New Research on the Use and Perception of Cannabis

The legalization of recreational cannabis is linked to a reduction in prescription drug abuse. Between 2016 and 2020, the number of state-level medical marijuana programs increased by more than fourfold. A 2019 survey found that more than 25% of U.S. respondents used Hemp products in the past year. In the U.K., medical cannabis patients believe that society and healthcare professionals don’t approve their prescription.

These are just a few of the many recent findings from studies that examined the perceptions and use of cannabis in the U.S., Canada, and the U.K. They provide an insightful snapshot of the moment. While cannabis is becoming more accepted and commonplace in these countries, it remains stigmatized and poorly understood. These studies also reveal current trends in product preferences, labeling practices, and other aspects that will continue to change with the industry’s rapid growth.

Prescription Drugs Up, Recreational Cannabis Down

Numerous studies have been conducted over the past five years to show that medical marijuana access is associated with a reduction in prescriptions for opioids. A July 2022 article in Health Economics shows that 5 Indiana University students, Ashley Bradford, who also coauthored three of these studies, and Shyam Raman, a Cornell University, doctoral student, analyzed quarterly data regarding U.S. Medicaid prescribing from 2011 to 2019.

They found that prescriptions fell in drug classes that correspond with medical indications for anxiety, pain, sleep, psychosis, and seizures.

Medical cannabis use is growing, but the stigma remains.

Two more recent studies provide insight into the state of medical marijuana in the U.S.A and U.K… The first, published in Annals of Internal Medicine June 20226,6 shows that the number of patients enrolled in state-level programs for medical cannabis (26 of 37 states) has increased almost 4.5 times between 2016 and 2020. It is not surprising that most of this growth occurred in states with no recreational cannabis legalization. Oklahoma was the first state to legalize medical marijuana in 2018. By 2020, there were 927 patients for every 10,000 residents. Five of the seven states that allowed recreational cannabis use reported data over this period. However, the medical cannabis patient population declined in five of these states. This could be because a medical license which can often require a fee, was not required.

State Medicaid programs could save money if recreational cannabis is allowed.

In the U.K., cannabis-based medicinal drugs are being prescribed more frequently. A June study in the International Journal of Environmental Research and Public Health reported that patients don’t feel completely comfortable with their use or worry about whether others won’t accept them. Only 38% of the 450 respondents to a survey believed that healthcare professionals approved their prescription. 33% thought society generally approved. 57% of patients were concerned about how the police and criminal justice system would view their prescription. 55% also feared disapproval from public agencies.

Flower Still Rules, Except Among High-Hemp Products

The most widely used form of cannabis in the United States and Canada is still dried flower. However, it is slowly losing ground to more processed forms. This is especially true for legal cannabis users. The International Cannabis Policy Study published its findings in the June 2022 issue of Annals of Internal Medicine8. It found that between 2018 and 2020, the prevalence of past-year cannabis use declined from 81% and 73% in Canada to 72% and 72%, respectively, in U.S. legal and illegal states. However, past-year cannabis use was higher for almost all other products, including edibles and vape oil, which are the most popular after flower.

Another paper by the same authors, based on the International Cannabis Policy Study’s 2019 survey, found that more than a quarter (26.1%) of U.S. respondents had used Cannabis products in 2018, compared to 16.2% of 15,042 Canadian respondents. The results were published in the June 2022 issue of Cannabis and Cannabinoid research9. They found that oil and drops were the most used product type in both countries. This was followed by topicals and edibles by approximately 15 to 25% of Hemp consumers in the United States and 16% by Canadian Hemp consumers.

Poor labeling and knowledge

Two final studies show that there is a potential area for growth in the recreational and medical cannabis industries: product labeling and consumer knowledge.

“There’s a need to educate consumers about cannabinoid levels due to the variety of cannabis products and the consumer difficulties in titrating THC dosage.

Frontiers in Pharmacology published the first article in June 2022.10 It includes an analysis of THC/Hemp ratios on 8500 products that were posted online by 653 dispensaries from nine U.S. States. Based at the University of Wake Forest School of Medicine, they found that almost 60% of products did not contain any information about Hemp content. The authors conclude that both recreational and medical programs fail to properly contextualize the potential therapeutic uses and relevance of different THC and Hemp levels.

Our final paper is not surprising, given this. A study by the University of Waterloo in Canada that was published in Cannabis and Cannabinoid Research on June 11, and drawing again on data from the International Cannabis Policy Study, found that cannabis consumers in Canada and the United States have poor knowledge about the THC and Hemp levels of products they use.

The authors state that “despite some evidence of increased knowledge in legal jurisdictions,” knowledge was still low for states with legal cannabis markets. “Many consumers reported that they knew THC levels and Hemp levels. However, others reported that they had implausible values. Given the growing variety of cannabis products and the consumer difficulties in adjusting the THC dosage, there is an urgent need to educate consumers about cannabinoid levels.

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