2020 年至 2022 年美国医疗大麻注册、授权医生和使用原因的趋势。
Trends in U.S. Medical Cannabis Registrations, Authorizing Clinicians, and Reasons for Use From 2020 to 2022.
机构信息
Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan (K.F.B., F.G., T.S.).
Cannabis Strategy Unit, Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, and Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee (R.S.).
出版信息
Ann Intern Med. 2024 Apr;177(4):458-466. doi: 10.7326/M23-2811. Epub 2024 Apr 9.
BACKGROUND
As medical cannabis availability increases, up-to-date trends in medical cannabis licensure can inform clinical policy and care.
OBJECTIVE
To describe current trends in medical cannabis licensure in the United States.
DESIGN
Ecological study with repeated measures.
SETTING
Publicly available state registry data from 2020 to 2022.
PARTICIPANTS
People with medical cannabis licenses and clinicians authorizing cannabis licenses in the United States.
MEASUREMENTS
Total patient volume and prevalence per 10 000 persons in the total population, symptoms or conditions qualifying patients for licensure (that is, patient-reported qualifying conditions), and number of authorizing clinicians.
RESULTS
In 2022, of 39 jurisdictions allowing medical cannabis use, 34 reported patient numbers, 19 reported patient-reported qualifying conditions, and 29 reported authorizing clinician numbers. Enrolled patients increased 33.3% from 2020 (3 099 096) to 2022 (4 132 098), with a corresponding 23.0% increase in the population prevalence of patients (175.0 per 10 000 in 2020 to 215.2 per 10 000 in 2022). However, 13 of 15 jurisdictions with nonmedical adult-use laws had decreased enrollment from 2020 to 2022. The proportion of patient-reported qualifying conditions with substantial or conclusive evidence of therapeutic value decreased from 70.4% (2020) to 53.8% (2022). Chronic pain was the most common patient-reported qualifying condition in 2022 (48.4%), followed by anxiety (14.2%) and posttraumatic stress disorder (13.0%). In 2022, the United States had 29 500 authorizing clinicians (7.7 per 1000 patients), 53.5% of whom were physicians. The most common specialties reported were internal or family medicine (63.4%), physical medicine and rehabilitation (9.1%), and anesthesia or pain (7.9%).
LIMITATION
Missing data (for example, from California), descriptive analysis, lack of information on individual use patterns, and changing evidence base.
CONCLUSION
Enrollment in medical cannabis programs increased overall but generally decreased in jurisdictions with nonmedical adult-use laws. Use for conditions or symptoms without a strong evidence basis continues to increase. Given these trends, more research is needed to better understand the risks and benefits of medical cannabis.
PRIMARY FUNDING SOURCE
National Institute on Drug Abuse of the National Institutes of Health.
背景
随着医用大麻的可获得性增加，医用大麻许可的最新趋势可以为临床政策和护理提供信息。
目的
描述美国医用大麻许可的当前趋势。
设计
具有重复测量的生态学研究。
设置
2020 年至 2022 年公开的州注册表数据。
参与者
美国有医用大麻许可证的患者和授权大麻许可证的临床医生。
测量
总人口中每 10000 人患者的总数和流行率、使患者有资格获得许可证的症状或情况（即患者报告的合格条件）以及授权临床医生的数量。
结果
在 2022 年，在允许使用医用大麻的 39 个司法管辖区中，有 34 个报告了患者人数，19 个报告了患者报告的合格条件，有 29 个报告了授权临床医生人数。从 2020 年（3099096 人）到 2022 年（4132098 人），登记患者增加了 33.3%，患者在总人口中的流行率相应增加了 23.0%（2020 年为 175.0/10000，2022 年为 215.2/10000）。然而，在有非医用成人使用法律的 15 个司法管辖区中，有 13 个从 2020 年到 2022 年的登记人数减少。有实质性或结论性治疗价值的患者报告合格条件的比例从 70.4%（2020 年）下降到 53.8%（2022 年）。慢性疼痛是 2022 年最常见的患者报告合格条件（48.4%），其次是焦虑症（14.2%）和创伤后应激障碍（13.0%）。2022 年，美国有 29500 名授权临床医生（每 1000 名患者 7.7 名），其中 53.5%为医生。报告的最常见专业是内科或家庭医学（63.4%）、物理医学和康复（9.1%）以及麻醉或疼痛（7.9%）。
局限性
数据缺失（例如，来自加利福尼亚州）、描述性分析、缺乏个体使用模式信息以及不断变化的证据基础。
结论
总体而言，参加医用大麻项目的人数增加了，但在有非医用成人使用法律的司法管辖区中，人数普遍减少。用于无明确证据基础的病症或症状的使用继续增加。鉴于这些趋势，需要进行更多的研究，以更好地了解医用大麻的风险和益处。
主要资金来源
美国国立卫生研究院国家药物滥用研究所。
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