As COVID-19 continues to spread in the United States, Denise Vidot, an epidemiologist and assistant professor in the School of Nursing and Health Studies at the University of Miami, is leading a cross-sectional study that seeks to document how cannabis consumers are being affected by the coronavirus.
Specifically, Vidot wants to know more about the physical and mental health of cannabis consumers during the pandemic, and whether cannabis consumers have “experienced changes in their frequency of cannabis use, dosing, access, or preferred methods of ingestion as a result of either COVID-19-related closures or emergency actions,” Vidot told Cannabis Wire.
Vidot is using an anonymous electronic survey to gather epidemiologic data on the mental and physical health of these consumers. The survey remains open, and so far, about 1,500 medical and adult use consumers from 27 countries including the United States have submitted, Vidot said.
Some early results shared with Cannabis Wire:
• 306 respondents (37.1 percent) said they’ve stopped sharing “joints, blunts, or spliffs” due to COVID-19
• 326 (39.5 percent) said medical cannabis use has increased
• 407 (49.3 percent) said they bought their medical cannabis supply in advance
• 448 (54.3 percent) said they have had concerns about being able to pay for their medical cannabis. (Health insurance, generally, does not cover the costs of medical cannabis in the US, as it is still federally illegal.)
Cannabis Wire talked with Vidot, who is leading the collaborative and interdisciplinary study, to learn more. (This conversation has been edited slightly for clarity.)
Alyson Martin, Cannabis Wire: Can you talk about the moment that you decided to pursue this research, and why? Was there a specific catalyst or a question in your mind that prompted it?
Denise Vidot, University of Miami: By background, I’m a cannabis epidemiologist. And so what does that mean? There’s probably not many people calling themselves that, especially since cannabis has been an evolving issue.
What I do in all of my studies is, I apply my epidemiologic training to see how I can provide data to help cannabis users who are using it for medicinal purposes, and also shed light on the potential negative consequences for those who are not using it for medical purposes.
I’m an epidemiologist and I teach introductory epidemiology. I have a class of about 85 students, and we’ve been tracking this since the very beginning of the semester, because I always teach outbreaks. So last semester, for example, I taught about the vaping outbreak, which I was also studying.
The students, really, are the ones that were like: “Dr. Vidot, what happens if it comes to the U.S.?” A student asked, “Dr. Vidot, are you looking at this?” And I was like, you know, indirectly, but maybe we should look at this more directly.
This is a collaborative study, and one of the things I really want to highlight is the fact that we are really using a multi-disciplinary approach, starting from undergrad students all the way to literal global experts.
Martin, Cannabis Wire: So, the survey is now open. Can you speak to the responses that have come in?
Vidot: We’re currently analyzing the data to submit for a brief report, because obviously the survey is not complete, but it’s good to get information. We received over a thousand responses. And that’s amazing because there’s no incentive.
“How are you going to be disseminating this information?” is what I keep hearing. Patients are scared to tell me. “Oh, I’m using cannabis to maintain the disease or manage disease, but don’t publish it.”
I think that is an interesting finding from a science perspective, because that speaks to the uncounted population, and the silent population that may be at more of a risk for just exposure at this point. That is what we’re the most interested in, to try to protect this vulnerable population. And so, if people are hiding their behavior just for fear of having that stigma, then I fear that we’re uncounting this population. And that’s why my quote is always: “medicinal cannabis users are a population we cannot forget about in our quest to flatten the curve.”
Martin, Cannabis Wire: Are survey respondents only domestic, or are they international, too?
Vidot: It’s international. Of the thousand or so that have submitted, about a hundred are international.
Martin, Cannabis Wire: Are you in touch with any cannabis companies or organizations to get the word out about the survey?
Vidot: I have been collaborating with NORML (the National Organization for the Reform of Marijuana Laws). They’ve shared the information, so that has been great. And getting medicinal users to you know—it’s kind of hard to trust research and I can’t blame anyone, honestly, even as a researcher. So I’ve found that collaborating has been helpful.
Martin, Cannabis Wire: Have you had any noteworthy response from fellow researchers? You mentioned the stigma earlier.
Vidot: I have to tell you that in the years that I’ve been working on cannabis research, this is the first time in my entire career that people are actually sharing the study, encouraging others to respond. And what that tells me is, wow, we’re finally listening.
It’s still relevant to know that it is a multi-disciplinary, collaborative study. On the collaboration of experts, none of them are cannabis researchers except for me. So the only thing that everyone has in common is, finally, everyone wants to do whatever we can to try to flatten the curve. And so people who are not normally collaborating with me with cannabis research are now collaborators because we all are understanding now, OK, we cannot ignore this population.
Martin, Cannabis Wire: Can you share the source of funding for this research?
Vidot: Well, this is my passion. And so it’s a self-funded study. It started that way. Since then, I received a rapid response grant from the University of Miami to extend the survey to young adults. That’s a new study that was just funded.
This study was originally internally-funded, just a University of Miami epidemiologist thinking, what can we do using the resources that we have.
The funding that we would need would be incentives for participants, and that’s what we’re currently working on.
So I’m writing grants to the NIH to get funding to pay participants for follow ups, so we can see, over time. But for right now, this is a cross-sectional study.
Martin, Cannabis Wire: When do you expect the survey to close and when do you expect to publish results?
Vidot: In my mind, it is going to be open until we figure out COVID. You know how it is rapidly evolving? That’s how long I would consider the survey open.
Martin, Cannabis Wire: Are you working on any other cannabis and COVID research?
Vidot: I would like to know how those who may be using cannabis consistently … I hesitate to say this word, but how they may or may not be protected from COVID.
How are they differentially impacted? Especially thinking of the endocannabinoid system and about immune systems. I research HIV patients, I research cancer patients, I also research healthy individuals who use cannabis.
And one thing that I can say in common for many of them, is that they will stop other medications, but they are less likely to stop medicinal cannabis.
And so with that being said, is that enough to protect them from other things? Is that smart? As a researcher, my question is, okay, this is happening. I hear it from participants. So, it’s no longer a question of are people doing it or not? My question now is, okay, that’s happening. Right? Fine. What does that mean for their health? So, I would be interested in studying people who mentioned that.
Martin, Cannabis Wire: What other kind of cannabis research have you done, or are you working on next? I don’t think I’ve heard of anyone else with the title “cannabis epidemiologist.”
Vidot: I think I’m trying to make it a thing. I don’t know. Maybe I’m the pioneer. I don’t know of any other person. Originally, it was all recreational. But since medicinal has become more popular and legal, I should say, now I’m able to separate between recreational and medicinal with regard to my research.
I have a lab that literally has 10 active studies going on. That means that they’re collecting data or analyzing data. One of their lines is in regard to bariatric surgery patients. I’ve been collaborating for a few years now looking at how cannabis can impact the outcome.
We also have one on pregnancy and breast feeding and maternal child health. Related to COVID, right now, we’re actually designing a survey to gauge the closures of things and how the lack of resources may be impacting mothers who are breastfeeding or nursing, some of them who may be using, let’s say, CBD for anxiety.
Are they using more than they were recommended to as a result? Or are they not able to have access? And how is that impacting their health and their child, unborn or alive child?
For another one, we’re looking at a cardiovascular outcome by age range, by ethnicity, from the entire United States.
I also have two live studies that are running right now on HIV patients, looking at their microbiome, and how engaging in cannabis use for medicinal purposes can either help or hurt your microbiome.
We’re also studying cancer patients who use it to manage their symptoms. Is it related to any negative or positive mental health effects? They may be using it to help with chemo, but is it also helping their mental health? Or is it making it worse?
I would say my favorite study that I’m working on is following a group of adults that don’t have a chronic health condition. So they’re just healthy community individuals, and we’re seeing how their cannabis use patterns change and how their health is coming about. Shockingly, most of my results are showing that cannabis users have sort of a lower prevalence of metabolic syndrome, lower prevalence of these negative health outcomes that we expect to see from cannabis users.
Martin, Cannabis Wire: Are there any specific preliminary results that you can share with our readers?
Vidot: Mental health is the most alarming, most prevalent thing that everyone is reporting, whether it’s a recreational or medicinal user. And also the majority of our respondents have been reporting increased use in their cannabis and a fear of not being able to pay for their cannabis. So they’ve been stockpiling.
But what’s most interesting to me is that we have the data showing that not only are these, especially medicinal cannabis users, stocking up on medicinal supply, but they’re also increasing their use, which is a little concerning to me from a science perspective. What happens after COVID?