After Florida legalized smokable medical cannabis, the average weekly THC dispensed per patient jumped 42%, far exceeding recommended daily doses.
Medical cannabis program administrators, regulators, and dispensary pharmacists.
42% increase in weekly THC dispensed per patient after Florida legalized smokable medical cannabis
What the researchers found
Legalizing smokable medical cannabis in Florida (SB182, March 2019) was associated with a 42.18% increase in mean weekly dispensed THC per patient (138.45 mg increase, 95% CI: 102.69-174.20) assuming 20% THC concentration. THC continued increasing by 5.62 mg per patient per week for 35 weeks post-policy. The number of certified patients also grew 24.8% in the first 4 months.
Why it matters
The finding that dispensed THC far exceeded recommended daily doses raises safety questions about medical cannabis programs that add smokable forms without dosing guidance.
The numbers in context
At 20% THC: +138.45 mg/week per patient (42.18% increase). Trend: +5.62 mg/week per patient each subsequent week. Patients: 197,107 (March 2019) to 325,868 (March 2020). At 10% THC: +35.10 mg/week (10.70% increase).
How the study worked
Quasi-experimental interrupted time series using Florida Department of Health dispensing data (April 2018-March 2020). Generalized least squares linear model with a 17-week phase-in period. THC estimated at both 10% and 20% flower concentrations.
What this study cannot tell us
THC concentration in flower is estimated (10-20%), not measured for each patient. Cannot determine individual consumption patterns from aggregate dispensing data. Pre-post design without a control state. Short post-policy period (35 weeks).
How to read the evidence
Strong quasi-experimental design with official dispensing data, but THC concentration estimates and short follow-up limit precision.
When this study was published
2025 publication with April 2018-March 2020 dispensing data.
The bigger picture
Most medical cannabis programs started with non-smokable forms (oils, capsules) with more controlled dosing. Adding smokable forms introduces the same dosing uncertainty seen in recreational markets, potentially undermining the medical framework.
Questions still open
- Should medical cannabis programs cap the amount of smokable cannabis dispensed per patient?
- Do patients titrate to higher THC levels with smokable forms compared to oils?
Read the original research
Legalization of Smokable Medical Cannabis and Changes in the Dispensed Amount of Δ-9 Tetrahydrocannabinol Per Patient.
Cannabis and cannabinoid research, 10(2), 207-212
Citation
Jugl, Sebastian; Sajdeya, Ruba; Buhlmann, Melanie; Cook, Robert L; Brown, Joshua D; Winterstein, Almut G; Goodin, Amie J. (2025). Legalization of Smokable Medical Cannabis and Changes in the Dispensed Amount of Δ-9 Tetrahydrocannabinol Per Patient.. Cannabis and cannabinoid research, 10(2), 207-212. https://doi.org/10.1089/can.2024.0073
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