Ageze Daniel, Dell'Acqua Renee, Marcotte Thomas D, Rybar Jill, Baird Sara, Gold Alice, Shaughnessy Tom, Lanin-Kettering Ilene, Hill Linda
Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0994, USA.
Department of Psychiatry, Center for Medicinal Cannabis Research, UC San Diego, 220 Dickinson Street, Suite B, MC8231, San Diego, CA, 92103-8231, USA.
J Cannabis Res. 2025 Jul 12;7(1):44. doi: 10.1186/s42238-025-00285-9.
Proposition 64, the Adult Use of Marijuana Act of 2016, reshaped cannabis use in California. This study explores the use patterns of people who use cannabis for medicinal-only and combined medicinal and recreational use after implementation of Proposition 64.
A quantitative, population-based online questionnaire included 4,020 current cannabis users, 523 former users, and 635 non-users. This analysis focuses on participants who self-identified as using cannabis for medicinal-only (n = 711) or both medicinal and recreational (M + R, n = 1719) purposes.
Sixty one percent of current cannabis users report medicinal use. Medicinal-only users were more likely to be female (OR 1.6, p < 0.001), have kids in household (OR 1.5, p < 0.001), and began cannabis use later (mean age 34 vs. 23, p < 0.001). Pain relief was the predominant reason for use, followed by sleep, anxiety, and stress relief. While both groups reported positive effects, M + R users experienced more negative side effects. Fewer medicinal-only users cited a desire to "feel the high," (42% vs. 75% M + R, p < 0.001). Medicinal-only users felt less comfortable discussing cannabis with primary care providers than M + R users (75% vs 83%, p < 0.01). All users were more likely to seek information online (44-57%) or from friends/family (47-52%) than health professionals (26-27%). Dispensaries were the main cannabis source for both medicinal groups (72% M vs. 84% M + R, p < 0.01), with licensure being very or extremely important (72% M, 66% M + R, p < 0.01). Monthly spending for medicinal-only users was lower ($127 vs. $186 for M + R, p < 0.001), and they were more likely than M + R users to wait before feeling safe to drive after using cannabis.
People who use medicinal cannabis alone vary in key areas from people who use cannabis for both medicinal and recreational reasons. The need for better patient-provider relationships and clinically informed guidance is evident to support medicinal cannabis users.
2016年的《第64号提案：成人使用大麻法案》重塑了加利福尼亚州的大麻使用情况。本研究探讨了在第64号提案实施后，仅将大麻用于医疗用途以及同时用于医疗和娱乐用途的人群的使用模式。
一项基于人群的定量在线调查问卷涵盖了4020名当前大麻使用者、523名曾经的使用者和635名非使用者。本分析聚焦于那些自我认定仅将大麻用于医疗用途（n = 711）或同时用于医疗和娱乐用途（M+R，n = 1719）的参与者。
61%的当前大麻使用者报告有医疗用途。仅用于医疗的使用者更可能为女性（比值比1.6，p < 0.001），家中有孩子（比值比1.5，p < 0.001），且开始使用大麻的时间较晚（平均年龄34岁对23岁，p < 0.001）。缓解疼痛是使用大麻的主要原因，其次是助眠、缓解焦虑和压力。虽然两组都报告有积极效果，但M+R组使用者经历的负面副作用更多。仅用于医疗的使用者中提及“体验快感”意愿的较少（42%对M+R组的75%，p < 0.001）。与M+R组使用者相比，仅用于医疗的使用者在与初级保健提供者讨论大麻时感觉更不自在（75%对83%，p < 0.01）。所有使用者从网上（44 - 57%）或朋友/家人（47 - 52%）获取信息的可能性都高于从医疗专业人员处获取信息（26 - 27%）。药房是两个医疗组获取大麻的主要来源（医疗组为72%，M+R组为84%，p < 0.01），执照非常重要或极其重要（医疗组为72%，M+R组为66%，p < 0.01）。仅用于医疗的使用者每月花费较低（127美元对M+R组的186美元，p < 0.001），且与M+R组使用者相比，他们在使用大麻后更可能等待一段时间才觉得开车安全。
仅使用医用大麻的人群在关键方面与同时将大麻用于医疗和娱乐用途的人群有所不同。显然需要建立更好的医患关系并提供基于临床的指导，以支持医用大麻使用者。
