After Getting Medical Cannabis Certification, 41% of Pain Patients Never Actually Used It

Within three months of certification, 29% used predominantly high-THC products, 30% used other products, and 41% did not use any cannabis. White race, multi-site pain, and sedative use predicted MC use. Current tobacco and unregulated cannabis use predicted non-use. Among those who used MC, female gender and older age predicted lower likelihood of choosing high-THC products.

Longitudinal cohort study of 225 adults with chronic/severe pain on opioids who were newly certified for medical cannabis in New York State (November 2018-January 2022). Web-based assessments every 2 weeks for 3 months. Generalized estimating equation models examined predictors.

Getting certified does not mean patients will use medical cannabis. Understanding who actually follows through -- and what products they choose -- reveals barriers to access and potential disparities that certification alone does not solve.

The finding that unregulated cannabis users were less likely to use medical cannabis after certification suggests these patients may already be accessing cannabis outside the medical system and see the legal program as redundant or inferior. This has implications for states trying to transition illicit users into regulated systems.

New York's medical cannabis program during the study period was restrictive compared to other states, potentially limiting product options and access. The 3-month follow-up may not capture longer-term adoption patterns. The sample may not represent all MC-certified patients.