One thing I’ve wondered about: What impact, if any, does a Medical Marijuana (MM) law have on other cannabis use– the so-called “recreational” sort? And on the prevalence of cannabis disorders in that state?

With so many states having adopted such laws, seems like this would be helpful information. My motives are entirely selfish– there’s a fast-growing medical cannabis presence where we live, and if we need to anticipate an influx of cannabis clients into treatment, it would be nice to do a little prep work.

That’s why I read this research report with interest.

The authors reviewed national survey data from three different years (1992, 2002, and 2013) covering the two decades since medical cannabis programs first made an appearance. The survey data covered just under 120,000 respondents. One conclusion: “…risk for cannabis use and cannabis use disorders increased at a significantly greater rate in states that passed medical marijuana laws than in states that did not.”

A caveat: Cannabis use has been on the increase anyway during that period. The real difference  between medical cannabis-friendly states (currently 29) and the rest is an average of 1.4% faster growth in recreational use, and 0.7% faster growth in cannabis disorders. That may not sound like much- until we realize how many individuals that can represent in a state population. It’s enough to affect limited resources, including treatment slots.

The researchers aren’t saying medical cannabis causes the increase, because other factors are involved. They’re just pointing out a correlation between medical cannabis laws and increases in the growth of  recreational use and addictive disorders.

Thing is, Substance Use Disorders (SUDs) don’t appear overnight. People may have problems for months, years, or even decades before they seek help. That’s certainly true for alcohol and presumably for cannabis. So the question becomes: How many will require treatment this year? How often will cannabis show up in drug tests following arrest for common criminal offenses?

Of course, cannabis is widely used by persons who have other SUDs– alcohol, for example, or heroin and opioids, or cocaine and methamphetamine. Many have been smoking grass for years before they enrolled in a medical marijuana program. It’s not a clean picture, clinically speaking.

As the authors note, there is a well-documented set of problems that can accompany cannabis use, especially over the long term. That’s true for most psychoactive drugs.

But users, especially the young, tend to ignore that. “If pot was harmful, it wouldn’t be legal for doctors to use it with their patients,” one young adult argued, with absolute confidence. Hadn’t occurred to him many common medications are potentially harmful– which is why they’re available only under a doctor’s supervision.

Not that most medical cannabis patients are closely supervised by practitioners. They aren’t. In many states, such supervision is minimal at best.

Here’s a wild suggestion: should medical cannabis be available by prescription, through the local pharmacy, along the lines of, say, a medication that contains codeine? Perhaps even with some quality-control, to ensure the contents are effective and safe?


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