Medical Cannabis Patients Increased Sixfold In Six Years, Declined In States Where Recreational Use Was Legalized

The use of cannabis, both for medical and recreational purposes, is rising across the United States. According to a study published by the University of Michigan (U-M), more than four million of these users are licensed medical cannabis patients, marking a six-fold increase since 2016.

Chronic Pain: The Leading Cause For Medical Cannabis Use

Kevin Boehnke, Ph.D., a pain researcher at U-M, revealed that the majority of these patients seek relief from chronic pain. “My studies have shown that people largely use cannabis for chronic pain,” said. “That's the most common reason that they obtain a medical cannabis license from the state that they live in.”

Patients are utilizing cannabis in various forms, such as edibles, smokables, tinctures and topical products. “They might eat, smoke, or use tincture, as well as rub a topical product on an inflamed joint or on their skin,” the researcher explained. “They also sometimes use it in place of other pain medications.”

Landscape And Potential Impact Of Rescheduling Cannabis

Cannabis is legal for medical or non-medical use in 38 and 23 states, respectively. Despite its legal status in many states, it remains classified as a Schedule I drug, and subject to the most restrictive regulations. However, there is ongoing discussion about rescheduling it to a Schedule III drug. “If cannabis is officially rescheduled, I think that that's a remarkable benefit in some ways for the scientific and medical community because it acknowledges that cannabis does have medical value,” Boehnke noted. “This can jumpstart some of those conversations that many clinicians and patients have been hesitant to have.”

Challenges in Cannabis Research Despite Potential Rescheduling

Rescheduling could ease some of the research constraints but won’t eliminate all obstacles. Boehnke added: “It doesn't make that much of a difference at this point scientifically because if cannabis remains the controlled substance, I, as a scientist, and my colleagues, as scientists, still can't access the products that are being sold in dispensaries because none of them have gone through the food and drug administration approval process.”

Rise of Delta-8 THC in States with Cannabis Restrictions

Boehnke also pointed out a growing trend in states where cannabis is not legal: the use of compounds like Delta-8 THC derived from hemp. These are not regulated under the Controlled Substances Act or state marketplaces, raising concerns about contamination and inaccurate labeling.

Medical Cannabis Use Trends And Legislative Impact

Despite overall enrollment in medical cannabis programs increasing more than 600% since 2016, a study published in Annals of Internal Medicine reveals that medical marijuana use declined in states where recreational use was legalized. “These findings indicate the growing use of cannabis for medical purposes, but also that adult use laws may decrease rates of patient enrollment,” said Boehnke.

Study Highlights the Need for Better Surveillance Methods

The latest study was conducted with repeated measures of individuals with medical cannabis licenses and physicians authorizing cannabis licenses in the United States between 2020 and 2022. It included 39 jurisdictions, and found a 33% increase in enrollments for those years. However, the results also revealed that in 13 of the 15 jurisdictions with adult non-medical use laws, the number of medical registrations decreased, and the proportion of qualified conditions reported by patients fell from 70.4% to 53.8%. The most common condition reported by patients was chronic pain, followed by anxiety and post-traumatic stress disorder.

The study highlights the need for improved monitoring methods to understand the outcomes of medical cannabis use and for thoughtful public health efforts to reduce the harms of increased cannabis availability.