Abstract
BackgroundUS states have been adopting their own medical cannabis laws since 1996. There is substantial variability in the medical cannabis programs between states, and these differences have not been thoroughly investigated in the literature. The objective of the study was to compare medical cannabis patient characteristics across five states to identify differences potentially caused by differing policies surrounding condition eligibility.MethodsWe conducted secondary analyses following a retrospective study of a registry database with data from 33 medical cannabis evaluation clinics in the US, owned and operated by CB2 Insights. This study narrowed the dataset to include patients from five states with the largest samples: Massachusetts (n = 27,892), Colorado (n = 16,434), Maine (n = 4591), Connecticut (n = 2643), and Maryland (n = 2403) to conduct an in-depth study of the characteristics of patients accessing medical cannabis in these states, including analysis of variance to compare average ages and number of conditions and chi-squared tests to compare proportions of patient characteristics between states.ResultsAverage ages varied between the states, with the youngest average in Connecticut (42.2) and the oldest in Massachusetts (47.0). Males represented approximately 60% of the patients with data on gender in each state. The majority of patients in each state had cannabis experience prior to seeking medical certification. Primary medical conditions varied for each state, with chronic pain, anxiety, and back and neck problems topping the list in varying orders for Massachusetts, Maine, and Maryland. Colorado had 78.7% of patients report chronic pain as their primary condition, and 70.4% of patients in Connecticut reported post-traumatic stress disorder as their primary medical condition.ConclusionThis study demonstrated the significant impact that policy has on patients’ access to medical cannabis in Massachusetts, Colorado, Maine, Connecticut, and Maryland utilizing real-world data. It highlights how qualifications differ between the five states and brings into question the routes through which patients in states with stricter regulations surrounding eligible conditions choose to seek treatment with cannabis. These patients may turn to alternative treatments, or to the illicit or recreational cannabis markets, where permitted.
Highlights
United States (US) states have been adopting their own medical cannabis laws since 1996
Demographic characteristics There were 61,379 patients included in the original analysis
The average age of females was older than males in each state, but the difference was only significant in Colorado, Massachusetts, and Maine (45.1 vs 42.2, p < 0.001; 48.9 vs 46.2, p < 0.001; and 47.0 vs 45.6, p = 0.0036, respectively)
Summary
US states have been adopting their own medical cannabis laws since 1996. There is substantial variability in the medical cannabis programs between states, and these differences have not been thoroughly investigated in the literature. The cannabis plant has been used for centuries in traditional medicine, the laws and policies surrounding its use have been drastically shifting in the US over the last two decades (Alsherbiny and Li 2018; Boehnke et al 2019a; Cambron et al 2017; Fairman 2016). Though it remains illegal on a federal level, since the mid-1990s, individual states have been developing their own laws for its use; California was the first state to legalize medical cannabis in 1996 (Legislatures NC of S 2020). Other states have decriminalized the use of recreational cannabis, whereas some still retain a strict prohibitionist approach both medically and recreationally (Legislatures NC of S 2020; Pacula and Smart 2017)
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