Title:Preferences for Medical Marijuana over Prescription Medications Among Persons Living with Chronic Conditions: Alternative, Complementary, and Tapering Uses
In a survey of 30 patients using medical cannabis for a range of diseases including rheumatoid arthritis, cancer, hepatitis C, PTSD, among others, patients reported an array of benefits they have reaped from cannabis use. Patients successfully used cannabis in several ways: as an alternative to prescription medication, complementarily with prescription medicine, and to gradually replace use of prescription medication.
Benefits described by participants included the effects of cannabis lasting longer than that of opioids, lower risk of addiction, fewer side-effects. Patients also saw their sleep, anxiety, appetite, and adverse reactions improve with the use of medical cannabis. Larger, more controlled studies may suggest cannabis more affirmatively as an alternative or complementary therapy with prescription medications.
In yesterday’s blog post, the discrepancies in the number of medical cannabis users were discussed and the suggestion arose that perhaps medical cannabis use may need stricter regulations. The author of the piece that inspired the letter featured in the post responded, highlighting the possibility that recreational cannabis is being used for medical purposes rather than users obtaining cannabis from more nefarious sources. The author points out that renewing medical licenses can be a hassle and in states where recreational cannabis has been legalized patients may just be obtaining their cannabis, used for medical purposes, from recreational dispensaries. Surveys that delve into this issue are needed to confirm the author’s hypothesis.
Describing the medical process of obtaining a cannabis license as a hassle is, unfortunately, reported by many consumers. State governments are forced to run the regulatory processes, in the absence of federal support, and conservative politicians and opposition groups often create difficulty around opening dispensaries in their districts. On top of the expenses of renewing or obtaining a medical license, it may seem almost less confrontational for people who reside in a state or have access to recreational marijuana (from a state-regulated dispensary) simply to purchase recreational cannabis, rather than take the time to obtain a license.
Of note, Massachusetts is one of the few states that has anticipated this circumstance and has codified protections and advantages of the medical program, into law. In Massachusetts, medical patients are incentivized through robust discounts (totaling greater than $2000 in discounts, and 20% cost reduction because of the absence of state taxation for medical patients.) Further, there are legal protections available only to medical patients, and the opportunity for delivery, which are not available to recreational consumers.
Benjamin Caplan, MDAuthor’s Response to Discrepancies in Medical Cannabis Use
A recent letter to the editor exposes the large discrepancy between the number of registered medical marijuana patients and those who self-reported medical cannabis use. Estimates given by the National Survey on Drug Use and Health (NSDUH) suggest that 2.5% of Americans over the age of 12 used medical cannabis in 2013-2015 but a study from 2016 found that only 641,176 people were licensed to receive medical cannabis, a prevalence of 0.4%. If the numbers published by the NSDUH are accurate then states may need to delve into how so many people are accessing medical cannabis without proper licensing in order to better regulate the supply. If the numbers are extrapolated to 2019 and include all states where medical cannabis use in legal then more than 6.2 million people should be licensed but may not be.
Medical cannabis can be difficult to acquire due to its cost, post-legalization. Although medical cannabis in Massachusetts is readily available with a large number of dispensaries across the state, the cost of obtaining a doctor’s recommendation, complying with state fees, and then paying for the cannabis at a dispensary can be too much for some patients. Although MA will soon be waving the state fee, to obtaining a license, clinicians are still expensive and without the support of the federal government allowing national insurance companies to cover medical cannabis the costs still add up quickly. Fortunately, some dispensaries are designed to cater to those who need financial support.
Medical marijuana is legal in 33 states, and recreational marijuana is legal in 11. But on a federal level, the use and possession of marijuana is illegal for any purpose. The illegal status of cannabis prohibits research opportunities and hinders the safety of cannabis sales.
Watch this video for 4 reasons to legalize marijuana on a federal level
Benjamin Caplan, MDVideo: Legalization of Cannabis?