Marijuana Dispensaries Research Articles

State licenses for medical marijuana dispensaries: neighborhood-level determinants of applicant quality in Missouri

BackgroundWhen state governments impose quotas on commercial marijuana licenses, regulatory commissions use an application process to assess the feasibility of prospective businesses. Decisions on license applications are often met with formal appeals and legal challenges from rejected applicants. Although prior research has examined substate disparities in the availability of marijuana dispensaries, less attention has been given to the quality of license applications. The present study analyzed the relationship between neighborhood-level characteristics and the quality of prospective dispensary businesses.MethodsDuring Missouri’s first applicant pool for medical marijuana dispensaries in 2019, a total of 606 census tracts contained the location site of at least one dispensary applicant. Using data from the Missouri Department of Health and Senior Services and the American Community Survey, fractional and binary logistic regression models were used to estimate the relationship between census-tract characteristics and application outcomes.ResultsLicense applications received higher evaluation scores when proposed dispensary sites were in census tracts with greater population densities and no majority in racial/ethnic composition. Census tracts with poorer socioeconomic conditions attracted a disproportionate share of low-scoring applicants from the bottom quartile of scores. These effects were stronger for certain application subsections, particularly those assessing the quality of an applicant’s business plan and on-site security.ConclusionsSome communities tend to attract prospective license holders who possess better quality resources, business practices, and industry experience. State disparities in commercial licensing requirements and application processes may lead to the inequities in legal product access found in some prior studies.

Dispensaries and Medical Marijuana Certifications and Indications: Unveiling the Geographic Connections in Pennsylvania, USA

Introduction: Pennsylvania opened its first medical marijuana (MMJ) dispensary in 2018. Qualifying conditions include six conditions determined to have no or insufficient evidence to support or refute MMJ effectiveness. We conducted a study to describe MMJ dispensary access in Pennsylvania and to determine whether dispensary proximity was associated with MMJ certifications and community demographics. Methods: Using data from the Pennsylvania Department of Health, we geocoded MMJ dispensary locations and linked them to US Census Bureau data. We created dispensary access measures from the population-weighted centroid of Zip Code Tabulation Areas (ZCTAs): distance to nearest dispensary and density of dispensaries within a 15-min drive. We evaluated associations between dispensary access and the proportion of adults who received MMJ certification and the proportion of certifications for low evidence conditions (amyotrophic lateral sclerosis, epilepsy, glaucoma, Huntington’s disease, opioid use disorder, and Parkinson’s disease) using negative binomial modeling, adjusting for community features. To evaluate associations racial and ethnic composition of communities and distance to nearest dispensary, we used logistic regression to estimate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for median income. Results: Distance and density of MMJ dispensaries were associated with the proportion of the ZCTA population certified and the proportion of certifications for insufficient evidence conditions. Compared to ZCTAs with no dispensary within 15 min, the proportion of adults certified increased by up to 31% and the proportion of certifications for insufficient evidence decreased by up to 22% for ZCTAs with two dispensaries. From 2018 to 2021, the odds of being within five miles of a dispensary was up to 20 times higher in ZCTAs with the highest proportions of individuals who were not White (2019: OR: 20.14, CI: 10.7–37.8) and more than double in ZCTAs with the highest proportion of Hispanic individuals (2018: OR: 2.81, CI: 1.51–5.24), compared to ZCTAs with the lowest proportions. Conclusions: Greater dispensary access was associated with the proportions of certified residents and certifications for low evidence conditions. Whether these patterns are due to differences in accessibility or demand is unknown. Associations between community demographics and dispensary proximity may indicate MMJ access differences.

The impact of recreational marijuana dispensaries on crime: evidence from a lottery experiment

The impact of recreational marijuana dispensaries on crime: evidence from a lottery experiment

Access to Marijuana by Minors Via Online Dispensaries

This cross-sectional study examines online marijuana dispensaries and their age verification procedures to prevent youth access.

Medical marijuana access and prolonged opioid use among adolescents and young adults.

Laws liberalizing access to medical marijuana are associated with reduced opioid analgesic use among adults, but little is known about the impact of such policies on adolescents and young adults. This retrospective cohort study used 2005 to 2014 claims from MarketScan® Commercial database, which covers all 50 states and Washington D.C. The sample included 195,204 adolescent and young adult patients (aged 12-25) who underwent one of 13 surgical procedures. Of the 195,204 patients, 4.8% had prolonged opioid use. Several factors were associated with a higher likelihood of prolonged opioid use, including being female (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], 1.21-1.33), longer hospital stay (aOR, 1.04; 95% CI, 1.02-1.06), greater days of index opioid supply (8-14 days: aOR, 1.39, 95% CI, 1.33-1.45; greater than 14 days: aOR, 2.42, 95% CI, 2.26-2.59), rural residence (aOR, 1.07; 95% CI, 1.01-1.14), and cholecystectomy (aOR, 1.16; 95% CI, 1.08-1.25). There was not a significant association of medical marijuana dispensary laws on prolonged opioid use (aOR, 0.98; 95% CI, 0.81-1.18). Medical marijuana has been suggested as a substitute for opioids, but our results focusing on adolescents and young adults provide new evidence that this particularly vulnerable population does not exhibit reductions in prolonged use of opioids after surgery when they have legal access to medical marijuana. These findings are the first to demonstrate potentially important age differences in sustained use of opioids, and point to the need for prescriber oversight and management with this vulnerable population.

Tobacco/nicotine use among individuals using cannabis for therapeutic purposes.

While the relationship between recreational cannabis and nicotine use is well established, little is known about nicotine use among users of cannabis for therapeutic purposes (CTP). Patients attending a medical marijuana dispensary (N = 697; 75.3% White; 60.0% male) completed a survey examining nicotine use, motivation to quit cigarette smoking, routes of administration of nicotine and cannabis, and CTP qualifying conditions. More than one-third (39.3%) of participants reported current nicotine use. Compared to exclusive cigarette smokers, e-cigarette users and non-users of nicotine were approximately four times more likely to vape, rather than to smoke, cannabis. Furthermore, 46.8% of cigarette smokers reported plans to quit smoking in the next 6 months (but not in the next month) and an additional 31.6% planned to quit in the next month. Having a psychiatric condition was associated with nicotine use and higher motivation to quit smoking. Users of CTP are more likely to use nicotine products than the general population and the route of administration of nicotine products is related to the route of administration of CTP. If aerosolized CTP is a less harmful route of administration than smoked CTP, dispensary staff should be aware of this relationship and take this into account when recommending a noncombustible route. This study further characterizes nicotine use behaviors and motivation to quit smoking among users of CTP and may be among the first to examine nicotine use among patients of a medical marijuana dispensary.

Does expanding access to cannabis affect traffic crashes? County-level evidence from recreational marijuana dispensary sales in Colorado.

This article examines the effect of recreational cannabis dispensary sales on traffic crashes by employing difference-in-differences model that exploits the variation in the timing of recreational marijuana dispensary entry across counties within Colorado. Using marijuana-related hospital discharge as a measure of marijuana abuse/misuse, the results indicate a sizable rise in marijuana-related hospital discharges after the entry of retail cannabis stores. However, there is a lack of evidence that traffic crash incidents are affected by the entry. The preferred estimate suggests that, at 90% confidence level, a large increase in traffic crashes by more than 5% can be ruled out.

Experience With Medical Marijuana for Cancer Patients in the Palliative Setting.

Objectives: Medical marijuana is a symptom treatment option for palliative cancer patients; however, its useful applications remain limited. The goals of this study were to review the characteristics of patients who received medical marijuana under our ambulatory palliative care program and to determine barriers to access and use of medical marijuana in this population.Methods: This study was a retrospective analysis of patients who were enrolled in the medical marijuana registry through the ambulatory palliative care department at Upstate Cancer Center. Data from June 2017 to June 2020 were analyzed. Patients were included if they had a diagnosis of cancer, were certified by a qualified practitioner in the New York Medical Marijuana Program, and received care at Upstate Medical University. Patients were excluded if no marijuana certificate was found or if they transferred care.Results: The study population was 184 patients. Ninety-three patients (51.5%) received at least one prescription from a New York licensed marijuana dispensary while 72 (39.13%) were certified but never obtained any medical marijuana. For patients who took at least one dose of medical marijuana, 48.14% experienced an improvement in pain, 44.95% used fewer opioids, and 85.11% had an improvement in at least one symptom. Adverse effects were low at 3.72%.Conclusion: Medical marijuana has an important role in the palliation of symptoms in advanced cancers with few adverse effects. There are still many barriers to effective use. More prospective research is needed to optimize delivery and dosing.

Recreational Marijuana Dispensaries and Fatal Car Crashes

Recreational Marijuana Dispensaries and Fatal Car Crashes

In Case You Haven't Heard…

Warwick, New York, will have a cannabis cultivation site soon, with construction already underway by Green Thumb Industries of Chicago. The location is on the site of a former prison, where there is already a greenhouse and processing facility. The company has invested $150 million to remodel the site, which will create 100 construction jobs and 100 permanent positions with benefits, according to an article in the Sept. 9 Times‐Union. Green Thumb purchased the 40 acres of former prison grounds for $3.3 million in May, after Orange County approved a 15‐year tax abatement. The $3.3 million covered the town's remaining debt on the cost of the purchase of the prison property from the state. The town is not ready, however, to allow on‐site cannabis consumption at its cafes or to allow marijuana dispensaries at all.

Changes in Emergency Department Encounters for Vomiting After Cannabis Legalization in Colorado

Cannabis hyperemesis syndrome is an emerging clinical issue associated with cannabis use. Legalization of cannabis has led to an increase in vomiting-related illnesses in health care settings. To examine whether legalization of cannabis in Colorado has been associated with increases in vomiting-related emergency department (ED) visits. A cross-sectional design was used to assess the increase in ED claims for vomiting reported to the Colorado Hospital Association between January 1, 2013, and December 31, 2018, in counties that had no prior cannabis dispensaries before legalization compared with those that did. A total of 820 778 patients seeking care through Colorado EDs were included in the analysis. The number of medical and recreational cannabis dispensaries per county per quarter. County per capita rate of vomiting-related ED claims per quarter. Vomiting-related ED health care encounters increased from 119 312 in 2013 to 153 699 in 2018 (29% increase). Over this period, 203 861 patients (25%) were aged 0 to 18 years; 114 201 (14%) were aged 19 to 25 years, and 502 771 (61%) were aged 26 years or older; 510 584 patients (62%) were female. Additional recreational dispensaries were associated with increased vomiting-related ED visits (incidence rate ratio, 1.03; 95% CI, 1.01-1.05), but counties with high baseline medical dispensary exposure experienced smaller increases in vomiting-related ED visits than counties with no baseline medical dispensary exposure (incidence rate ratio, 0.97; 95% CI, 0.95-0.99). Counties with a high number of medical marijuana dispensaries had increases at a 5.8% slower rate than counties with none. The findings of this study suggest that cannabis legalization in Colorado is associated with an increase in annual vomiting-related health care encounters with regard to exposure to these markets. It may be useful for health care clinicians to be aware of cannabis hyperemesis syndrome and inquire about cannabis use when appropriate.

The Evident Need for Banking Reform in the Legal Marijuana Industry

Marijuana reform legislation has created a lucrative industry for legal marijuana on the local and state level in some jurisdictions. Federal laws have forced legal marijuana dispensaries to be cash-only businesses with limited banking options. The lack of normal banking services has also affected firms’ ability to manage profits earned from operations. Our hermeneutic phenomenological study was grounded by the conceptual framework of the motivations of humans and humans’ need to feel safe. The participants in this study were owners and operators in the legal marijuana industry in Colorado. Data were collected through interviews, although the Coronavirus (COVID-19) pandemic of 2020 made data collection more challenging because of the added pressure on potential participants. The data analysis plan for this study consisted of transcribing and reviewing the data, coding themes and supporting themes, and synthesizing and reporting findings from the data collected. The study’s findings included the participants’ concerns about safety in their cash-only operations, their methods for conducting business, and the banking options available to them. Common themes that emerged from the interviews were cash, banking, safety, and the limitations of business size. Findings from my study contribute to fostering positive social change on the organization and industry level by providing accounts of how owners and operators navigate the banking dilemma in the legal marijuana industry.

The Evident Need for Banking Reform in the Legal Marijuana Industry

Marijuana reform legislation has created a lucrative industry for legal marijuana on the local and state level in some jurisdictions. Federal laws have forced legal marijuana dispensaries to be cash-only businesses with limited banking options. The lack of normal banking services has also affected firms’ ability to manage profits earned from operations. Our hermeneutic phenomenological study was grounded by the conceptual framework of the motivations of humans and humans’ need to feel safe. The participants in this study were owners and operators in the legal marijuana industry in Colorado. Data were collected through interviews, although the Coronavirus (COVID-19) pandemic of 2020 made data collection more challenging because of the added pressure on potential participants. The data analysis plan for this study consisted of transcribing and reviewing the data, coding themes and supporting themes, and synthesizing and reporting findings from the data collected. The study’s findings included the participants’ concerns about safety in their cash-only operations, their methods for conducting business, and the banking options available to them. Common themes that emerged from the interviews were cash, banking, safety, and the limitations of business size. Findings from my study contribute to fostering positive social change on the organization and industry level by providing accounts of how owners and operators navigate the banking dilemma in the legal marijuana industry.

State Recreational Marijuana Laws and Dispensaries: Chronic School Absenteeism in Washington State

Objective: Whereas states continue to experiment with liberalized marijuana laws, how these laws impact health, education, and social factors is not yet fully understood. In this study, we examined whether chronic school absenteeism rates changed in Washington State in the presence of recreational marijuana dispensaries pursuant to implementation of the state’s recreational marijuana laws. Methods: We conducted a secondary analysis using school district chronic absenteeism rates before and after the presence of recreational dispensaries. Results: The results of the independent samples t-test showed no statistically significant difference in chronic absenteeism rates among districts with or without recreational marijuana dispensaries. Conclusions: The finding of no statistical significance for chronic absenteeism in districts with and without recreational dispensaries – a pattern that largely persisted among at-risk groups – supports that the presence of recreational marijuana dispensaries seems neither to exacerbate nor improve chronic school absenteeism rates. This finding is important for policymakers, practitioners, and researchers trying to understand the changing marijuana legal landscape.

The use of an integrated opioid and medical marijuana prescription drug monitoring program

ObjectivesTo (1) identify the reasons for which pharmacists in Connecticut use the CPMRS when dispensing opioid medications and medical marijuana products, (2) determine pharmacists’ perceived value of the CPMRS when dispensing opioids or medical marijuana, and (3) compare practices and the perceived value of the CPMRS among community-based pharmacists (CBPs) and medical marijuana dispensary pharmacists (MMDPs). MethodsAn online survey was administered from May 2019 to June 2019 to CBPs (n = 178) and MMDPs (n = 12). The survey included items about background, use, and attitudes about current and future use of the CPMRS. ResultsBoth pharmacist groups indicated that opioid use information was the most useful aspect of the CPMRS. Ninety percent of both groups checked patients’ use of opioids using the CPMRS, and 81.2% of the MMDPs compared with 38.4% of the CBPs indicated that they checked for patients’ use of medical marijuana. A greater percentage of MMDPs than CBPs felt that access to the marijuana use information was useful and needed for counseling. Several pharmacists recommended improvements in marijuana use information in the CPMRS and greater efficiencies for users of the system. ConclusionAccess to both marijuana and opioid use information can allow pharmacists to make specific recommendations on the basis of potential drug interactions and dose adjustments. The results from the present study highlight how integrated systems of opioid and marijuana dispensing information can be further enhanced by resolving existing pharmacy barriers involving technology, workflow, and need for systems with more detailed marijuana product information.

The political economy of drug and alcohol regulation during the COVID‐19 pandemic

States tightly regulate access to alcohol and other substances. During the pandemic and related state of emergency, state and federal governments adopted a variety of regulations affecting this access. State shelter‐in‐place orders included decisions about whether liquor stores and marijuana dispensaries are essential businesses. Decisions about telehealth access to medical marijuana or treatments for substance use disorders were made at the state and federal levels. This article examines the political economy behind these decisions, focusing on deviations from the norm including Pennsylvania's decision to close state‐run liquor stores. Interest groups and other political considerations help explain state and federal policy changes affecting access to alcohol and other substances.

Hits from the Bong: The impact of recreational marijuana dispensaries on property values

We exploit a natural experiment in Washington state that randomly allocates recreational marijuana retail licenses to estimate the capitalization effects of dispensaries into property sale prices. Developing a new cross-validation procedure to define the treatment radius, we estimate difference-in-differences, triple difference, and instrumental variables models. We find statistically significant negative effects of recreational marijuana dispensaries on housing values that are relatively localized: home prices within a 0.36 mile area around a new dispensary fall by 3–4% on average, relative to control areas. We also explore increased crime near dispensaries as a possible mechanism driving depressed home prices. While we find no evidence of a general increase in crime in Seattle, WA, there is a significant increase in nuisance-related crimes in census tracts with marijuana dispensaries relative to other census tracts in Seattle.

The associations of medical marijuana policies with opioid-related health care utilization.

To examine the associations between medical marijuana policies and opioid-related hospitalizations and emergency department visits. We utilized quarterly rates of hospital discharge data from the Healthcare Cost and Utilization Project's (HCUP) Fast Stats Database from 2005 to 2016 along with state-level sociodemographic data from US Census Bureau and Bureau of Labor Statistics and opioid-related state health policy data from publicly available sources for the analysis. Analyses were carried out using a difference-in-differences regression approach. We estimate heterogeneous effects of medical marijuana policies such as initial policy, presence of active dispensary, and home cultivation on opioid-related hospitalizations and emergency department visits related to opioids. Publicly available secondary data were collected, linked, and analyzed. Observations with missing values for explanatory variables were excluded from the analysis. Regression results indicate that type of medical marijuana policy has varying effects on opioid-related hospitalizations and emergency department visits. States that allow home cultivation of medical marijuana experienced significant positive associations with opioid-related hospitalizations and emergency department visits, while no effect was observed with medical marijuana dispensaries. Moreover, recreational marijuana policies were positively associated with opioid-related hospitalizations. The findings indicate that the effects of medical marijuana policies on opioid-related hospitalizations and emergency department visits vary depending on the type of medical marijuana policy. Our findings indicate that the implementation of home cultivation of marijuana is positively associated with hospitalizations and emergency department visits related to opioids, suggesting that easier access to marijuana among opioid users may result in adverse health conditions that need treatment.

Proximity and Child-appealing Marketing Activities of Recreational Marijuana Dispensaries and Adolescents’ Marijuana Use

Proximity and Child-appealing Marketing Activities of Recreational Marijuana Dispensaries and Adolescents’ Marijuana Use

Geolocation of Maryland Medical Marijuana Dispensaries by Community Income and Racial Characteristics: An Ecological Design

Background: Prior investigations have documented disparities in the supply side of Maryland’s Medical Marijuana program. Initially a disproportionate share of licenses to cultivate and distribute medical marijuana were awarded to Non-Hispanic White owned businesses. The state has implemented measures to ameliorate the inequity by prioritizing license awards to qualified minority owned businesses. Objectives: The objective of this study is to examine the racial and income characteristics of communities where licensed dispensaries are located. We quantify the racial and income characteristics of communities where Maryland medical cannabis dispensaries are located and explore whether Maryland medical marijuana dispensaries disproportionately locate in high-income, majority-White zip codes. Method: Using data from the Maryland Medical Cannabis Commission and the American Communities Survey, we create geocodes for each of the operating dispensaries as of December 2019. We examine the distribution of medical cannabis dispensaries by zip code level household income and zip code level racial distribution. The data set encompasses 85 operating cannabis dispensaries in Maryland and 6.1 million Marylanders distributed across 468 zip codes in 2018–2019. Results: The analysis indicates that dispensaries are concentrated in zip codes whose residents are racially diverse, and with higher concentrations of retail establishments. Conclusion: Community level racial or income disparities in access to medical cannabis were not observed in Maryland. Access to medical cannabis, based on ability to pay out of pocket for the product, may be uneven.