Medical Marijuana Card Users At Risk Of Developing Cannabis Use Disorder

A study published by researchers at the Massachusetts General Hospital or MGH and published in JAMA Network Open has revealed that securing a medical marijuana card to purchase cannabis products to cure pain, anxiety or depression can lead to cannabis use disorder or CUD.

The study found that in a significant minority of individuals who used marijuana for medical purposes, while they did not get the significant results, there were at greatest risk of developing the addictive symptoms of CUD. Those who were more vulnerable were people seeking help for anxiety and depression. This heightens the need for more control over the distribution, use, and professional follow-up of people who purchase cannabis through the legal route by using MMC.

Lead author of the study, Jodi Gilman, PhD, with the Center for Addiction Medicine at MGH, said, "There have been many claims about the benefits of medical marijuana for treating pain, insomnia, anxiety and depression, without sound scientific evidence to support them. In this first study of patients randomized to obtain medical marijuana cards, we learned there can be negative consequences to using cannabis for medical purposes. People with pain, anxiety or depression symptoms failed to report any improvements, though those with insomnia experienced improved sleep."

What the researchers found extremely disturbing is the fact that individuals with symptoms of anxiety or depression, the most common problems for which medical cannabis is sought, were the most likely to developing cannabis use disorder. The symptoms of the disorder include the need for more cannabis to overcome drug tolerance, and continued use despite physical or psychological problems caused by the cannabis."

Using cannabis for medical purposes has increased in popularity as 36 states and the District of Columbia have commercialized its use for different health conditions through medical marijuana cards. These cards need written approval of a licensed physician who, under the current system, is typically not the patient's main care provider but a "cannabis doctor" who gives authorization to patients with only a cursory examination and no recommendations for alternative treatments and no follow-up.

Researchers began the trial in 2017 with 269 adults with an average age of 37from the greater Boston area who were interested in obtaining a medical marijuana card. One group was allowed to get MMCs immediately, while the second group, designed to serve as a control, was asked to wait 12 weeks before obtaining a card. Both groups were studied over a period of 12 weeks.

The team found that the odds of developing CUD were nearly two times higher in the group, which got the cards immediately than in the wait list control group, and by week 12, 10 percent of the MMC group had developed a CUD diagnosis, with the number rising to 20 percent in those seeking a card for anxiety or depression.

Commenting on the finding results, Gilman said, "Our study underscores the need for better decision-making about whether to begin to use cannabis for specific medical complaints, particularly mood and anxiety disorders, which are associated with an increased risk of cannabis use disorder."

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