Illicit Drug Use More Likely in Patients With Psoriasis

Cocaine, heroin, and cannabis use is reported more often in patients with psoriasis; physicians should be alert to this possibility in their patients.

Patients with psoriasis are more likely to use cocaine, heroin, and cannabis, according to study data published in the Journal of the American Academy of Dermatology.

Researchers sought to determine whether illicit drugs or cannabis is associated with psoriasis in order to develop evidence-based recommendations for clinicians. Using data from the United States National Health and Nutrition Examination Survey (NHANES) from 2009 to 2014, they conducted a cross-sectional study that included 309 patients with psoriasis and 1236 matched controls without psoriasis. The researchers found that after taking comorbidities, alcohol use, and smoking into consideration, psoriasis was consistently associated with the use of illicit drugs (adjusted odds ratio [aOR] = 1.54), cocaine (aOR = 1.66), heroin (aOR = 1.83), and regular cannabis (aOR = 1.66).

There were several study limitations, including a series of cross-sectional surveys and  concerns about the temporal relationship between psoriasis and illicit drug use. In addition, the study was limited by the available data in the NHANES and the investigators were unable to control for certain variables. Finally, the study was conducted using self-reported questionnaires, which may have been susceptible to recall and information biases.

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The researchers concluded that the study, “found that patients with psoriasis had a significantly higher probability of using illicit drugs, cocaine, heroin, and cannabis (on a regular basis) than the participants without psoriasis.” They added that, “Physicians and policy makers should be alert to possible drug use among populations with psoriasis.”

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Kao L-T, Li I-H, Wang W-M, Lee H-C, Kao H-H, Pan K-T. Illicit drugs, cannabis, and psoriasis in the United States: National Health and Nutrition Examination Survey [published online January 8, 2020]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2020.01.001