With the legalization of medical and recreational cannabis there have been positive and negative health claims. We are sometimes asked whether cannabis can help or hurt people with Valley Fever. Since feedback from users has been inconsistent we are not able to report on trends within our community. There also had not been a specific medical study.
Now there is a study, although after answering some questions it raises others.
A recent article from Emerging Infectious Diseases checked the IBM MarketScan Research Databases for medical insurance information from over 27 million Americans. When checking for patients who had a major invasive fungal infections, the study found cannabis users were 4.6 times more likely to have mold infections like aspergillosis than non users. When looking for medically recognized systemic fungal infections (coccidioidomycosis was included in this list) cannabis users were almost 3 times more likely to be diagnosed than non-users.
What does this mean?
The short answer is that this study follows previous data trends, like a study suggesting that cannabis may be dangerous for the health of transplant patients dealing with fungal infections.
The longer answer is that new questions have been raised.
The risk calculations were based on the insurance data set and handled with adjusted odds ratios that accounted for a number of factors: Immunocompromised status, tobacco use, medically recognized chemical dependence, and other considerations.
In this large commercially insured population in the United States, cannabis use was associated with a higher prevalence of certain fungal infections. Although these infections were uncommon,* they can result in substantial illness and even death, particularly in immunocompromised persons.
*VFS Note: Fungal infections are often wrongly regarded as uncommon often due to a lack of medical awareness and poor diagnostic tools but kill 1.6 million people annually worldwide.
Generally the cannabis users in the study were sicker and had more risk factors, making their bodies weaker at defending against severe fugnal infections like Valley Fever. The use of adjusted odds ratios attempted to account for these general differences in relation to non-users and still showed a dramatically higher risk among users.
Were the patients using cannabis for a escape from the pain of their health problems or did it cause their health problems directly? The possibility of pain reilef was not a consideration.
Would edibles produce less damage due to the absence of damaging smoke inhalation?
Cannabis itself has many components that can be separated and studied individually for their pharmacological effects. Some components are antifungal and may be studied ultimately to fight Valley Fever. Some are immunosuppressive, which could pose a danger for people with fungal infections like Valley Fever. No particular cannabis product’s composition was evaluated within the study.
Is it possible that infectious fungi are passed to the consumer as an inherent part of cannabis agriculture, only now being discovered as insurance codes can be tracked to look for the danger?
Many questions remain. As the Valley Fever Epidemic continues, it could be expected that there will be time for answers.
Sources:
The original medical article:
Benedict K, Thompson GR 3rd, Jackson BR. Cannabis Use and Fungal Infections in a Commercially Insured Population, United States, 2016. Emerg Infect Dis. 2020;26(6):1308‐1310.
A quick summary of the original article:
https://www.healio.com/primary-care/infectious-diseases/news/online/%7B8bc83258-f975-4994-8508-6b661ae1d3d4%7D/cannabis-users-at-higher-risk-for-fungal-infections-causal-link-missing
Additional information:
Avery RK, Michaels MG, Infectious Diseases AST; AST Infectious Diseases Community of Practice. Strategies for safe living following solid organ transplantation-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019;33:e13519