Reeves Carter, Franks Lirit, Kelley A Taylor, Incze Michael, Gordon Adam J, Yu Ziji, Flake Eden, Cochran Gerald
Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
J Cannabis Res. 2025 Jul 18;7(1):48. doi: 10.1186/s42238-025-00284-w.
Medical Cannabis (MC) is authorized in numerous state-legislated programs to treat approved medical conditions. Notwithstanding MC access, some participants continue to use cannabis purchased outside of a state licensed MC pharmacy, otherwise known as illicit medicinal cannabis (IMC), to treat their medical conditions. Identifying barriers and contributors to MC use and motives for IMC use can promote safety, improve program design, and inform future research efforts.
This exploratory analysis utilized baseline survey data from a convenience sample-based prospective cohort evaluation of newly registered (< 6 months) adult participants in Utah's MC program who had been diagnosed with chronic pain, post-traumatic stress disorder, and/or cancer. Participants completed surveys assessing physical and mental health, program experience, and barriers and contributors to MC access. We employed descriptive analysis, chi-squared analysis, and logistic regression to identify factors influencing IMC use.
Among 273 MC program participants screened for eligibility, 227 were enrolled in the cohort evaluation, and 211 participants completed the baseline survey. Approximately 1 in 10 survey respondents (N = 24, 11.9%) reported IMC use within the past two weeks. Participants accessing IMC were 40.5 years old, 58.3% male, 70.8% employed, and 87.5% white. Participants using IMC reported barriers to MC, including product cost (n = 19, 79%) and assurance of adequate supply (n = 11, 45.8%) as the most common motives for IMC use. Participants who reported experiencing MC access barriers were significantly more likely to report IMC use than those reporting no barriers (Odds Ratio (OR) = 4.73, p <.001). Participants using IMC reported lower levels of trust in (p <.04) and reliance (p <.02) upon the state program and less reliance on MC pharmacists (p's < 0.01). However, participants who relied on the state program for MC information were less likely to report IMC use (Adjusted Odds Ratio AOR = 0.16, p <.05).
In a state MC program, barriers related to MC access and cost indicated a significant increase in the likelihood of IMC use, while reliance on the state program for MC information indicated a significant decrease in the likelihood of IMC use. Future research can explore how increasing affordable access to MC and availability of reliable information may affect IMC use.
医用大麻（MC）在许多州立法项目中被批准用于治疗特定的医学病症。尽管有合法的医用大麻获取途径，但仍有一些参与者继续使用在州立有执照的医用大麻药房以外购买的大麻，即非法药用大麻（IMC）来治疗他们的病症。识别影响医用大麻使用的障碍和因素以及非法药用大麻使用的动机，有助于提高安全性、改进项目设计并为未来的研究工作提供参考。
本探索性分析利用了基于便利样本的前瞻性队列评估的基线调查数据，该评估针对犹他州医用大麻项目中刚注册（<6个月）且被诊断患有慢性疼痛、创伤后应激障碍和/或癌症的成年参与者。参与者完成了评估身心健康、项目体验以及获取医用大麻的障碍和影响因素的调查。我们采用描述性分析、卡方分析和逻辑回归来确定影响非法药用大麻使用的因素。
在筛选出的273名符合条件的医用大麻项目参与者中，227名被纳入队列评估，211名参与者完成了基线调查。大约十分之一的调查受访者（N = 24，11.9%）报告在过去两周内使用过非法药用大麻。使用非法药用大麻的参与者平均年龄为40.5岁，58.3%为男性，70.8%有工作，87.5%为白人。使用非法药用大麻的参与者报告了获取医用大麻的障碍，包括产品成本（n = 19，79%）和充足供应的保证（n = 11，45.8%），这是使用非法药用大麻最常见的动机。报告有获取医用大麻障碍的参与者比没有障碍的参与者更有可能报告使用非法药用大麻（优势比（OR）= 4.73，p <.001）。使用非法药用大麻的参与者对州项目的信任度（p <.04）和依赖度（p <.02）较低，对医用大麻药剂师的依赖也较少（p < 0.01）。然而，依赖州项目获取医用大麻信息的参与者报告使用非法药用大麻的可能性较小（调整后的优势比AOR = 0.16，p <.05）。
在一个州的医用大麻项目中，与获取医用大麻和成本相关的障碍表明使用非法药用大麻的可能性显著增加，而依赖州项目获取医用大麻信息则表明使用非法药用大麻的可能性显著降低。未来的研究可以探讨增加可负担的医用大麻获取途径和可靠信息的可用性如何影响非法药用大麻的使用。
