Enrollment in medical cannabis programs increased more than 4-fold from 2016 to 2020
Medical cannabis laws in 35 states and Washington, D.C., expansion in the number of qualifying conditions, and increased enrollment nationally seem to be driving the upward trend.
The number of patients enrolled in medical cannabis programs increased by about 4.5-fold between 2016 and 2020, an observational study found.
Researchers from the University of Michigan Medical School analyzed medical cannabis program registry data from 35 states and Washington, D.C., to describe recent trends in medical cannabis program enrollment in the United States. Results were published June 14 by Annals of Internal Medicine.
In 2020, 26 states and Washington, D.C. reported patient numbers, and 19 states reported patient-reported qualifying conditions. The total number of enrolled patients increased from 678,408 in 2016 to 2,974,433 in 2020. Patients per 10,000 total population generally increased from 2016 to 2020, most dramatically in Oklahoma (by 927.1 patients per 10,000 population). Enrollment increased in states where recreational cannabis is not legal, whereas enrollment decreased in five of seven states with recreational legalization.
In 2020, 68.2% of patient-reported qualifying conditions had substantial or conclusive evidence that cannabis provides therapeutic value versus 84.6% in 2016, the study authors observed. Chronic pain was the most common patient-reported qualifying condition in 2020 (60.6%), followed by posttraumatic stress disorder (10.6%). Use for conditions or symptoms without a strong evidence basis increased from 15.4% (2016) to 31.8% (2020), with increasing enrollment for posttraumatic stress disorder (which has limited evidence of efficacy) and vague categories like “other” and “psychiatric conditions” (which have no evidence).
The study authors noted that use of cannabis for chronic pain and posttraumatic stress disorder was more common in medical-only states, whereas states allowing recreational use reported comparably higher percentages of patients reporting experiencing multiple sclerosis, arthritis, and chemotherapy-induced nausea and vomiting.
“Combined with growing scientific and public acceptance of cannabis's therapeutic properties, our results highlight the value of aligned federal and state cannabis regulation,” the authors wrote. “The federal schedule I designation is inconsistent with accepted therapeutic uses of cannabis and cannabinoids, and legal consequences of cannabis' criminalization disproportionately impact racial minority and low-income communities. Well-crafted federal regulation could improve patchwork state policies, enforce adequate labeling and potency testing, clarify blurred lines between medical and recreational use, and ensure appropriate training for dispensary employees and health care professionals.”