Medical Marijuana Research Articles

Is cannabis a slippery slope? Associations between psychological dysfunctioning, other substance use, and impaired driving, in a sample of active cannabis users.

Cannabis is a gateway drug that can lead to the engagement of other substances. Psychological dysfunctioning and dependence have been highlighted as primary components to substance misuse. The purpose of this study was to investigate what aspects of cannabis use and psychological dysfunctioning are associated with the engagement of other substances and impaired driving. Subject to screening, 200 active adult cannabis users completed an online survey. Existing data involving non-cannabis users (N = 833) were also implemented as comparative data. The comparisons suggested that cannabis users were far more likely to have used other drugs in the past 12 months, compared to non-cannabis users. Bivariate correlations and multiple regressions indicated that the degree of cannabis use and likely dependence, psycho-social motives for using cannabis, emotion dysregulation, and psychopathology were positively associated with the frequency of using and driving on other substances. Finally, an ANOVA demonstrated that outside of age, there were no apparent differences in substance use behaviours, motives for using cannabis, and psychological dysfunction, between medicinal and black-market cannabis users. These findings highlight the potential benefits of incorporating self-regulatory concepts into current road safety initiatives, which aim to reduce the interconnected issue of substance misuse and impaired driving behaviours.

“California on the Vistula River?” Cannabis users’ engagement with licit and illicit cannabis markets in Poland

Purpose Poland, like many other countries, is experiencing a shift in its drug policy as reflected with the decision of its government to legalise medical cannabis in 2017. This paper aims to explore the engagement of cannabis consumers with legal and illegal markets for cannabis in Poland. Design/methodology/approach Data comes from the Polish Ministry of Health and a survey of 571 cannabis users. The questionnaires were posted on Polish Facebook groups consisting of users, and other people interested in science/politics associated with cannabis. The users were asked if they currently use the illegal market to buy cannabis, and if yes then why. Findings Most respondents report that they do not engage with the illegal market for cannabis. Those who described themselves as medical users now enjoy a better access to cannabis, but even recreational users are finding ways to use the system. Some, however, continue to use the illegal market for cannabis due to reasons associated with honesty, access, price and quality of cannabis. Research limitations/implications Given a convenience sample, generalisable conclusions cannot be made on the impact of the medical cannabis policy on the illegal market for cannabis yet. However, what can be concluded is that increasingly more users are likely opting out for the regulated medical market than the traditional illegal market. This could be associated with an increasing willingness of medical practitioners to prescribe medical cannabis. Originality/value Only a handful of articles have been written on the Polish medical cannabis policy. This is the first article to show that the Polish medical cannabis policy has changed very significantly since the early enactment. Very probably contrary to the wishes of the policymakers who wanted to create a stricter model than the one in California, for example, which they named as more permissive one.

Comparison of Cannabis-Based Medicinal Product Formulations for Fibromyalgia: A Cohort Study

This cohort study aims to assess the outcomes of fibromyalgia patients enrolled in the UK Medical Cannabis Registry prescribed a homogenous selection of cannabis-based medicinal products (CBMPs). A cohort study of fibromyalgia patients treated with oils (Adven®, Curaleaf International, UK), dried flower (Adven®, Curaleaf International, UK) or both CBMPs was performed. Primary outcomes were changes from baseline at 1, 3, 6 and 12 months in validated patient-reported outcome measures. Secondary outcomes included descriptive analysis of adverse events. One hundred and forty-eight participants were treated with oils (n = 77; 52.03%), dried flower (n = 14; 9.46%) or both (n = 57; 38.51%). Improvements in the generalized anxiety disorder-7 questionnaire, single-item sleep quality scale, fibromyalgia symptom severity score and EQ-5D-5L Index values were observed at each follow up period compared to baseline (p < 0.050). Thirty-six (24.32%) patients experienced 648 adverse events. Improvements were observed across all primary outcomes with no differences observed across different formulations of CBMPs. Adverse events were reported by one-quarter of participants and were more likely to reported by cannabis naïve patients. This present work through focusing on a homogeneous group of CBMPs can help inform randomized controlled trials after observing signals of improvement associated with a specific cultivar of CBMPs.

Legalization of Smokable Medical Cannabis and Changes in the Dispensed Amount of Δ-9 Tetrahydrocannabinol Per Patient.

Introduction: Florida's medical cannabis (marijuana) program is among the largest in the United States. Smokable cannabis forms were not legally available in this program until 2019, and five years after other forms of cannabis were available. This study assessed changes in Δ-9 tetrahydrocannabinol (THC) dispensed per patient following legalization of smokable cannabis in Florida. Materials and Methods: This quasi-experimental study used data from the Florida Department of Health Office of Medical Marijuana Use Reports on THC dispensing from April 6, 2018, through March 13, 2020. Certified medical cannabis user during the study period was included. The exposure was the dispensed amount of THC from legalized smokable forms of medical cannabis (statute identified as SB182), effective as of March 2019. Changes in level and trend of average milligram (mg) of dispensed THC per certified patient with 95% confidence intervals (CIs), before and after SB182, were calculated by fitting a generalized least squares linear model and allowing a 17-week phase-in period. Results: The number of certified patients increased by 24.8% from 197,107 (March 22, 2019) to 246,079 (July 19, 2019) and to 325,868 by March 13, 2020. Assuming that a 20% THC concentration in smokable products, there was a significant level increase in the mean weekly dispensed THC amount per certified patient of 138.45 mg (95% CI: 102.69-174.20), translating to a 42.18% increase (95% CI: 33.14-50.28), from the pre-policy period. We noted a continuous increase of 5.62 mg per certified patient per week (95% CI: 4.35-6.89) throughout the 35 weeks following the policy, when compared with the period before. Assuming 10% THC concentration in smokable products, we observed a significant level increase of 35.10 mg (95% CI: 5.31-64.88), corresponding to an increase of 10.70% (95% CI: 1.70-18.89), and a trend increase of 2.23 mg per certified patient per week (95% CI: 1.18-3.29). Discussion: The expansion of the Florida medical cannabis program to include smokable cannabis forms was associated with a significant increase in the mean amount of weekly dispensed THC per certified patient. Findings suggest that the dispensed amount of THC after legalization of smokable medical cannabis far exceeds the maximum recommended daily dose, based on extrapolation from oral cannabis product dosing recommendations from one expert consensus statement, raising questions about the safety, and need for consumer education.

Identification of the TRPA1 cannabinoid-binding site

Chronic pain accounts for nearly two-thirds of conditions eligible for medical cannabis licenses, yet the mechanisms underlying cannabis-induced analgesia remain poorly understood. The principal phytocannabinoids, the psychoactive Δ9-tetrahydrocannabinol (THC) and non-psychoactive cannabidiol (CBD), exhibit comparable efficacy in pain management. Notably, THC functions as an agonist of cannabinoid receptor 1 (CB1), whereas CBD shows minimal activity on CB1 and CB2 receptors. Elucidating the molecular targets through which phytocannabinoids modulate the pain system is required for advancing our understanding of the pain pathway and optimizing medical cannabis therapies. Transient receptor potential ankyrin 1 (TRPA1), a pivotal chemosensor in the pain pathway, has been identified as a phytocannabinoid target. Unlike most TRPA1 activators, phytocannabinoid activation is not mediated through the electrophilic binding site, suggesting an alternative mechanism. Here, we identified the human TRPA1 channel cannabinoid-binding site (CBS) and demonstrated that mutations at residue Y840 abolished responses to both THC and CBD at saturating concentrations, indicating a shared primary binding site. Molecular modeling revealed distinct interactions of THC and CBD with the Y840 residue within the CBS. Additionally, CBD binds to the adjacent general anesthetic binding site at oversaturating concentrations. Our findings define the CBS of TRPA1 as overlapping with and adjacent to binding sites for other allosteric activators, suggesting that TRPA1 possesses a highly adaptable domain for binding non-electrophilic activators. This underscores its unique role as a chemosensor in the pain pathway. Furthermore, our results provide new insights into the molecular mechanisms of cannabinoid-induced analgesia and identify novel targets for pain management therapies.

Medical cannabis use in young adults with cancer: a self-reported survey study

ObjectivesMedical cannabis is increasingly used by young patients with cancer. We aimed to describe the patterns and perceptions of medical cannabis use among young adults with cancer.MethodsThis cross-sectional survey was...

Canada's Recreational Cannabis Legalization and Medical Cannabis Patient Activity, 2017-2022.

Objectives. To estimate changes in medical cannabis patient activity after Canada's recreational cannabis legalization. Methods. I used linear regressions of interrupted times series models to analyze medical cannabis patient registrations per 10 000 residents, purchases per 100 registrations, and packages per purchase in Canada's 10 provinces between April 2017 and December 2022. I tested relationships between the recreational law's passage in June 2018, recreational sales starting in October 2018, and the arrival of edibles and vapes in December 2019. Results. Medical patient registrations initially increased; they slowed after the law passed and started decreasing after edibles became available. Medical purchasing frequencies initially decreased; they decreased further in proportion to recreational sales but stabilized after edibles became available. Medical purchase sizes were initially stable; they began increasing after edibles became available. Conclusions. Canada saw substantial decreases in medical cannabis patient registrations, but the remaining patients stabilized their purchasing frequencies and increased their purchase sizes. Public Health Implications. Other countries might see significant changes in patient usage of their medical cannabis systems after nationwide recreational cannabis legalization. (Am J Public Health. Published online ahead of print October 3, 2024:e1-e8. https://doi.org/10.2105/AJPH.2024.307721).

A 10-year trend in cannabis potency (2013-2022) in different geographical regions of the United States of America.

The prevalence of cannabis as the most commonly used illicit substance in the United States and around the globe is well-documented. Studies have highlighted a noticeable uptrend in the potency of cannabis in the United states. This report examines the concentration of cannabinoids in illicit cannabis samples seized by the United States Drug Enforcement Administration (DEA) over the last 10 years (2013-2022). Samples received during the course of study (2013-2022) were categorized based on the geographical region where collected, as Western Region, Midwest Region, Northeast Region, South East Region, Southern Region as well as Alaska and Hawaii. These samples were processed for analysis using a validated gas chromatography with flame ionization detector method. The data showed that the cannabinoids profile of all high Δ9-THC cannabis samples, regardless of the state or region from which the samples are seized or the state from which the sample is produced under a state medical marijuana program, is basically the same with the major cannabinoid being Δ9-THC (>10% for most samples) and all other cannabinoids with less than 0.5%, with the exception of CBG (<1%) and CBN (<1%). Overall, it appears the cannabinoids profile is controlled by the genetics of the plant and is not affected much by the geographical location in which the plants are cultivated.

Illuminating Cannabis sativa L.: The Power of Light in Enhancing C. sativa Growth and Secondary Metabolite Production.

Light is crucial for higher plants, driving photosynthesis and serving as a powerful sensory signal that profoundly modulates growth, development, physiological functions, hormone activation, and biochemical pathways. Various light parameters-quality, intensity, composition, and photoperiod-exert a tremendous influence on plant growth and development, particularly in industrial hemp (Cannabis sativa L.). C. sativa, a crop of historical significance and unparalleled versatility, holds immense value in the food, fiber, and medicinal industries. The cultivation of medicinal cannabis is burgeoning in controlled environments due to evolving healthcare regulations. Optimal light conditions significantly enhance both yield and harvest quality, notably increasing the density of apical inflorescences and the ratio of inflorescence to total aboveground biomass. C. sativa metabolites, especially phenolic and terpene compounds and Phytocannabinoids like CBD (cannabidiol), THC (tetrahydrocannabinol), and CBG (cannabigerol), possess immense medicinal value. Secondary metabolites in C. sativa predominantly accumulate in the trichomes of female flowers and surrounding sugar leaves, underscoring the critical need to boost inflorescence weight and metabolite concentrations while ensuring product consistency. Different light parameters distinctly impact C. sativa's metabolic profile, providing a robust foundation for understanding the optimal conditions for synthesizing specific secondary metabolites. While the effects of light measurement on various crops are well-established, scientific evidence specifically relating to light quality effects on C. sativa morphology and secondary metabolite accumulation remains scarce. In this review, we critically summarized how different light properties can alter cannabis growth (vegetative and reproductive), physiology and metabolism. Furthermore, the mechanisms by which specific wavelengths influence growth, development, and secondary metabolite biosynthesis in C. sativa are not fully elucidated, which could be a prospective task for future researchers. Our review paves the way for a profound understanding of light's influence on C. sativa growth and advancements in greenhouse settings to maximize metabolite production for commercial use.

An Exploration of Registered Nurses' Experiences Caring for Patients Taking Medicinal Cannabis.

This study aimed to describe nurses' experiences caring for patients who use medicinal cannabis. For the purpose of this study, the term 'medicinal cannabis' is used to describe cannabis-based products that are sourced legally or illegally. Qualitative study using thematic analysis. Eleven registered nurses explored their experiences caring for patients using medicinal cannabis in the Australian healthcare sector. Semistructured interviews were via telephone, Zoom or face to face. Transcribed interview data were analysed using the six phases of thematic analysis. The nurses' experiences of caring for patients who use medicinal cannabis were described in three themes; 'Searching for predictable processes of regulation, access and use of medicinal cannabis', 'One conundrum after another' and 'There is a lot to learn'. Overall, nurses described feeling underprepared to care for patients who use or want to use medicinal cannabis in the Australian healthcare sector. The results indicate that nurses want to have meaningful discussions with patients about the use of medicinal cannabis, yet do not always have the confidence to do so. Nurses sought their own education on how to better support patients. All participants echoed the need for education. The nurse's role in caring for and supporting patients using medicinal cannabis could improve the patient experience. Nurses play an essential role in improving the patient's experience and advocating for those using or wanting to discuss medicinal cannabis as a part of holistic care. Defining the nurse's role in effectively caring for patients can begin by providing evidence-based education to nurses. Including nurses in policy development and beginning to understand the legal and regulatory implications for nurses are important. This is the first study presenting current issues for nurses who care for patients using medicinal cannabis in Australian healthcare systems. COREQ guidelines were adhered to for this study. For this research project on the experiences of registered nurses caring for patients using medicinal cannabis, we did not engage members of the patient population or the general public.

Medical Cannabis Dosing Trajectories of Patients: Evidence From Sales Data

Medical cannabis use is rising with limited high-quality clinical trial data to guide dosing. This study relies on real-world, longitudinal medical cannabis purchase data to provide information on Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) dosing trends for patients with qualifying medical conditions. A retrospective study of purchases by 16,727 patients obtaining medical cannabis from dispensaries located in New York between 2016 and 2019, recorded in point-of-sale data. Group-based trajectory modeling was used to identify clusters of patients following similar progressions in dosing of THC and CBD over time. χ2 tests were performed to identify which patient characteristics and qualifying medical conditions were associated with membership in each trajectory group. Six trajectory groups were identified that described different patterns in the THC and CBD doses that patients purchased over the whole time period. For THC, the majority of patients (62.6%) purchased a steady amount but at different levels: consistently low (4.1 mg) or moderate (7.4 mg). Three groups, representing 22.0% together, exhibited doses that either fluctuate or constantly increase over time (5-20 mg). A final group of patients (15.8%) exhibited constant decrease in dose from 11 to 5 mg. For CBD, the data show similar trajectories, but at the generally higher values (4-16 mg). Patients with chronic pain, neuropathy, and cancer were overrepresented in groups where higher doses of THC were purchased over time. Patients with epilepsy had a higher representation in groups with higher doses of CBD across time. Results suggest heterogeneous dosing patterns and trajectories in the use of medical cannabis by patients with different medical conditions.

Predictors of participant compliance with ecological momentary assessment among individuals with chronic pain who are using cannabis and opioids

BackgroundCannabis may be an alternative or adjunct to opioid therapy for chronic pain. However, there are limited data on patterns of opioid medication and medical cannabis use. The current study investigated the feasibility of using Ecological Momentary Assessment (EMA) to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain. MethodThe study included 133 participants recruited online. Participants were 42.6 (SD = 13.9) years old on average and the majority were men (57.9 %) and Non-Hispanic White (63.2 %). Participants completed a baseline assessment, followed by 30-days of EMA data collection with four randomly prompted past-hour surveys and one daily diary per day, and a follow-up survey that assessed perceived EMA burden. Simple and multivariable linear regression models were estimated to investigate participant predictors of the proportion of EMA surveys completed (past-hour surveys and daily diaries in separate models). ResultsCompliance rates for EMAs prompts were 89.7 % for daily diaries and 63.3 % for past-hour surveys. In multivariable regression, participants holding a graduate degree completed a lower proportion of daily diaries (b = −0.109, SE = 0.052, p < .05) and past-hour surveys (b = −0.148, SE = 0.071, p < .05), compared to those with less than a 4-year degree. Participants completing a higher proportion of daily diaries reported greater ease of use at follow-up (b = 0.050, SE = 0.022, p < .05) and those completing a higher proportion of past-hour surveys desired higher rewards (b = 0.066, SE = 0.033, p < .05). ConclusionsStudy results confirm the feasibility of using EMA methods to assess patterns of prescription opioids and medical cannabis among individuals experiencing chronic pain.

Clinical Benefits and Safety of Medical Cannabis Products: A Narrative Review on Natural Extracts.

Interest in medical cannabis and cannabis-based medicinal products (CBMPs) has increased greatly in recent years. Two cannabinoids are of principal importance; delta-9-tetrahydrocannabinol (∆9-THC), the primary psychoactive component, and also cannabidiol (CBD), considered non-intoxicating. Each has distinct mechanisms of action and different therapeutic potentials. CBMPs differ in their ∆9-THC and CBD components; predominantly ∆9-THC, balanced formulations with equivalent ∆9-THC and CBD elements, and CBD-predominant products. In this narrative review, we evaluate the published evidence for the clinical benefits of CBMPs and overall benefits in well-being. We also review the overall safety profile and discuss the potential for dependence with CBMPs. Evidence can be drawn from a wide range of randomized and other controlled studies and from observational real-world studies. Most data from observational registry studies are supportive of ∆9-THC-based products (∆9-THC-predominant or balanced CBMPs) in the management of chronic neuropathic pain. Balanced products are also effective in reducing spasticity in multiple sclerosis. Most CBMPs show benefit in providing symptomatic benefits in reducing anxiety, nausea, and in improving sleep, but the place of specific products is more subtle, and choice guided by specific circumstances. Symptomatic improvements are accompanied by improved quality of life and well-being. Safety data indicate that CBMPs are generally well tolerated in most patients without specific contraindications. The majority of adverse effects are non-serious, and transient; most are principally associated with ∆9-THC and are dose-dependent. In contrast to recreational cannabis use, there is little evidence from clinical studies that CBMPs have any potential for dependence.

The Combined Relationship of Prescription Drug Monitoring Program Enactment and Medical Cannabis Laws with Chronic Pain-Related Healthcare Visits.

U.S. state electronic prescription drug monitoring programs (PDMPs) are associated with reduced opioid dispensing among people with chronic pain and may impact use of other chronic pain treatments. In states with medical cannabis laws (MCLs), patients can use cannabis for chronic pain management, reducing their need for chronic-pain related treatment visits and moderating effects of PDMP laws. Given high rates of chronic pain among Medicaid enrollees, we examined associations between PDMP enactment in the presence or absence of MCL on chronic pain-related outpatient and emergency department (ED) visits. We created annual cohorts of Medicaid enrollees with chronic pain diagnoses using national Medicaid claims data from 2002-2013 and 2016. Negative binomial hurdle models produced adjusted odds ratios (aOR) for the likelihood of any chronic pain-related outpatient or ED visit and incident rate ratios (IRR) for the rate of visits among patients with ≥ 1 visit. Medicaid enrollees aged 18-64years with chronic pain (N = 4,878,462). A 3-level state-year variable with the following categories: 1) no PDMP, 2) PDMP enactment in the absence of MCL, or 3) PDMP enactment in the presence of MCL. Healthcare codes for chronic pain-related outpatient and ED visits each year. The sample was primarily female (67.2%), non-Hispanic White (51.2%), and ages 40-55years (37.2%). Compared to no-PDMP states, PDMP enactment in the absence of MCL was not associated with chronic pain-related outpatient visits but PDMP enactment in the presence of MCL was associated with lower odds of chronic pain-related outpatient visits (aOR = 0.81, 95% CI:0.71-0.92). PDMP enactment was not associated with ED visits, irrespective of MCL. During a period of PDMP and MCL expansion, our findings suggest treatment shifts for persons with chronic pain away from outpatient settings, potentially related to increased use of cannabis for chronic pain management.

The contribution of addictovigilance data to the French medical cannabis experimentation

The contribution of addictovigilance data to the French medical cannabis experimentation

Understanding Medical Cannabis: A Simple Guide to CBD and THC

There is an ongoing debate in the literature about the place of cannabinoid therapy in everyday clinical practice. The overview examined systematic reviews and meta-analyses on the use of medical marijuana (MM) in specific or diseases, such as epilepsy, multiple sclerosis, pain, nausea and vomiting during chemotherapy, cachexia, and sleep disorders. We analyzed different cannabinoids like CBD, THC, dronabinol, nabilone, and THC:CBD combinations (Nabiximol) to understand their effects on various medical conditions, dose effectiveness, and side effects. CBD showed promise epilepsy, Nabilone showed a significant reduction in pain and insomnia, Nabiximol has been effective in reducing spasticity, pain, and sleep disturbance in multiple sclerosis patients. Nabilone and dronabinol improve nausea and vomiting due to chemotherapy, but the evidence is low. The results on the effectiveness of MM in the treatment of cachexia and cancer pain are inconclusive. Outcomes suggest that side effects typically were mild to moderate in severity. The type of cannabinoid (including CBD and THC content) and amount of dose, were found to potentially influence the results obtained in the trials, affecting both the effectiveness and the side effects experienced by patients. Young people, elderly, and children are particularly vulnerable and, despite ongoing research in these age groups, we still know too little about whether and in which clinical conditions the use of medical cannabis is justified. The analyzed studies faced limitations due to heterogeneity in methodology, dosages, and outcome measures and highlighting potential controversies in interpreting the results, so further research is needed.

Towards a comprehensive understanding of medical conditions among medical cannabis patients in a large database: A descriptive analysis

Towards a comprehensive understanding of medical conditions among medical cannabis patients in a large database: A descriptive analysis

Association between state-level medical marijuana legalization and marijuana use during pregnancy: A population-based study.

Despite marijuana's association with adverse pregnancy and birth outcomes, its use during pregnancy increased over the last two decades. During this period, medical marijuana has been legalized in 38 states and the District of Columbia. States with legalized medical marijuana have observed increased marketing of marijuana and related products. This study aims to examine the association between state-level medical marijuana legalization and marijuana use during pregnancy in the United States. Using the 2015-2021 National Survey on Drug Use and Health, we evaluated the association between marijuana use in the past month among currently pregnant mothers (N = 4338) and legalized medical marijuana in their state of residence. Survey-weighted descriptive, bivariate, and multivariable logistic regression analyzes were performed. About 5.7% of pregnant women reported using marijuana in the past month, and 59.0% lived in a state where medical marijuana was legalized across 2015-2021. Compared to those living in states without marijuana legalization, more pregnant women living in states with marijuana legalization reported using marijuana (4.6% vs. 6.5%). In the multivariable model, pregnant women residing in states with medical marijuana legalization were more likely to use marijuana than residents of states without legalization (adjusted Odds Ratio: 1.56; 95% Confidence Interval: 1.11-2.18). This is the first known study to find that pregnant women living in states where medical marijuana is legalized are more likely to use marijuana during pregnancy. Pregnant women should be informed of adverse pregnancy and birth outcomes linked to marijuana use during pregnancy.

Cannabinoids and the heart-apsychiatrist's perspective.

The partial legalization of cannabis in Germany in 2024 will affect both medical and recreational use of cannabis. Tetrahydrocannabinol (THC), the main psychoactive component of the cannabis plant, influences heart rate and blood pressure through the endocannabinoid system. Acute and chronic use can pose cardiovascular risks. There is evidence of alink between cannabis use and cardiovascular events such as stroke and myocardial infarction, although studies show conflicting results. The non-psychoactive cannabidiol (CBD) could have anti-inflammatory and antioxidant effects. Smoking cannabis poses additional cardiovascular risks similar to tobacco. Given these risks, cardiologists should routinely ask their patients about possible cannabis use and inform them about the potential cardiovascular dangers. The article also highlights the psychiatric risks of cannabis use, including dependence and psychosis, and emphasizes the need for interdisciplinary collaboration between cardiologists and psychiatrists to effectively manage cannabis-related health problems.

Rural reticence to inform physicians of cannabis use.

Over 75% of Americans have legal access to medical cannabis, though physical access is not uniform and can be difficult for rural residents. Additionally, substantial stigma remains in using medical cannabis, particularly within the health care system. This article argues that rural Americans may be particularly affected by such stigma and may thus be more likely to not report cannabis use to health care providers. Data were obtained from 1,045 adult Pennsylvanians using a self-administered web panel omnibus survey. Rurality was determined by overlaying Zip Code Tabulation Areas with urban areas, as defined by the U.S. Census Bureau. Primary outcomes were prior use of cannabidiol (CBD) or marijuana and reporting of such use to medical professionals. Covariates utilized in logistic regressions included rurality, gender, age, race/ethnicity, political affiliation, political ideology, and veteran status. Living in an urban area was positively associated with disclosure of marijuana use to health care providers as compared to those in rural areas, although there were no differences found in CBD disclosure. Stigma surrounding marijuana usage may have a disproportionate impact on health outcomes for rural residents who use marijuana. Nonreporting prevents effective holistic medical care and can result in negative drug interactions and other side effects.