Original Research
9 April 2024

Trends in U.S. Medical Cannabis Registrations, Authorizing Clinicians, and Reasons for Use From 2020 to 2022

Publication: Annals of Internal Medicine
Volume 177, Number 4
Visual Abstract. Trends in U.S. Medical Cannabis Registrations, Authorizing Clinicians, and Reasons for Use From 2020 to 2022
The authors discuss key data regarding licensed medical cannabis use in the United States, including changes in estimates of patients using medical cannabis overall, conditions for which patients obtain medical cannabis licenses, passage of new state-level medical cannabis laws, the number and type of clinicians authorizing medical cannabis use, and shifts in the number of patients based on the presence of nonmedical adult use laws.

Abstract

Background:

As medical cannabis availability increases, up-to-date trends in medical cannabis licensure can inform clinical policy and care.

Objective:

To describe current trends in medical cannabis licensure in the United States.

Design:

Ecological study with repeated measures.

Setting:

Publicly available state registry data from 2020 to 2022.

Participants:

People with medical cannabis licenses and clinicians authorizing cannabis licenses in the United States.

Measurements:

Total patient volume and prevalence per 10 000 persons in the total population, symptoms or conditions qualifying patients for licensure (that is, patient-reported qualifying conditions), and number of authorizing clinicians.

Results:

In 2022, of 39 jurisdictions allowing medical cannabis use, 34 reported patient numbers, 19 reported patient-reported qualifying conditions, and 29 reported authorizing clinician numbers. Enrolled patients increased 33.3% from 2020 (3 099 096) to 2022 (4 132 098), with a corresponding 23.0% increase in the population prevalence of patients (175.0 per 10 000 in 2020 to 215.2 per 10 000 in 2022). However, 13 of 15 jurisdictions with nonmedical adult-use laws had decreased enrollment from 2020 to 2022. The proportion of patient-reported qualifying conditions with substantial or conclusive evidence of therapeutic value decreased from 70.4% (2020) to 53.8% (2022). Chronic pain was the most common patient-reported qualifying condition in 2022 (48.4%), followed by anxiety (14.2%) and posttraumatic stress disorder (13.0%). In 2022, the United States had 29 500 authorizing clinicians (7.7 per 1000 patients), 53.5% of whom were physicians. The most common specialties reported were internal or family medicine (63.4%), physical medicine and rehabilitation (9.1%), and anesthesia or pain (7.9%).

Limitation:

Missing data (for example, from California), descriptive analysis, lack of information on individual use patterns, and changing evidence base.

Conclusion:

Enrollment in medical cannabis programs increased overall but generally decreased in jurisdictions with nonmedical adult-use laws. Use for conditions or symptoms without a strong evidence basis continues to increase. Given these trends, more research is needed to better understand the risks and benefits of medical cannabis.

Primary Funding Source:

National Institute on Drug Abuse of the National Institutes of Health.

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Information & Authors

Information

Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 177Number 4April 2024
Pages: 458 - 466

History

Published online: 9 April 2024
Published in issue: April 2024

Keywords

    Authors

    Affiliations

    Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan (K.F.B., F.G., T.S.)
    Cannabis Strategy Unit, Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, and Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee (R.S.)
    Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan (K.F.B., F.G., T.S.)
    Veterans Affairs Ann Arbor Healthcare System and Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan (A.H.)
    Cannabis Strategy Unit, Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (D.R.R., B.H.).
    Tristin Smith, MPH
    Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan (K.F.B., F.G., T.S.)
    Brooke Hoots, PhD
    Cannabis Strategy Unit, Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (D.R.R., B.H.).
    Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
    Grant Support: Dr. Boehnke’s effort on this publication was partially supported by grant K01DA049219 from the National Institute on Drug Abuse of the National Institutes of Health.
    Reproducible Research Statement: Study protocol: Not applicable. Statistical code: All graphs were created in Excel, so no code was used. Data set: Available from Dr. Boehnke (e-mail, [email protected]).
    Corresponding Author: Kevin F. Boehnke, PhD, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106; e-mail, [email protected].
    Author Contributions: Conception and design: K.F. Boehnke, B. Hoots, D.R. Roehler, R. Sinclair.
    Analysis and interpretation of the data: K.F. Boehnke, F. Gordon, B. Hoots, D.R. Roehler, R.A. Sinclair, T. Smith.
    Drafting of the article: K.F. Boehnke, B. Hoots, D.R. Roehler, R. Sinclair, T. Smith.
    Critical revision for important intellectual content: K.F. Boehnke, B. Hoots, A. Hosanagar, D.R. Roehler, T. Smith.
    Final approval of the article: K.F. Boehnke, F. Gordon, B. Hoots, A. Hosanagar, D.R. Roehler, R. Sinclair, T. Smith.
    Statistical expertise: K.F. Boehnke, T. Smith.
    Obtaining of funding: K.F. Boehnke.
    Administrative, technical, or logistic support: K.F. Boehnke.
    Collection and assembly of data: K.F. Boehnke, F. Gordon, R. Sinclair, T. Smith.
    This article was published at Annals.org on 9 April 2024.

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    Kevin F. Boehnke, Rachel Sinclair, Felicia Gordon, et al. Trends in U.S. Medical Cannabis Registrations, Authorizing Clinicians, and Reasons for Use From 2020 to 2022. Ann Intern Med.2024;177:458-466. [Epub 9 April 2024]. doi:10.7326/M23-2811

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