A Michigan program donated cannabis to people using more dangerous drugs as a harm reduction strategy | Research

The takeaway

A rural Michigan harm reduction program provided cannabis donations to 10 clients using more harmful substances, documenting the first US case study of cannabis donation as an alternative to higher-risk drug use.

Harm reduction program administrators; drug policy researchers exploring cannabis substitution strategies.

First US cannabis donation harm reduction program documented

What the researchers found

Ten cannabis-experienced harm reduction clients received weekly cannabis donations, with clinical staff determining appropriateness. Administrative data from a partnering cannabis company showed donations were primarily edibles, oils, and topicals (not flower), represented only 1% of gross sales, and cost less than anticipated. The program was operationally feasible within Michigan's legal framework.

Why it matters

Cannabis substitution for more dangerous substances has been documented in Canada but not the US. This case study establishes that such programs can operate within US state legal frameworks and at minimal cost to commercial partners.

The numbers in context

10 clients received cannabis donations over 20 months. Donations represented 1% of the cannabis company's total gross sales. Flower dominated sales but edibles, oils, and topicals dominated donations. Costs were lower than the expected yearly donation amount.

How the study worked

Community-driven research approach with qualitative data from harm reduction staff and 20 months of administrative data (September 2021-May 2023) from a commercial cannabis company providing donations.

What this study cannot tell us

Very small sample of 10 clients. No individual-level outcome data on whether cannabis substitution reduced other drug use. Single program in one state. Case study design limits generalizability. No comparison group.

How to read the evidence

Single-site case study with 10 participants. Establishes feasibility but not effectiveness.

When this study was published

2024 study

The bigger picture

If cannabis can serve as a less harmful substitute for opioids or stimulants for some people, donation programs through harm reduction agencies could complement existing overdose prevention strategies, though individual-level outcomes remain unstudied.

Questions still open

Does providing cannabis actually reduce use of more dangerous drugs in these clients? Could this model scale to other states with different cannabis laws?

Common questions

Does cannabis substitution actually reduce overdose risk?

Canadian research suggests potential benefits, but this US study only documented that the program was feasible, not whether it changed drug use patterns or health outcomes for the 10 participants.

Why did donations focus on edibles and topicals instead of flower?

The study did not explain this directly. It may reflect harm reduction principles favoring non-smoked products or the types of products the cannabis company had available for donation.

Read the original research

Cannabis donation as a harm reduction strategy: a case study.

Harm reduction journal, 21(1), 58

View on PubMed ↗Publisher’s paper ↗

Citation

Duhart Clarke, Sarah E; Victor, Grant; Lynch, Pamela; Suen, Leslie W; Ray, Bradley. (2024). Cannabis donation as a harm reduction strategy: a case study.. Harm reduction journal, 21(1), 58. https://doi.org/10.1186/s12954-024-00974-3