patterns of substance use [ 31 — Add and smoking pot ], though this has not been extended to substance use in ADHD. Online forums in particular were selected for this study since psychiatric and substance use populations report using forums to Add and smoking pot their healthcare decisions [ 3536 ].
Indeed, more individuals indicate they are more likely to use online forums to address mental health concerns than face-to-face with another person [ 37 ]. These forums facilitate social interactions and allow individuals to self-disclose their unfiltered experiences, inquiries, and opinions about substance use in an anonymous format [ 3438 — 43 ], and may be a fruitful starting point for understanding what patients and caregivers are exposed to when searching for information about the effects of cannabis on ADHD. A qualitative methodology was adopted for the current study to examine the content of online forum thre on the topic of ADHD and cannabis use to identify trends in comments about their relation, particularly regarding therapeutic and adverse effects of cannabis on ADHD.
There are no studies examining how ADHD and cannabis are portrayed online, therefore we adopted a largely exploratory approach to identify trends in forum content that will inform future studies. However, based on changes in the perceived risks of cannabis use [ 24 ], patients and caregivers increasingly inquiring about the therapeutic effects of cannabis [ 25 ], and anecdotal clinical observations on the relationship between ADHD and cannabis, we hypothesized that the majority of forum posts would advocate for the therapeutic effects of cannabis for ADHD in comparison to harmful effects.
A qualitative descriptive methodological approach was adopted. As outlined in Flower et al. To identify forum thre, past studies [ 4447 ] have collected posts from a particular online forum dedicated to a specific patient population. We attempted to expand upon this approach and sample a variety of online forums that patients with ADHD and caregivers may come across when conducting a search for discussions on the topic of ADHD and cannabis.
Forum thre that included links to any other forum thre addressing ADHD and cannabis were also included. This resulted in a total sample of forum thre identified for the current study.
The average of individual posts within each forum thread was The 55 thre yielded a total of individual posts. Such thre included wording used in our search, but did not actually include any comments on any aspect of the relationship between ADHD and cannabis use. Removal of these 9 thre totaling 84 individual Add and smoking pot resulted in 46 thre for analysis.
These 46 thre contained individual posts. The average of individuals posts within each forum thread was A total of the individual posts within the 46 thre did not receive an endorsement for various reasons, such as thanking others for commenting on a question, introducing themselves to the discussion, or tangentially commenting on a discussion about cannabis and ADHD e.
These posts were excluded given the primary aim of this study to characterize the content of comments on ADHD and cannabis. A total of individual forum posts received at least one topic endorsement within the 46 thre see Qualitative Coding below. See Fig 1 for a summary. To allow for analysis of temporal distribution of forum thre, the year of each post was recorded.
This study was exempted from human subjects review by the Duke Institutional Review Board due Add and smoking pot the anonymous and public-access format of the source data.
A list of topics for coding individual posts in a binary response format i. First, a list of potential codes was created a priori by the authors for anticipated online forum discussions involving cannabis and ADHD based on knowledge of the literature and aims of this study. This was followed by a review of individual posts across 30 different thre, prior to random selection of posts, to assess topics that emerged that were not ly considered in the first stage. The authors then finalized the list of specific topics that were coded based on the primary aims of the current study—additional topics on the subject of ADHD and cannabis were coded as well, but are not reported in this study.
All individual posts analyzed in this study received at least one endorsement from any of the topics on the subject of ADHD and cannabis used in the coding process including the additional topics not reported on in this study. For each of these topics, coding was carried out to indicate if the effect of cannabis was stated to be therapeutic, harmful, or both therapeutic and harmful. For the code on the effect of cannabis on ADHD, a null effects option i.
Percentage calculations based on a denominator of From these forum thre, individual posts received at least one code endorsement by a rater. In cases where a person posting quoted another post that was endorsed but they themselves did not clearly endorse or provide sufficient information for the rater to determine if an endorsement was warranted for a particular Add and smoking pot, then an endorsement was not made by the rater.
Multiple posts by the same person as indicated by a user identification name or were allowed since the main purpose of this study was to assess what forum users might be exposed to when looking for information on the topic of ADHD and cannabis use, therefore multiple posts by the same person would not have a meaningful impact on interpretation of the.
Examples that typified endorsements for different topics are reported. Spelling and grammatical errors were not corrected, although vague use of pronouns e. We also compared posts proposing that cannabis is therapeutic to domains other than ADHD.
Table 1 demonstrates that the higher percentage of posts supporting therapeutic versus harmful effects of cannabis was not as apparent for other outcomes i. If anything, it makes it worse. I cant pay attention sober much less high. All posts were made between and Add and smoking pot The percentage of individual post endorsements on the therapeutic, harmful, therapeutic and harmful, and null effects of cannabis on ADHD per year was considered e.
As shown in Fig 2endorsements indicating that cannabis is therapeutic for ADHD has been consistently higher since relative to posts about its potential harmful impact, combined therapeutic and harmful effects, or null effect. Comments about the medicinal aspects of cannabis use in Add and smoking pot context of discussing ADHD were also considered across the posts Table 1. Overall, few commented on how cannabis compares to ADHD medications i. Fifteen percent 62 posts indicated that cannabis was considered medicinal or sanctioned by healthcare providers.
In many cases, these posts pertained to the medicinal use of cannabis for ADHD. Other examples of posts that typified this topic include:. It works very well. I'm 64 and was diagnosed with adult ADD 4 years ago. I had it confirmed by two MD's and a psychiatrist.
This study is the first to systematically analyze a source of online information that patients and caregivers may use to inform their opinions about ADHD and cannabis. A qualitative analysis examining the content of online forum thre on the topic of ADHD and cannabis use indicated that at least three times as many comments advocated for therapeutic effects of cannabis on ADHD compared to comments that cannabis is harmful, both therapeutic and harmful, or has no effect on ADHD.
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The disproportionate of comments favoring the therapeutic over harmful effects of cannabis was specific to ADHD and was not generalizable when mood, non-ADHD psychiatric conditions, or general quality of life were considered. Analysis of the temporal distribution of posts about the effects of cannabis on ADHD indicated that the tendency to advocate for its therapeutic effects has generally been consistent since Qualitative analysis also indicated that comments purporting the therapeutic effects of cannabis for ADHD predominantly referenced improvement in inattentive symptoms, as opposed to hyperactive-impulsive symptoms.
Relatively few comments comparing cannabis against ADHD medications emerged.