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Enrolment in medical marijuana programs dips in U.S. states with legal recreational cannabis

Nov 23, 2021
“Findings suggest that recreational cannabis legalization is associated with decreasing enrolment in medical cannabis programs, particularly for males,” notes the research paper published ...

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A new study showing lower medical marijuana enrolment in U.S. states where recreational cannabis has been legalized could potentially have public health and policy implications, researchers caution.

“Findings suggest that recreational cannabis legalization is associated with decreasing enrolment in medical cannabis programs, particularly for males,” notes the research paper published online this week.

To reach their conclusion, investigators out of Arizona — where both adult-use and medicinal cannabis is legal — looked at medical cannabis registry data from the almost two dozen states with mandatory registries between 2013 and 2020. They then considered if enrolment trends change depending on legalization of adult-use cannabis.

In general, the data showed registered active medical cardholders increased over time while recreational cannabis was not legal, but decreased in years when it was legal.

More specifically, the results indicate an increase of 380 cardholders per 100,000 people per year when only medicinal marijuana was legal. But after a state gave recreational cannabis the green light, there was a corresponding decrease of 100 cardholders per 100,000 people per year.

Researchers found that in medical-only states, older cardholders (those 35 and older) increased faster than younger (those aged 18 to 30) cardholders. In recreational states, however, male cardholders decreased faster than female cardholders.

And for the three states with medical-only cannabis, “results showed significant increases from 2016 to 2020 in enrolment of White, African-American and Hispanic individuals,” study authors write.

A Canadian study exploring overlapping patterns of recreational and medical cannabis use also cautioned that understanding those patterns “is a high public health priority,” particularly given regulatory changes are increasing access to both types of cannabis in general.

“Interestingly, a large majority of medical users also reported using recreationally (80.6 per cent), while exclusive medical use was less common (19.3 per cent),” note authors in the study published in Comprehensive Psychiatry last year.

Another Canadian study explored how legalizing recreational cannabis influenced the access of medical users who had cancer. B.C. investigators considered the experiences of cancer patients two months before and three months following adult-use legalization.

“In the post-legalization cohort, more current users reported problems getting cannabis (18 per cent) than the pre-legalization cohort (eight per cent),” study authors write.

A common barrier was the lack of preferred products, including edibles, some of which did not become available in legal dispensaries until later. Cost and difficulties using a legal access system were also cited as barriers.

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