Women, medical-only users, and cannabis novices prefer lower-THC products and edibles over smoking | Research

The takeaway

Among 1,321 medical cannabis users with chronic pain, 76.5% used daily and 72.5% used 3+ delivery methods, but women, medical-only users, and novices preferred low-THC products, edibles, and tinctures, while only 2.6% chose products with medical professional input.

Pain clinicians, dispensary operators, cannabis researchers, and anyone interested in how chronic pain patients navigate cannabis products.

Only 2.6% get medical advice

What the researchers found

76.5% used cannabis daily, 93.4% used 2+ administration routes, and 72.5% used 3+ routes. Women, medical-only users, and novices were less likely to smoke or vaporize and preferred edibles, tinctures, and topicals with low THC:high CBD ratios. Only 2.6% selected products with medical professional input, while 54.9% relied on dispensary employee advice.

Why it matters

The wide variability in how chronic pain patients use cannabis makes standardized clinical guidance nearly impossible. The finding that only 2.6% get medical input in product selection highlights a massive gap in clinical engagement.

The numbers in context

1,321 participants, 59% female. Daily use: 76.5%. 3+ routes: 72.5%. Medical professional input: 2.6%. Dispensary advice: 54.9%. Women preferred low THC:high CBD. Medical-only users preferred edibles, tinctures, topicals over smoking.

How the study worked

Cross-sectional online survey of 1,321 medical cannabis users with chronic pain (59% female). Examined cannabinoid preferences, administration routes, and product selection, stratified by sex, use intentions (medical-only vs medical+recreational), and experience level.

What this study cannot tell us

Self-selected online sample biased toward engaged cannabis users. No clinical outcomes linked to preferences. Product availability varies by state. Dispensary employee advice quality is unregulated and unstandardized.

How to read the evidence

Rated moderate because the large sample reveals clinically relevant patterns, though the self-selected population limits generalizability.

When this study was published

Published in 2019. Cannabis product diversity has continued to expand.

The bigger picture

The cannabis-for-pain population is not monolithic. Sex, experience level, and intentions behind use all dramatically shape product choices. Clinicians who understand these patterns can have more productive conversations with patients.

Questions still open

Do different product preferences lead to different clinical outcomes? Should dispensary employees receive standardized training? How can medical professionals become more involved in product selection?

Common questions

How do chronic pain patients choose cannabis products?

Most rely on dispensary employee advice (54.9%). Only 2.6% selected products with medical professional input. Experienced users chose based on smell, appearance, and cannabis variety.

Do men and women use cannabis differently for pain?

Yes. Women preferred low THC:high CBD ratios and non-smoking routes (edibles, tinctures, topicals) more than men, who were more likely to smoke or vaporize and choose higher-THC products.

Read the original research

Cannabis Use Preferences and Decision-making Among a Cross-sectional Cohort of Medical Cannabis Patients with Chronic Pain.

The journal of pain, 20(11), 1362-1372

View on PubMed ↗Publisher’s paper ↗

Citation

Boehnke, Kevin F; Scott, J Ryan; Litinas, Evangelos; Sisley, Suzanne; Clauw, Daniel J; Goesling, Jenna; Williams, David A. (2019). Cannabis Use Preferences and Decision-making Among a Cross-sectional Cohort of Medical Cannabis Patients with Chronic Pain.. The journal of pain, 20(11), 1362-1372. https://doi.org/10.1016/j.jpain.2019.05.009