Medical Cannabis Patients Use More Cannabis But Fewer Prescription Drugs Than Recreational Users | Research

The takeaway

Young adult medical marijuana patients used cannabis more frequently and spent more money on it than non-patients, but showed trends toward lower prescription drug misuse and greater use of non-combustible methods.

Read this if you are a medical cannabis patient or want to understand how medical and recreational cannabis use patterns differ.

Medical patients used cannabis 76 days per 90 vs. 59 days for non-patients, but misused fewer prescription drugs

What the researchers found

This study compared 210 young adult medical marijuana patients (MMP) with 156 non-patient marijuana users (NPU) aged 18-26 in Los Angeles.

Medical patients used significantly more cannabis: an average of 76.4 days in the past 90 days compared to 59.2 days for non-patients. They also spent substantially more ($564.50 vs. $266.90 over 90 days).

Medical patients were significantly more likely to vaporize their cannabis, both as concentrates and as flower, suggesting they were accessing and choosing non-combustible delivery methods more often than recreational users.

An interesting pattern emerged regarding other drugs: medical patients showed trends toward lower misuse of prescription drugs compared to non-patients, though this did not reach statistical significance.

Notably, about 22.6% of both groups reported selling dispensary-obtained marijuana to someone else in the past 90 days, indicating diversion from the legal supply chain was common across both groups.

Why it matters

This study challenges simple narratives about medical versus recreational cannabis use. Medical patients used more cannabis but in potentially less harmful ways (more vaporizing, less prescription drug misuse). The diversion finding raises policy concerns about dispensary sales reaching non-patients.

The numbers in context

210 medical patients, 156 non-patients. Mean days of use: 76.4 vs. 59.2 (p<0.001). Mean spending: $564.50 vs. $266.90 (p<0.001). Vaporization of concentrates: 1.5x more likely among MMP. 22.6% of both groups sold dispensary marijuana to others.

How the study worked

Cross-sectional study of 366 young adults (18-26) sampled in Los Angeles in 2014-2015. Medical patients had current, verified recommendations. Self-reported marijuana and other drug use during the past 90 days were compared using unadjusted risk ratios and differences in means.

What this study cannot tell us

Cross-sectional design in Los Angeles may not generalize to other markets. Self-reported data may be subject to social desirability bias. Medical marijuana recommendations in California at this time were relatively easy to obtain, blurring the line between medical and recreational users.

How to read the evidence

Cross-sectional comparison with verified medical status. Preliminary because of potential selection bias and inability to establish causal relationships.

When this study was published

Published in 2017, with data from 2014-2015 Los Angeles.

The bigger picture

The finding that medical patients used more but in less harmful ways (vaporization, less prescription drug misuse) suggests that medical cannabis programs may shape user behavior in health-relevant ways. However, the higher intensity of use also means greater cannabinoid exposure, and the health implications of that higher exposure remain debated.

Questions still open

Does the lower prescription drug misuse among medical patients reflect cannabis substitution, or pre-existing differences between the groups? Would similar patterns appear in states with stricter medical cannabis programs? Does greater vaporization among medical patients translate to measurably better respiratory outcomes?

Common questions

Do medical marijuana patients use more cannabis than recreational users?

Yes. In this study, medical patients used cannabis about 76 days out of 90 compared to 59 days for non-patients, and spent roughly twice as much money on cannabis products.

Do medical patients use cannabis differently?

Yes. Medical patients were significantly more likely to use vaporization methods for both concentrates and flower, potentially reducing respiratory harm from combustion. They also showed trends toward less prescription drug misuse.

Read the original research

Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users.

Drug and alcohol dependence, 170, 181-188

View on PubMed ↗Publisher’s paper ↗

Citation

Lankenau, Stephen E; Fedorova, Ekaterina V; Reed, Megan; Schrager, Sheree M; Iverson, Ellen; Wong, Carolyn F. (2017). Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users.. Drug and alcohol dependence, 170, 181-188. https://doi.org/10.1016/j.drugalcdep.2016.10.025