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Medical Cannabis Cards Often Sought by Heavy Users, Says Study

By Alexander Beadle

Published: Dec 06, 2019   
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Young adults who seek medical cannabis cards through state medical cannabis programs are often those who already use the drug heavily, rather than those with mental or physical health issues which may be helped by medical cannabis. That’s according to new research published in the Journal of Studies on Alcohol and Drugs this week.

While previous studies had shown that adolescents and young adults with medical cannabis cards were at a greater risk for developing a problematic cannabis use pattern, it wasn’t known what factors might influence them to obtain a medical cannabis card in the first place.

This new study reveals that more frequent use, and not necessarily mental or physical health concerns, is a major influence on medical cannabis card acquisition.

Health conditions not a predictor for cannabis card acquisition

In the new study, researchers from the RAND Corporation examined data from 264 participants aged between 18 and 20 years old from the years 2015 to 2017. During this timeframe, medical cannabis was legal in California, but retail outlets weren’t yet allowed to begin the sale of recreational cannabis.

All participants in this study sub-sample had used cannabis within a month of the beginning of the study period, but none had obtained a medical cannabis card which would allow them to buy and use the drug legally. 

At the one-year follow-up, participants were asked about their cannabis use and if they were experiencing any symptoms of depression or anxiety, or any physical health problems. Nearly 20 percent had Californian medical cannabis cards, allowing them to purchase and use cannabis for medicinal purposes despite being under the age of 21.

The RAND Corporation researchers note that men were around three times more likely than women to have received a medical cannabis card by the one-year follow up. More generally, for every additional day of cannabis use reported at the beginning of the study timeframe, the researchers found that odds of having received a medical cannabis card increased by seven percent.

After statistically adjusting for known demographic variables, the researchers concluded that frequency of cannabis use was the only significant predictor (other than male gender) of whether a participant would obtain a medical cannabis card within the next year. None of the physical and mental health problems, as detected by the study questionnaire, were deemed to be significant factors.

Implications for lawmakers

If the results of this study are representative of a broader behavioral pattern, they could present several important policy implications for state lawmakers designing their own medical cannabis programs.

“Making medical marijuana cards easy to obtain for vaguely defined mental or physical health conditions that are not supported by any research evidence has potential for those who use more heavily to claim need for a medical marijuana card solely to have easier access," said lead author Eric Pedersen in a statement.

“It seems that more frequent use of marijuana, and not the physical and mental health problems that one ostensibly seeks a medical marijuana card to address, is what drives acquisition of a medical marijuana card.”

As more states legalize medical cannabis and bring in patient access programs, this study suggests that medical care providers carefully assess their symptom management practices, to ensure that younger cannabis users aren’t putting themselves at risk of negative outcomes by using this medical cannabis. Previous research from the same team has found that young adults with medical cannabis cards were more likely to report heavy use, greater consequences from use, and haven driven under the influence of cannabis.

The limitations 

The authors note several limitations of their study. Firstly, the design of the online questionnaire didn’t allow researchers to directly ask participants about their personal reasons behind obtaining a medical cannabis card, which could include financial reasons or a perception that medical cannabis is of a higher quality. But without directly asking the participants, it’s impossible to draw any further conclusions about why frequent users might apply for medical cannabis cards.

Secondly, the study design was limited in terms of the mental and physical health problems that were assessed, and there were no specific questions pertaining to current qualifying conditions.

Under Californian law, there are specific qualifying conditions, such as HIV/AIDS, seizures, and chronic pain, that are a main focus of medical cannabis treatment, though it’s possible for care providers to recommend a medical cannabis card to patients with “any other chronic or persistent medical problem” that may limit major life activities.

"It's not clear to us what participants are telling providers," Pedersen said, "but we suspect that under this catch all, you can get a recommendation pretty easily."

The study authors also acknowledge that “many individuals… struggle with legitimate medical and psychological concerns that can benefit from medical marijuana,” and that the study’s assessment of qualifying conditions could have missed several other valid qualifying medical conditions that the participants may have had.

The researchers say that more longer studies into the conditions reported by the medical cannabis users may help to improve scientific understanding of this behavior. 

Alexander Beadle

Science Writer

Alexander Beadle has been working as a freelance science writer since 2017 and has covered the cannabis industry for Analytical Cannabis since 2018. He has also written for our sister publication, Technology Networks, and the cannabis industry consultant firm Prohibition Partners, among others. Alexander holds a Master's in Materials Chemistry from the University of St. Andrews, where he won a Chemistry Purdie scholarship, and conducted research into zeolite crystal growth mechanisms and the action of single-molecule transistors.


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