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Approach to Marijuana Use in College Students with Inflammatory Bowel Disease: A Mixed Methods Study

Naueen Chaudhry
University of Florida

Co-Authors: Karen Yung, Chelsea Salmon, S Devi Rampertab, Angela Pham, Ellen M Zimmermann, Ludmila Barbosa De Faria
University of Florida

Introduction: Inflammatory bowel disease (IBD) patients often use marijuana for disease-related symptoms. Since legalization in some states, the college-aged population has shown the greatest increase in its use. Our study explores attitudes towards marijuana among college students with IBD.

Methods: Anonymous survey comprising 39 questions on demographics, disease features, patterns of marijuana use, disease symptoms, quality of life, and true/false statements about marijuana was administered via REDCap to 108 participants recruited from University of Florida (UF) IBD clinic. Responses of college students were compared to the older cohort. Two 60-minute focus groups were conducted via Zoom with 8 participating college students. An interview guide of was shared with participants in advance. Interviews were transcribed for analysis. Compiled data was analyzed by the grounded-theory approach to identify any unique themes that arose from the collected data. Focus group transcripts were independently open-coded by 2 authors prior to categorizing the codes and identifying common emergent themes.

Results: Of 108 survey participants,18 were college students. Medical vs recreational marijuana was more predominant among both college students (8 [44.4%]) and the older>25 yrs cohort (57, [65.5%]). College students reported a greater ratio of medical vs recreational marijuana when using combination patterns of medical/recreational therapies (p=0.0184), and greater hesitancy when considering to start using marijuana (p=0.0451) compared to older>25 yrs. Eleven themes emerged from focus group discussions (Table 3: themes, descriptions and representative quotes). Participants reported ability to avoid opioids and additional pharmaceuticals for symptom management with marijuana use, especially nausea, abdominal pain and poor appetite. It was helpful in navigating mental health challenges such as anxiety and college stress, without impacting their social interactions. Overall, students demonstrated cautious use patterns and good understanding of different formulary effects. They acknowledged challenges such as binge eating, and managing timing of academic and extra-curricular activities to prevent sub-optimal performance associated with their marijuana use. Since recreational marijuana illegal in Florida, they voiced concerns about legal repercussions.

Conclusion: Our findings provide valuable insight into the attitudes of college students with IBD towards marijuana use for symptom management and reveal an understanding of its impact on college students’ mental and physical health, social life, relationships, and academic needs. The healthcare and academic aspects of marijuana use in this population warrant further investigation. Our findings are limited due to sample size and possible positive response bias since participants were current marijuana users.