Three studies (93 participants) that assessed cannabis in people with active CD met the inclusion criteria. One ongoing study was also identified. Participants in two of the studies were adults with active Crohn’s disease who had failed at least one medical treatment. The inclusion criteria for the third study were unclear. No studies that assessed cannabis therapy in quiescent CD were identified. The studies were not pooled due to differences in the interventional drug.
Crohn’s disease (CD) is a chronic immune-mediated condition of transmural inflammation in the gastrointestinal tract, associated with significant morbidity and decreased quality of life. The endocannabinoid system provides a potential therapeutic target for cannabis and cannabinoids and animal models have shown benefit in decreasing inflammation. However, there is also evidence to suggest transient adverse events such as weakness, dizziness and diarrhea, and an increased risk of surgery in people with CD who use cannabis.
The effects of cannabis and cannabis oil on Crohn’s disease are uncertain. Thus no firm conclusions regarding the efficacy and safety of cannabis and cannabis oil in adults with active Crohn’s disease can be drawn. The effects of cannabis or cannabis oil in quiescent Crohn’s disease have not been investigated. Further studies with larger numbers of participants are required to assess the potential benefits and harms of cannabis in Crohn’s disease. Future studies should assess the effects of cannabis in people with active and quiescent Crohn’s disease. Different doses of cannabis and delivery modalities should be investigated.
The researchers studied whether cannabis is better than placebo (e.g. a sugar pill) therapy for treating adults with active Crohn’s disease or Crohn’s disease that is in remission.
We searched MEDLINE, Embase, AMED, PsychINFO, the Cochrane IBD Group Specialized Register, CENTRAL, ClinicalTrials.Gov, and the European Clinical Trials Register up to 17 October 2018. We searched conference abstracts, references and we also contacted researchers in this field for upcoming publications.
What did the researchers find?
Crohn’s disease is a long-term condition that results in inflammation of the gastrointestinal tract, occurring anywhere from the mouth to the anus. Common symptoms include fever, diarrhoea, abdominal pain and weight loss. Crohn’s disease is characterized by periods of relapse when people are actively experiencing symptoms and periods of remission when the symptoms stop.
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The answer is no, she says. There’s no objective improvement in inflammation.
Only one of the three suggests that cannabis in the form of marijuana cigarettes might help people who hadn’t done well with other treatments control their disease. Five out of 11 people who smoked cannabis cigarettes for 8 weeks in the study had a remission, compared to one person in the group that smoked placebo cigarettes. The other two studies looked at CBD oil. Neither found CBD helped people control their Crohn’s disease. One of them did show some evidence that the treatment helped improve quality of life.
What the Studies Say
Experts generally agree that the data on cannabis for Crohn’s is uncertain for now. The only data in people with Crohn’s disease come from three small clinical studies. Altogether, those studies include fewer than 100 people with active Crohn’s.
People who use cannabis may be more likely than those who don’t to stop traditional therapy. And there are risks when you stop the treatment you need. “One of the biggest risks of relapse is hospitalization requiring steroids or surgery,” Kinnucan says.
More research is needed in more people with Crohn’s disease, and there are studies ongoing. One reason it’s complicated is that cannabis comes in many varieties. The plant has two main active ingredients: THC (short for delta-9 tetrahydrocannabinol) and CBD (short for cannabidiol). It’s the THC in marijuana that gives you a high. The CBD products you can buy usually come from hemp and shouldn’t have much if any THC. We need more time to study the various compounds found in cannabis.