Self-reported use of cannabidiol as a substitute or adjunct for approved medications

To assess the prevalence of CBD use among US adults, identify the health conditions for which CBD is used, and examine whether CBD is used as a substitute or adjunct to conventional treatments.

This cross-sectional survey used Ipsos KnowledgePanel®, a US probability-based online panel covering approximately 97% of US adults and including households without internet access (which are provided internet service and/or devices). Between October 25 and November 3, 2023, a random sample of 4,505 US adults was invited; 2,880 responded (63.9% completion) and 1,523 qualified (1,008 ever CBD users and 515 never users). The survey was administered in English and Spanish and weighted analyses provided nationally representative estimates.

Self-reported use of CBD as a substitute (replacement) for or adjunct (combined use) with another medication.

Respondents reporting substitute or adjunct use listed specific health conditions and medications; these were coded using the Medical Dictionary for Regulatory Activities (MedDRA) and RxNav, respectively.

An estimated 35.2% (95% CI, 32.7-37.9) of US adults (approximately 90.8 million) reported ever using CBD, and 21.8% (95% CI, 20.0-23.8) reported use in the past 12 months. Among ever CBD users, 32.0% (95% CI, 29.1-35.1) had used CBD as a substitute or adjunct for at least one medication. Adjunct use (24.2%; 95% CI, 21.5-27.1) was more common than substitute use (11.0%; 95% CI, 9.1-13.3). The conditions most frequently targeted were musculoskeletal and connective tissue disorders (e.g., joint pain; 10.1%; 95% CI, 8.4-12.2), psychiatric disorders (e.g., anxiety; 7.4%; 95% CI, 5.9-9.2), and general disorders or administration site conditions (e.g., procedural pain; 6.8%; 95% CI, 5.4-8.6). Frequently replaced or co-administered medications included ibuprofen (4.8, 95% CI: 3.6-6.3), Tylenol (3.9, 95% CI: 2.8-5.3), and other over-the-counter analgesics. Only a small proportion of CBD ever users reported ever having a health problem they believed resulted from CBD use (2.4%; 95% CI: 1.5-3.6).

CBD use as a substitute or adjunct to medications was common among US adults particularly for pain medications. These patterns underscore the need for better evidence and clearer guidance on dosing, product quality, and co-use with other treatments.