Beyond the hype - who uses cannabidiol for self-medication - and why: a cross-sectional study in Germany

Cannabidiol (CBD) products are increasingly popular, marketed with health claims despite limited clinical evidence. This study investigates motives for CBD use in self-medication and explores sociodemographic characteristics and consumption patterns among regular users (at least monthly).

Cross-sectional data were collected via an online survey (January 15-March 15, 2023) in Germany using convenience sampling. Associations between the motive of use (self-medication vs. recreational), sociodemographic characteristics, and consumption patterns were assessed using cross-tabulations, with Chi-square tests (x²) and Cramér's V (V) for effect sizes. Self-medication predictors were analyzed using logistic regression, reporting adjusted odds ratios (aOR) and confidence intervals (CI).

A total of 730 participants participated in the study, with 702 (96.2%) complete cases included in the final analysis. The sample comprised 78.8% males with a mean age of 34.9 years (mean SD: 11.4). Among those using CBD primary for self-medication (37.9%, n = 266), the most prevalent motives were sleeping problems (52.3%), chronic pain (47.4%), depression (45.5%), and anxiety (44.4%). Motives for use were significantly associated with gender (x²=18.4, V = 0.162, p < .001), age (x²=42.3, V = 0.246, p < .001) and occupation (x²=51.8, V = 0.272, p < .001). In the adjusted logistic regression, older individuals (40-49 years, aOR: 1.97, CI: 1.05-3.70, p = .035; ≥50 years, aOR: 2.81, CI: 1.36-5.83, p = .005) and those unemployed or retired (aOR: 3.55, CI: 2.13-5.92, p < .001) were more likely to use CBD for self-medication. Higher chances were also observed in once-daily users (aOR: 2.52, CI:1.23-5.13, p = .011), those consuming CBD morning and evening (aOR: 3.05, CI: 1.42-6.56, p = .004), and individuals using it when needed (aOR: 2.72, CI: 1.72-4.29, p < .001). Smoking CBD mixed with tobacco (aOR: 0.37, CI: 0.22-0.62, p < .001) or pure CBD (aOR: 0.55, CI: 0.30-0.99, p = .046) was negatively associated with self-medication.

This study identifies motives for CBD use in self-medication and examines associations with sociodemographic characteristics and consumption patterns. Clinical trials are needed to confirm efficacy, focusing on dose-response, administration and drug interactions. In the interest of users, the legal status-especially considering the recent partial legalization-should be clearly defined.