Policy Studies Harm Reduction

Putting Patients First: Medical Cannabis Use Patterns and Policy Protections


Chelsea Boyd
Resident Research Fellow, Harm Reduction

Key Points

By keeping patient safety and preference at the forefront, policies can be made that regulate medical access to cannabis without harming patients. Accurate, comprehensive labeling; diverse product availability; ensuring the existence of medical markets; and regulating contaminants are all areas in which practical policies can improve access and safety in medical markets.

In the absence of conclusive recommendations for specific cannabis products for specific conditions, it is vital that patients have the information necessary to make decisions about their treatment so that patients can adjust dosage based on individual preference.

Although more research is needed to assess the specific policies that protect and encourage medical dispensaries, at least one study has found differential effects on medical cannabis sales and number of patient registrations by state. This suggests that differences in states’ regulation of medical and adult-use markets can affect the sustainability of medical programs. 

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Executive Summary

Historically, cannabis has been used for medical purposes for millennia. Cannabis was introduced into western medicine in the mid-1800s but began to decline in use by the early 1900s. It was made a Schedule I substance under the Controlled Substances Act of 1970, which effectively prevented research on its potential medical uses and benefits. Nevertheless, since 1996, more than three-quarters of states have legalized the medical use of cannabis in some form. This policy study explores what is known about medical cannabis patients’ use patterns and preferences; describes marketplace trends and medical relevance of cannabinoid content; and suggests policies that promote the availability of safe, effective and accessible medical cannabis products for patients.

Because there is limited research on cannabis as a therapeutic treatment, it is hard to make conclusive statements about effective dosing and use patterns for specific conditions or patient populations. Nevertheless, compared to non-medical users, medical cannabis patients tend to use daily, via multiple routes of administration, and do not report a desire to experience cannabis’ psychotropic effects. Medical patients also seem to prefer different cannabinoid profiles than non-medical users. Keeping in mind that, for many patients, finding the most effective use pattern is a process of trial and error, ensuring a wide variety of products with different cannabinoid ratios is one policy that can enable patients to find the most beneficial product combinations for their conditions. Similarly, because medical patient preferences are different from non-medical users, insulating medical markets from the potential pressures of the adult-use market can ensure that patients have access to products they prefer, even after a state legalizes adult use.

Additionally, when states legalize medical cannabis, they have a duty to ensure that any markets that emerge are safe. Because cannabis is regulated at the state level, there is notable variability in cannabis markets and product standards. Ensuring that each state has accurate, comprehensive and (when possible) evidence-based labeling standards can help patients make informed decisions about the products they use. States can also protect patients by regulating contaminants appropriately. Practical medical cannabis policies are necessary to ensure patient safety and allow the greatest accessibility.

Read the rest of the study here.