Advertisement

Alternative and Complimentary Medication Use in Singers: A Pilot Survey

Published:October 18, 2022DOI:https://doi.org/10.1016/j.jvoice.2022.08.021

      Summary

      Objective

      Cannabidiol (CBD) is an active ingredient in marijuana that has demonstrated anti-inflammatory properties. It's therapeutic potential and accessibility has made the product popular. Over the counter products (OTC) products have also demonstrated therapeutic potential and have been accessible in public markets for a long time. The objective was to better understand the use of CBD and OTC products amongst singers with varying singing styles.

      Methods

      An anonymous online survey was distributed to 1053 singers via The Research Electronic Data Capture (RED-Cap) program in association with Drexel University. The survey aimed to obtain information regarding singing proficiency, styles, if respondents used CBD/OTC products, reasons for use, perceived effects on the voice due to use of these products, and how informed were they in regards to use of these products.

      Results

      From 1053 singers, we obtained 144 respondents (response rate of 13.7%). The average age of respondents was 51.8 years; There were 47 males, 93 females, and four who were nonbinary or preferred not to provide their gender. The majority of respondents (63.2%) were professional singers. Primary singing styles included operatic (18.1%), sacred (20.8%), and musical theater (20.1%). Eighty-seven point five percent of respondents reported warming up before singing and 22.9% reported cooling down after singing. Thirteen respondents reported use of a cannabidiol (CBD) product. Information resources for CBD used primarily came from an online website (38.5%). Among the 13 respondents who reported use of CBD products, 46.2% of these respondents did not notice any positive effects and 46.2% reported no negative effects on the voice when using CBD products. Eighty-two respondents (56.9%) reported use of an OTC, supplement, or alternative medicine product. Majority received Information resources from a physician or other healthcare provider (81.7%). The most frequently reported OTC or complimentary medications used were reflux medications, antihistamines, acetaminophen, and NSAIDs. Reduced inflammation, improved voice recovery, improved voice quality, and improved voice endurance were commonly reported positive effects on the voice with OTC/AM use. Vocal strain, hoarseness, and dryness were the most commonly reported negative effects on the voice with OTC/AM use.

      Conclusions

      Stress, anxiety, or chronic pain was often the primary reason for CBD use amongst singers. The most common OTC medications were used reflux medications, antihistamines, acetaminophen, and NSAIDs.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Behlau M
        • Oliveira G.
        Vocal hygiene for the voice professional.
        Curr Opin Otolaryngol Head Neck Surg. 2009; 17: 149-154https://doi.org/10.1097/MOO.0b013e32832af105
      1. Calcinoni O, Borgonovo G, Cassanelli A, et al. Herbs for voice database: developing a rational approach to the study of herbal remedies used in voice care. J Voice. Published online 2020. doi:10.1016/j.jvoice.2019.12.027

        • Harris PA
        • Taylor R
        • Minor BL
        • et al.
        The REDCap consortium: Building an international community of software platform partners.
        J Biomed Inform. 2019; : 95https://doi.org/10.1016/j.jbi.2019.103208
        • Harris PA
        • Taylor R
        • Thielke R
        • et al.
        Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381https://doi.org/10.1016/j.jbi.2008.08.010
        • Hazekamp A
        • Ware MA
        • Muller-Vahl KR
        • et al.
        The medicinal use of cannabis and cannabinoids-An International Cross-Sectional Survey on Administration Forms.
        J Psychoactive Drugs. 2013; 45: 199-210https://doi.org/10.1080/02791072.2013.805976
      2. CANNABIDIOL (CBD) Critical Review Report. Expert Committee on Drug Dependence Fortieth Meeting. World Health Organization. Geneva. June 4-7, 2018.

        • Hazekamp A.
        The trouble with CBD oil.
        Med Cannabis Cannabinoids. 2018; 1: 65-72https://doi.org/10.1159/000489287
        • Laprairie RB
        • Bagher AM
        • Kelly MEM
        • et al.
        Cannabidiol is a negative allosteric modulator of the cannabinoid CB 1 receptor.
        Br J Pharmacol. 2015; 172: 4790-4805https://doi.org/10.1111/bph.13250
        • Amenta PS
        • Jallo JI
        • Tuma RF
        • et al.
        Cannabinoid receptor type-2 stimulation, blockade, and deletion alter the vascular inflammatory responses to traumatic brain injury.
        J Neuroinflammation. 2014; 11: 191https://doi.org/10.1186/s12974-014-0191-6
        • Pazos MR
        • Mohammed N
        • Lafuente H
        • et al.
        Mechanisms of cannabidiol neuroprotection in hypoxic-ischemic newborn pigs: Role of 5HT1A and CB2 receptors.
        Neuropharmacology. 2013; 71: 282-291https://doi.org/10.1016/j.neuropharm.2013.03.027
        • Kaplan BLF
        • Springs AEB
        • Kaminski NE.
        The profile of immune modulation by cannabidiol (CBD) involves deregulation of nuclear factor of activated T cells (NFAT).
        Biochem Pharmacol. 2008; 76: 726-737https://doi.org/10.1016/j.bcp.2008.06.022
        • Hampson AJ
        • Grimaldi M
        • Axelrod J
        • et al.
        Cannabidiol and (-)Δ9-tetrahydrocannabinol are neuroprotective antioxidants.
        Proc Natl Acad Sci U S A. 1998; 95: 8268-8273https://doi.org/10.1073/pnas.95.14.8268
        • Haney M
        • Malcolm RJ
        • Babalonis S
        • et al.
        Oral cannabidiol does not alter the subjective, reinforcing or cardiovascular effects of smoked cannabis.
        Neuropsychopharmacology. 2016; 41: 1974-1982https://doi.org/10.1038/npp.2015.367
        • Babalonis S
        • Haney M
        • Malcolm RJ
        • et al.
        Oral cannabidiol does not produce a signal for abuse liability in frequent marijuana smokers.
        Drug Alcohol Depend. 2017; 172: 9-13https://doi.org/10.1016/j.drugalcdep.2016.11.030
        • Fernholz I
        • Mumm JLM
        • Plag J
        • et al.
        Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects.
        Psychol Med. 2019; 49: 2287-2306https://doi.org/10.1017/S0033291719001910
        • Fogaça MV
        • Reis FMCV
        • Campos AC
        • et al.
        Effects of intra-prelimbic prefrontal cortex injection of cannabidiol on anxiety-like behavior: Involvement of 5HT1A receptors and previous stressful experience.
        Eur Neuropsychopharmacol. 2014; 24: 410-419https://doi.org/10.1016/j.euroneuro.2013.10.012
        • Hundal H
        • Lister R
        • Evans N
        • et al.
        The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group.
        J Psychopharmacol. 2018; 32: 276-282https://doi.org/10.1177/0269881117737400
        • Sataloff RT
        • Hawkshaw MJ
        Medications and the voice.
        in: Sataloff RT Professional Voice: The Science and art of Clinical Care. fourth ed. Plural Publishing, Inc, San Diego, CA2017: 1103-1133
        • Clarós P
        • Mikolajczyk K
        • Pujol AC
        • et al.
        Side effects of medications in professional opera singers’ voice: survey findings.
        Int J Otorhinolaryngol Head Neck Surg. 2020; 6: 213https://doi.org/10.18203/issn.2454-5929.ijohns20200131
      3. Calcinoni O, Borgonovo G, Cassanelli A, et al. Herbs for voice database: developing a rational approach to the study of herbal remedies used in voice care. J Voice. Published online 2020. doi:10.1016/j.jvoice.2019.12.027

        • Kwok M
        • Eslick GD.
        The impact of vocal and laryngeal pathologies among professional singers: A meta-analysis.
        J Voice. 2018; 33: 58-65https://doi.org/10.1016/j.jvoice.2017.09.002
        • Hirzel E
        • Lindinger PW
        • Maseneni S
        • et al.
        Differential modulation of ROS signals and other mitochondrial parameters by the antioxidants MitoQ, resveratrol and curcumin in human adipocytes.
        J Recept Signal Transduct. 2013; 33: 304-312https://doi.org/10.3109/10799893.2013.822887
        • Surow JB
        • Lovetri J.
        "Alternative medical therapy” use among singers: prevalence and implications for the medical care of the singer.
        J Voice. 2000; 14: 398-409https://doi.org/10.1016/S0892-1997(00)80085-5
      4. (PDF) Contribution of Herbal Products In Global Market. Available at: https://www.researchgate.net/publication/320357308_Contribution_of_Herbal_Products_In_Global_Market. Accessed June 22, 2021.

        • Johnson TP
        • Wislar JS.
        Response rates and nonresponse errors in surveys.
        JAMA - J Am Med Assoc. 2012; 307: 1805-1806https://doi.org/10.1001/jama.2012.3532