Attitude and Use of Cannabis in People With Multiple Sclerosis: A Scoping Review

This scoping review examines factors influencing attitude, knowledge, decision-making, and cannabis use in people with multiple sclerosis (PwMS). We searched PubMed, CINAHL (EBSCO), PsycINFO (ProQuest), and Scopus on June 9, 2024, and registered the protocol on the Open Science Framework (DOI:10.17605/OSF.IO/SMFZ5). Quantitative, qualitative, and empirical peer-reviewed articles on cannabis use prevalence, perception, knowledge, attitude, decision-making, and influencing factors by PwMS were included, whereas overviews, commentaries, reviews, book chapters, or dissertations were excluded. We retrieved 345 articles, screened 116 for eligibility, and found 13 qualified. Cannabis use in PwMS was associated with gender, age, smoking experience, education, employment, disability magnitude, and legalization status. Reported incentives included pain relief, sleep improvement, and spasticity reduction. Family, friends, health care providers, and state laws influenced decisions to use cannabis. Inhibitors included legal issues, lack of information, health risks, side effects, parental disapproval, religious views, and costs of cannabis products. As cannabis legalization expands, understanding its use patterns and impacts among PwMS is crucial, particularly for usage duration, frequency, and interaction with multiple medications and therapies. We proposed a cannabis use framework to help health care providers assess the intention, interest, status, and experience in cannabis use/disuse of PwMS.