Medical cannabis use in the United States: a retrospective database study
Abstract
Introduction:
Growing interest in the medicinal properties of cannabis has led to an increase in its use to treat medical conditions, and the establishment of state-specific medical cannabis programs. Despite medical cannabis being legal in 33 states and the District of Colombia, there remains a paucity of data characterizing the patients accessing medical cannabis programs.
Methods:
We retrospectively reviewed a registry with data from 33 medical cannabis evaluation clinics in the United States, owned and operated by CB2 Insights. Data were collected primarily by face-to-face interviews for patients seeking medical cannabis certification between November 18, 2018 and March 18, 2020. Patients were removed from the analysis if they did not have a valid date of birth, were less than 18, or did not have a primary medical condition reported; a total of 61,379 patients were included in the analysis. Data were summarized using descriptive statistics expressed as a mean (standard deviation (SD)) or median (interquartile range (IQR)) as appropriate for continuous variables, and number (percent) for categorical variables. Statistical tests performed across groups included t-tests, chi-squared tests and regression.
Results:
The average age of patients was 45.5, 54.8% were male and the majority were Caucasian (87.5%). Female patients were significantly older than males (47.0 compared to 44.6). Most patients reported cannabis experience prior to seeking medical certification (66.9%). The top three mutually exclusive primary medical conditions reported were unspecified chronic pain (38.8%), anxiety (13.5%) and post-traumatic stress disorder (PTSD) (8.4%). The average number of comorbid conditions reported was 2.7, of which anxiety was the most common (28.3%). Females reported significantly more comorbid conditions than males (3.1 compared to 2.3).
Conclusion:
This retrospective study highlighted the range and number of conditions for which patients in the US seek medical cannabis. Rigorous clinical trials investigating the use of medical cannabis to treat pain conditions, anxiety, insomnia, depression and PTSD would benefit a large number of patients, many of whom use medical cannabis to treat multiple conditions.
Article type: Review Article
Keywords: Medical cannabis, Chronic pain, Anxiety, Post-traumatic stress disorder, Gender
Affiliations: CB2 Insights, 5045 Orbitor Dr, Building 11, Suite 300, Mississauga, ON L4W 4Y4 Canada
License: © The Author(s) 2020 CC BY 4.0 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Article links: DOI: 10.1186/s42238-020-00038-w | PubMed: 33526110 | PMC: PMC7819290
Relevance: Moderate: mentioned 3+ times in text
Full text: PDF (648 KB)
References
- 2018 NSDUH Detailed Tables | CBHSQ Data. 2019 https://www.samhsa.gov/data/report/2018-nsduh-detailed-tables. Accessed 27 Mar 2020.
- Alsherbiny MA, Li CG. Medicinal Cannabis-Potential Drug Interactions. Med (Basel, Switzerland). 2018;6(1). 10.3390/medicines6010003.
- Bertakis K, Azari R, Helms L, Callahan E, Robbins J. Gender differences in the utilization of health care services. J Fam Pr 2000;49(2):147–152. https://pubmed.ncbi.nlm.nih.gov/10718692/. Accessed 9 June 2020.
- KF Boehnke, S Gangopadhyay, DJ Clauw, RL Haffajee. Qualifying conditions of medical cannabis license holders in the United States. Health Aff, 2019. [DOI]
- MO Bonn-Miller, MT Boden, MM Bucossi, KA Babson. Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. Am J Drug Alcohol Abuse, 2014. [DOI | PubMed]
- Bureau UC. U.S. Median Household Income Up in 2018 From 2017. 2019. https://www.census.gov/library/stories/2019/09/us-median-household-income-up-in-2018-from-2017.html. Accessed 26 Sept 2019.
- Buvinić M, Medici A, Fernández E, Torres AC. Gender differentials in health. The International Bank for Reconstruction and Development / The World Bank; 2006. http://www.ncbi.nlm.nih.gov/pubmed/21250310. Accessed 14 Aug 2020.
- TL Caputi, K Humphreys. Medical marijuana users are more likely to use prescription drugs medically and nonmedically. J Addict Med, 2018. [DOI | PubMed]
- DISA Global Solutions. Map of marijuana legality by state. Retrieved from URL https://disa.com/map-of-marijuana-legality-by-state. 2019. https://disa.com/map-of-marijuana-legality-by-state.
- DT Eurich, JG Hanlon, JJ Boisvenue, H Meng, JRB Dyck. A description of the medical Cannabis use in Ontario, Canada. Cannabis Cannabinoid Res, 2019. [DOI]
- BJ Fairman. Trends in registered medical marijuana participation across 13 US states and District of Columbia. Drug Alcohol Depend, 2016. [DOI | PubMed]
- AI Fraguas-Sanchez, AI Torres-Suarez. Medical use of cannabinoids. Drugs., 2018. [DOI | PubMed]
- P Hanlon, L Hannigan, J Rodriguez-Perez. Representation of people with comorbidity and multimorbidity in clinical trials of novel drug therapies: an individual-level participant data analysis. BMC Med, 2019. [DOI | PubMed]
- Institute of Medicine (U.S.). Marijuana and medicine: assessing the science base. Natl Acad Press https://doi.org/1017226/6376. 1999. 10.5860/choice.37-2206.
- R Kaur, SR Ambwani, S Singh. Endocannabinoid system: a multi-facet therapeutic target. Curr Clin Pharmacol, 2016. [DOI | PubMed]
- LE Klumpers, DL Thacker. A brief background on Cannabis: from plant to medical indications. J AOAC Int, 2019. [DOI | PubMed]
- JD Kosiba, SA Maisto, JW Ditre. Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: systematic review and meta-analysis. Soc Sci Med, 2019. [DOI | PubMed]
- Legislatures NC of S. State Medical Marijuana Laws. https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx. Published 2020.
- Y Lu, HD Anderson. Cannabinoid signaling in health and disease. Can J Physiol Pharmacol, 2017. [DOI | PubMed]
- S MacIntyre, G Ford, K Hunt. Do women “over-report” morbidity? Men’s and women’s responses to structured prompting on a standard question on long standing illness. Soc Sci Med, 1999. [DOI | PubMed]
- Martin CB, Hales CM, Gu Q, Ogden CL. Prescription Drug Use in the United States, 2015–2016 Key Findings Data from the National Health and Nutrition Examination Survey; 2015. https://www.cdc.gov/nchs/data/databriefs/db334_tables-508.pdf#1. Accessed 3 Apr 2020.
- RL Pacula, R Smart. Medical marijuana and marijuana legalization. Annu Rev Clin Psychol, 2017. [DOI | PubMed]
- RG Pertwee. Pharmacology of cannabinoid CB1 and CB2 receptors. Pharmacol Ther, 1997. [DOI | PubMed]
- RG Pertwee, AC Howlett, ME Abood. International union of basic and clinical pharmacology. LXXIX. Cannabinoid receptors and their ligands: beyond CB(1) and CB(2). Pharmacol Rev, 2010. [DOI | PubMed]
- A Reiman. Medical Cannabis patients: patient profiles and health care utilization patterns. Complement Health Pract Rev, 2007. [DOI]
- C Reinarman, H Nunberg, F Lanthier, T Heddleston. Who are medical marijuana patients? Population characteristics from nine California assessment clinics. J Psychoactive Drugs, 2011. [DOI | PubMed]
- Salazar CA, Tomko RL, Akbar SA, Squeglia LM, Mcclure EA. Medical Cannabis Use among Adults in the Southeastern United States. Cannabis. 2019;2(1):53–65.
- MV Seeman. Psychopathology in women and men: focus on female hormones. Am J Psychiatry, 1997. [DOI | PubMed]
- M Sexton, C Cuttler, JS Finnell, LK Mischley. A cross-sectional survey of medical Cannabis users: patterns of use and perceived efficacy. Cannabis Cannabinoid Res, 2016. [DOI | PubMed]
- US Income Statistics – Current Census Data for Zip Codes. 2018. https://www.incomebyzipcode.com/. Accessed 27 Mar 2020.
- LM Verbrugge, DL Wingard. Sex differentials in health and mortality. Health Matrix, 1987. [DOI | PubMed]
- S Vuckovic, D Srebro, KS Vujovic, C Vucetic, M Prostran. Cannabinoids and pain: new insights from old molecules. Front Pharmacol, 2018. [DOI | PubMed]
- I Waldron. Sex differences in illness incidence, prognosis and mortality: issues and evidence. Soc Sci Med, 1983. [DOI | PubMed]
- D Westergaard, P Moseley, FKH Sørup, P Baldi, S Brunak. Population-wide analysis of differences in disease progression patterns in men and women. Nat Commun, 2019. [DOI | PubMed]
- B Yu, X Chen, X Chen, H Yan. Marijuana legalization and historical trends in marijuana use among US residents aged 12-25: results from the 1979-2016 National Survey on drug use and health. BMC Public Health, 2020. [DOI | PubMed]
- N Zaller, A Topletz, S Frater, G Yates, M Lally. Profiles of medicinal cannabis patients attending compassion centers in Rhode Island. J Psychoactive Drugs, 2015. [DOI | PubMed]
