Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan (K.F.B.).
College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, Michigan (O.D.).
Ann Intern Med. 2022 Jul;175(7):945-951. doi: 10.7326/M22-0217. Epub 2022 Jun 14.
Cannabis policy liberalization has increased cannabis availability for medical or recreational purposes. Up-to-date trends in medical cannabis licensure can inform clinical policy and care.
To describe recent trends in medical cannabis licensure in the United States.
Ecological study with repeated measures.
State registry data via state reports and data requests on medical cannabis licensure from 2016 to 2020.
Medical cannabis patients (persons with medical cannabis licenses) in the United States.
Total patient volume, patients per 10 000 of total population, and patient-reported qualifying conditions (that is, symptoms or conditions qualifying patients for licensure)-including whether these symptoms align with current therapeutic evidence of cannabis-cannabinoid efficacy.
In 2020, 26 states and Washington, DC reported patient numbers, and 19 states reported patient-reported qualifying conditions. Total enrolled patients increased approximately 4.5-fold 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 (927.1 patients per 10 000 population). However, enrollment increased in states without recreational legalization (that is, medical-only states), whereas enrollment decreased in 5 of 7 with recreational legalization (that is, recreational states). In 2020, 68.2% of patient-reported qualifying conditions had substantial or conclusive evidence of therapeutic value versus 84.6% in 2016. Chronic pain was the most common patient-reported qualifying condition in 2020 (60.6%), followed by posttraumatic stress disorder (10.6%).
Missing state data; lack of rationale for discontinuing medical cannabis licensure.
Enrollment in medical cannabis programs approximately increased 4.5-fold from 2016 to 2020, although enrollment decreased in recreational states. Use for conditions or symptoms without a strong evidence basis increased from 15.4% (2016) to 31.8% (2020). Thoughtful regulatory and clinical strategies are needed to effectively manage this rapidly changing landscape.
National Institute on Drug Abuse of the National Institutes of Health.
大麻政策的自由化增加了医用或娱乐用大麻的供应。最新的医用大麻许可趋势可为临床政策和护理提供信息。
描述美国近期医用大麻许可趋势。
具有重复测量的生态学研究。
通过州报告和数据请求获得的州级登记数据，内容为 2016 年至 2020 年医用大麻许可情况。
美国医用大麻患者（拥有医用大麻许可证的人）。
总患者数量、每 10000 名总人口中的患者数量以及患者报告的合格条件（即有资格获得许可证的症状或情况），包括这些症状是否与当前大麻-大麻素疗效的治疗证据相符。
2020 年，有 26 个州和华盛顿特区报告了患者人数，有 19 个州报告了患者报告的合格条件。自 2016 年的 678408 名登记患者增加到 2020 年的 2974433 名，总注册患者数量增加了约 4.5 倍。每 10000 名总人口中的患者数量总体上从 2016 年到 2020 年有所增加，在俄克拉荷马州增幅最大（每 10000 名居民中有 927.1 名患者）。然而，在没有娱乐合法化的州（即仅医用大麻合法化的州），登记人数有所增加，而在有 7 个娱乐合法化的州中，有 5 个州（即娱乐用大麻合法化的州）登记人数有所减少。2020 年，68.2%的患者报告的合格条件具有治疗价值的充分或确凿证据，而 2016 年为 84.6%。慢性疼痛是 2020 年最常见的患者报告的合格条件（60.6%），其次是创伤后应激障碍（10.6%）。
州数据缺失；缺乏停止医用大麻许可的理由。
自 2016 年以来，医用大麻项目的注册人数增加了约 4.5 倍，尽管在娱乐用大麻合法化的州，注册人数有所下降。用于缺乏强有力证据基础的病症或症状的大麻使用比例从 2016 年的 15.4%增加到 2020 年的 31.8%。需要深思熟虑的监管和临床策略，以有效应对这一快速变化的局面。
美国国立卫生研究院国家药物滥用研究所。
