Massachusetts Cannabis Control Commission, Worcester, Massachusetts, USA.
Program Design and Evaluation Services, Multnomah County/Oregon Public Health Division, Portland, Oregon, USA.
Clin Ther. 2023 Jun;45(6):578-588. doi: 10.1016/j.clinthera.2023.01.017.
Since October 2022, a total of 21 states have enacted both medical-use and adult-use cannabis legalization, each with their own unique set of laws, regulations, implementation, structures, and enforcement ("policies"). Unlike adult-use programs, medical-use programs often represent a safer and affordable option for patients with diverse needs; however, current evidence suggests that medical-use program activity decreases after implementation of adult-use retail. The current study compares medical patient registration data and medical- and adult-use retail data from 3 distinct medical- and adult-use states (Colorado, Massachusetts, and Oregon) in the time after adult-use retail implementation in each state.
To investigate changes in medical cannabis programs with simultaneous adult-use legalization, correlation and linear regression analyses were used to assess outcome measures: (1) medical-use retail sales; (2) adult-use retail sales; and (3) number of registered medical patients in all fiscal quarters after adult-use retail sales were implemented in each state to September 2022.
Adult-use cannabis sales increased significantly over time in all 3 states. However, both medical-use sales and number of medical patients registered in the states increased only in Massachusetts.
Results indicate that states' preexisting medical-use programs may undergo critical changes after adult-use cannabis legalization is enacted and implemented. Key policy and program differences, such as regulatory differences in the implementation of adult-use retail sales, may have differential impacts on medical-use programs. For continued patient access, it is critical that future research assess the differences within and between states' medical-use and adult-use programs that permit sustainability of medical-use programs alongside adult-use legalization and implementation.
自 2022 年 10 月以来，共有 21 个州颁布了医用和成人用大麻合法化法案，每个州都有自己独特的法律、法规、实施、结构和执法（“政策”）。与成人用计划不同，医用计划通常代表着满足各种需求的患者更安全、更经济的选择；然而，现有证据表明，在成人用零售实施后，医用计划的活动会减少。本研究比较了来自 3 个不同医用和成人用州（科罗拉多州、马萨诸塞州和俄勒冈州）的医用患者注册数据和医用及成人用零售数据，这些州在每个州实施成人用零售后。
为了研究同时实施成人用合法化对医用大麻计划的变化，采用相关和线性回归分析来评估以下结果指标：（1）医用零售销售；（2）成人用零售销售；（3）在每个州实施成人用零售销售后的所有财政季度中注册的医用患者数量。
在所有 3 个州，成人用大麻销售随着时间的推移显著增加。然而，医用销售和在这些州注册的医用患者数量仅在马萨诸塞州增加。
结果表明，在实施成人用大麻合法化后，各州现有的医用计划可能会发生重大变化。关键政策和项目差异，例如成人用零售销售实施方面的监管差异，可能对医用计划产生不同的影响。为了继续为患者提供服务，至关重要的是，未来的研究评估允许医用计划与成人用合法化和实施并存的各州内和州际之间的医用和成人用计划的差异，以确保医用计划的可持续性。
