TY - JOUR
T1 - Factors Associated with Medical Cannabis Use After Certification
T2 - A Three-Month Longitudinal Study
AU - Zhang, Chenshu
AU - Slawek, Deepika E.
AU - Ross, Jonathan
AU - Zolotov, Yuval
AU - Castillo, Felipe
AU - Levin, Frances R.
AU - Sohler, Nancy L.
AU - Minami, Haruka
AU - Cunningham, Chinazo O.
AU - Starrels, Joanna L.
AU - Arnsten, Julia H.
N1 - Publisher Copyright:
Copyright 2023, Mary Ann Liebert, Inc., publishers.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - Background: Over the past decade, there has been increased utilization of medical cannabis (MC) in the United States. Few studies have described sociodemographic and clinical factors associated with MC use after certification and more specifically, factors associated with use of MC products with different cannabinoid profiles. Methods: We conducted a longitudinal cohort study of adults (N=225) with chronic or severe pain on opioids who were newly certified for MC in New York State and enrolled in the study between November 2018 and January 2022. We collected data over participants' first 3 months in the study, from web-based assessment of MC use every 2 weeks (unit of analysis). We used generalized estimating equation models to examine associations of sociodemographic and clinical factors with (1) MC use (vs. no MC use) and (2) use of MC products with different cannabinoid profiles. Results: On average, 29% of the participants used predominantly high delta-9-tetrahydrocannabinol (THC) MC products within the first 3 months of follow-up, 30% used other MC products, and 41% did not use MC products. Non-Hispanic White race, pain at multiple sites, and past 30-day sedative use were associated with a higher likelihood of MC use (vs. no MC use). Current tobacco use, unregulated cannabis use, and enrollment in the study during the COVID-19 pandemic were associated with a lower likelihood of MC use (vs. no MC use). Among participants reporting MC use, female gender and older age were associated with a lower likelihood of using predominantly high-THC MC products (vs. other MC products). Conclusion: White individuals were more likely to use MC after certification, which may be owing to access and cost issues. The findings that sedative use was associated with greater MC use, but tobacco and unregulated cannabis were associated with less MC use, may imply synergism and substitution that warrant further research. From the policy perspective, additional measures are needed to ensure equitable availability of and access to MC. Health practitioners should check patients' history and current use of sedative, tobacco, and unregulated cannabis before providing an MC recommendation and counsel patients on safe cannabis use. clinicaltrials.gov
AB - Background: Over the past decade, there has been increased utilization of medical cannabis (MC) in the United States. Few studies have described sociodemographic and clinical factors associated with MC use after certification and more specifically, factors associated with use of MC products with different cannabinoid profiles. Methods: We conducted a longitudinal cohort study of adults (N=225) with chronic or severe pain on opioids who were newly certified for MC in New York State and enrolled in the study between November 2018 and January 2022. We collected data over participants' first 3 months in the study, from web-based assessment of MC use every 2 weeks (unit of analysis). We used generalized estimating equation models to examine associations of sociodemographic and clinical factors with (1) MC use (vs. no MC use) and (2) use of MC products with different cannabinoid profiles. Results: On average, 29% of the participants used predominantly high delta-9-tetrahydrocannabinol (THC) MC products within the first 3 months of follow-up, 30% used other MC products, and 41% did not use MC products. Non-Hispanic White race, pain at multiple sites, and past 30-day sedative use were associated with a higher likelihood of MC use (vs. no MC use). Current tobacco use, unregulated cannabis use, and enrollment in the study during the COVID-19 pandemic were associated with a lower likelihood of MC use (vs. no MC use). Among participants reporting MC use, female gender and older age were associated with a lower likelihood of using predominantly high-THC MC products (vs. other MC products). Conclusion: White individuals were more likely to use MC after certification, which may be owing to access and cost issues. The findings that sedative use was associated with greater MC use, but tobacco and unregulated cannabis were associated with less MC use, may imply synergism and substitution that warrant further research. From the policy perspective, additional measures are needed to ensure equitable availability of and access to MC. Health practitioners should check patients' history and current use of sedative, tobacco, and unregulated cannabis before providing an MC recommendation and counsel patients on safe cannabis use. clinicaltrials.gov
KW - CBD
KW - COVID-19 pandemic
KW - THC
KW - chronic pain
KW - demographic characteristics
KW - insomnia
KW - medical cannabis
KW - mental health symptoms
KW - opioid use
KW - substance use
KW - unregulated cannabis use
UR - http://www.scopus.com/inward/record.url?scp=85163706114&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85163706114&partnerID=8YFLogxK
U2 - 10.1089/can.2022.0248
DO - 10.1089/can.2022.0248
M3 - Article
C2 - 36961410
AN - SCOPUS:85163706114
SN - 2378-8763
VL - 9
SP - e859-e869
JO - Cannabis and Cannabinoid Research
JF - Cannabis and Cannabinoid Research
IS - 3
ER -
