A new federal study shows that enrollment in state-legal medical marijuana programs increased significantly across the U.S. in recent years.<\/p>\n
The researchers\u2014from the Centers for Disease Control and Prevention (CDC), the Department of Veterans Affairs (VA) and the University of Michigan\u2014noted that the uptick comes amid \u201cincreasing cultural acceptance of cannabis, recognition of the harm of the \u2018war on drugs\u2019 (for example, mass incarceration and related consequences, such as family separation, trauma, and economic loss), and interest in the potential therapeutic properties of cannabis.\u201d<\/p>\n
Between 2020 and 2022, the number of enrolled medical marijuana patients in the U.S. increased by a third (33.3 percent), says the report, which was funded by the National Institute on Drug Abuse (NIDA) and published this week in the journal Annals of Internal Medicine. All told, the country had more than 4.1 million registered patients in 2022, up from about 3.1 million in 2020.<\/p>\n
At the same time as the medical marijuana patient population has generally grown across the country, however, the study also found that jurisdictions with legal adult-use cannabis have generally seen patient registrations fall.<\/p>\n
To arrive at their conclusions, researchers looked at available data from 39 U.S. jurisdictions with legal medical marijuana. Of those, 34 reported patient enrollment, 19 included information on qualifying conditions and 29 provided information on the number of physicians authorized to recommend marijuana.<\/p>\n
The team previously showed that, between 2016 and 2020, the number of enrolled patients in the U.S. grew \u201cdramatically,\u201d the report says, rising from about 678,000 in 2016 to more than 3 million in 2020.<\/p>\n
\n\u201cThis analysis indicates a 610% increase in patient number in the United States from 2016 to 2022.\u201d<\/p>\n<\/blockquote>\n
California was excluded from the analysis because, as the researchers noted, \u201cit has a voluntary registry that may not be accurate\u201d with respect to the state\u2019s actual medical cannabis patient population.<\/p>\n
The research team said it decided to update its analysis to look at the growth in patient numbers over the last few years in light of the possible federal rescheduling of marijuana<\/a> to Schedule III of the Controlled Substances Act.<\/p>\n
\u201cGiven this potential federal policy shift, which would acknowledge therapeutic potential of cannabis and reduce research barriers,\u201d the study team largely comprised of federal workers wrote, \u201cunderstanding the current national landscape of medical cannabis use and authorization patterns is essential to help inform future public health efforts related to cannabis.\u201d<\/p>\n
The study\u2019s lead author, Kevin Boehnke, a University of Michigan Medical School anesthesiology professor, said in an email to Marijuana Moment that the report \u201cprovides a high-level view of the evolving national cannabis landscape at a time when cannabis may be rescheduled.\u201d<\/p>\n
\u201cThis scheduling change may open up many policy questions into how cannabis regulated at the federal levels, so understanding how many people may be affected and ensuring their needs are met in subsequent policy is critical,\u201d Boehnke said. \u201cOn the clinical side, this study shows that medical cannabis isn\u2019t going anywhere, and it\u2019s important to figure out how best to effectively integrate cannabis into medical treatment given the widespread use.\u201d<\/p>\n
The seven-person team behind the new report includes researchers at CDC\u2019s cannabis strategy unit, VA\u2019s Ann Arbor Healthcare System and the University of Michigan Medical School. It includes a notable acknowledgement by federal officials that \u201cdespite increased use of cannabis for medical and nonmedical purposes, enforcement of cannabis prohibition continues to disparately affect groups that have been marginalized for racial or socioeconomic reasons.\u201d<\/p>\n
Beyond the growing number of states that are legalizing medical marijuana and related \u201cincreasing acceptance of cannabis,\u201d the researchers suggested that pandemic-era policies may have also played a role in the rise in patient registrations.<\/p>\n
\u201cThe study period encompassed the COVID-19 pandemic, during which many medical cannabis markets were designated \u2018essential\u2019 industries, thereby increasing access through curbside pickup, delivery services, and telemedicine visits for licensure,\u201d authors wrote, adding the pandemic \u201cmay have affected the number of people who obtained cannabis licensure for anxiety and PTSD because pandemic-related stress often resulted in worsened mental health conditions.\u201d<\/p>\n
Only two of 15 jurisdictions with legal adult-use marijuana markets saw patient registrations rise during the study period: Massachusetts and Maine. All others saw enrollment fall.<\/p>\n
\u201cThis decreasing enrollment was most dramatic in Arizona,\u201d the report says, \u201cwhich had 295,295 patients in 2020 (411.3 per 10,000 persons in the population) and only 129,836 in 2022 (176.4 per 10,000) after the adult-use law was implemented in 2021.\u201d<\/p>\n
As for why registrations in states with legal marijuana fell, researchers said it could result from patients \u201copting out because they no longer need legal cover for nonmedical adult use,\u201d due to \u201clicensing fees or the inconvenience of certification visits\u201d or simply because they\u2019re buying adult-use products and using them medically.<\/p>\n
In terms of qualifying conditions for state programs, chronic pain and PTSD were by far the most common.<\/p>\n
\u201cChronic pain remained the most common patient-reported qualifying condition during the study period,\u201d the report says, \u201cbut decreased from 1,119,678 instances (65.7% of all patient-reported qualifying conditions) in 2020 to 934,603 (48.4%) in 2022.\u201d<\/p>\n
PTSD, meanwhile, also made up a smaller share of overall reported conditions in 2022 compared to 2020, falling from 14.2 percent to 13.0 percent.<\/p>\n
Part of that change may be due to the addition of more qualifying conditions as medical marijuana programs mature, although researchers noted that a decreasing proportion of total reported conditions are for ailments for which a 2017 National Academies of Sciences, Engineering and Medicine (NASEM) report found that \u201ccannabis has substantial or conclusive evidence of therapeutic value.\u201d By that measure, the percentage of reported conditions dropped from 70.4 percent in 2020 to 53.8 percent in 2022.<\/p>\n
\u201cThe number of conditions in the \u2018other\u2019 category (such as Sj\u00f6gren syndrome, cerebral palsy, muscular dystrophy, and psychiatric conditions) increased considerably,\u201d the study says, \u201cwith substantial contributions from vague categories, such as \u2018all other conditions.’\u201d<\/p>\n
Authors acknowledged that a limitation of the study was the relatively dated 2017 NASEM report, explaining that while it \u201cis the most comprehensive data source on cannabis efficacy for health conditions,\u201d the categories are \u201cimperfect\u201d for three reasons: First, they are broad. Second, NASEM \u201cused products that do not generalize to those in the legal cannabis marketplace.\u201d<\/p>\n
And third, \u201cas research continues, cannabinoids are being shown to be effective for more conditions, such as cannabidiol for Lennox-Gastaut syndrome and Dravet syndrome.\u201d<\/p>\n
Indeed, it was those findings that led to the Food and Drug Administration\u2019s (FDA) only approval of a cannabis-derived medicine, Epidiolex, a pharmaceutical CBD product used to treat the two epilepsy disorders.<\/p>\n
Part of the problem behind the slow research, lead author Boehnke said, is federal prohibition.<\/p>\n
\u201cThe continued criminalization of cannabis at the federal level through \u2018War on Drugs\u2019 policies is harmful and needs to change,\u201d he told Marijuana Moment. \u201cThese policies are a substantial barrier to effective research into the potential benefits and risks of cannabis, criminalize use such that hundreds of thousands of Americans are still being arrested each year (mostly for simple cannabis possession), and present legal and cultural concerns (e.g,. stigma) for clinicians who want to help their patients but are scared to talk about cannabis and likely have received minimal training around using cannabis as a therapeutic option.\u201d<\/p>\n
The number of authorizing clinicians for medical marijuana in 2022 was largely flat compared to two years earlier, falling from 29,552 to 29,500, the study<\/a> found. Notably, however, only 10 of 34 medical marijuana jurisdictions as of 2019 \u201crequired clinicians to register with a state or jurisdiction program to certify patients,\u201d and only nine required clinicians \u201cto complete a course or training to certify patients.\u201d<\/p>\n
Authors concluded that their findings \u201chighlight the need for better surveillance methods to adequately understand the outcomes of medical cannabis use and thoughtful strategies and public health efforts to reduce harms from increased cannabis availability.\u201d<\/p>\n
Boehnke said the further tracking \u201ccould occur through studies on people who obtain medical cannabis licenses and more systematic public health surveillance on the outcomes of widespread cannabis use.\u201d<\/p>\n
\u201cThere should also be more explicit and thoughtful integration of medical cannabis content into clinician curricula, including potential harms and evidence-base therapeutics, as well as understanding the changing legal and use landscape,\u201d he wrote in the email to Marijuana Moment. \u201cWe should also develop thoughtful public health campaigns that offer simple, digestible messages on harm reduction and use behaviors, e.g., avoiding driving while high.\u201d<\/p>\n
To limit potentially negative health consequences, the study also recommends \u201cimplementing appropriate safety and delta-9-tetrahydrocannabinol concentration testing for cannabis products, clarifying the uncertain boundaries between medical and nonmedical markets, and increasing education and training for clinicians and cannabis dispensary employees.\u201d<\/p>\n
Federal agencies have taken a keener interest in studying trends in cannabis markets in recent years, as more U.S. jurisdictions have legalized medical and adult-use marijuana and as the Drug Enforcement Administration (DEA) itself now weighs rescheduling.<\/p>\n
A separate NIDA-funded study on youth cannabis use earlier this year, for instance, found no association between legal adult-use cannabis sales and the prevalence of consumption among middle-school students<\/a>.<\/p>\n
A Department of Justice-funded project, meanwhile, also recently led to what researchers say are new procedures to enhance the selectivity of a popular forensic testing method, allowing better detection of delta-9 THC and its metabolites in blood<\/a>.<\/p>\n
The U.S. Census also launched a map detailing the proportion of state revenue made up by marijuana tax money<\/a> last fall, which it\u2019s updated since then to allow for further comparisons to be made over time<\/a>.<\/p>\n
The 2018 Farm Bill\u2019s legalization of hemp has also spurred more federal investigation, such as a recent analysis of smokable hemp products by researchers at the National Institute of Standards and Technology (NIST). That study found that the vast majority of samples marketed as hemp\u2013about 93 percent\u2014contained more than 0.3 percent THC<\/a>, meaning they in fact qualified as federally illegal marijuana.<\/p>\n
U.S. Customs and Border Protection (CBP) also put out a solicitation in 2022, seeking\u00a0portable marijuana analyzers to quickly identify cannabinoid profiles<\/a>\u00a0and help distinguish between marijuana and hemp.<\/p>\n
USDA last month\u00a0announced a new hemp \u201croadmap,\u201d which includes a call for a public\u2013private hemp consortium<\/a>\u00a0to streamline research into hemp products, and the agency also recently approved a new genetically modified version of hemp that does not produce THC or CBD but is designed to have higher levels of the cannabinoid CBG. It\u2019s at least the second type of genetically modified hemp to get the OK after\u00a0another modified plant, which produces lower levels of THC and CBC<\/a>, was approved in October.<\/p>\n
This article has been updated with comments from the study\u2019s lead author.<\/em><\/p>\n
\nTeen Marijuana Use Has Declined In Washington Since Legalization, New State Research Shows<\/a><\/p>\n<\/blockquote>\n\n
Photo courtesy of Chris Wallis \/\/ Side Pocket Images.<\/em><\/p>\n
The post Medical Marijuana Patient Enrollment Grew 610% Since 2016, Showing \u2018Increasing Cultural Acceptance Of Cannabis,\u2019 Federal Study Finds<\/a> appeared first on Marijuana Moment<\/a>.<\/p>\n
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