Reasons for Use and Perceived Effects of Medical Cannabis: A Cross-Sectional Statewide Survey

Abstract

Introduction: Medical cannabis (MC) is available upon certification for one of several qualifying conditions in Florida, USA. Previous studies suggested that some people seek cannabis for medical conditions/symptoms beyond those legally permitted. However, data remain limited on patient motives for seeking MC and their experiences around its impact on their health. We aimed to compare reported qualifying conditions for MC certification with the most frequently self-reported reasons for using MC while assessing the alignment between the two and understanding the perceived impacts of MC on self-reported conditions and symptoms.

Methods: We conducted a cross-sectional study using survey data from the Medical Marijuana and Me (M³) Data Bank of individuals receiving MC in Florida, USA, in 2022. Participants were recruited via convenience sampling from nine MC clinics/clinic networks across Florida and were asked to fill out an online survey. The study measures included sociodemographic variables, self-reported health conditions, self-reported main reasons for using MC, self-reported qualifying conditions for MC certification, and self-reported perceived impact of MC on health conditions. We cross-tabulated reported qualifying conditions and reasons for MC use and reported the perceived impact per condition.

Results: A total of 632 participants completed the survey, of whom 396 (62.66%) were female and 471 (74.53%) were non-Hispanic white. The median (IQR) age was 45 (35, 58). The most frequently reported qualifying conditions were post-traumatic stress disorder (PTSD) (n = 187, 29.59%), a condition not on the qualifying conditions list (n = 175, 27.69%), medical conditions of the same kind/comparable to those listed (n = 140, 22.15%), and chronic nonmalignant pain (n = 62, 25.63%). The top ten most frequently reported reasons for using MC were anxiety (n = 383, 60.60%), chronic pain (n = 278, 43.99%), depression (n = 252, 39.87%), PTSD (n = 220, 34.81%), headaches/migraine (n = 134, 21.20%), fibromyalgia (n = 67, 10.60%), attention-deficit hyperactivity disorder (ADHD) (n = 59, 9.34%), bipolar disorder (n = 53, 8.39%), high blood pressure (n = 41, 6.49%), and cancer (n = 18,2.85%). Of respondents, 70-90% with each qualifying condition reported it as one of the main reasons for using MC. Most respondents reported improvement of anxiety (n = 430/451, 95.34%), depression (n = 381/392, 97.20%), chronic pain (n = 305/310, 98.39%), insomnia/sleeping problems (n = 225/295, 86.44%), PTSD (n = 247/270, 91.48%), headaches/migraine (n = 172/218, 78.90%), ADHD (n = 82/123, 66.67%), bipolar disorder (n = 79/89, 88.76%), and fibromyalgia (n = 77/82, 93.90%). Most respondents were unsure/reported no change in blood pressure (n = 93/162, 57.41%). A small percentage reported perceived worsening impacts on their conditions.

Conclusion: Qualifying conditions and self-reported reasons for using MC aligned for most respondents. Yet, a notable proportion of respondents sought MC for broader treatment effects beyond those delineated by the officially recognized qualifying conditions in Florida, USA. Most patients perceived positive effects, including those with limited available evidence on efficacy.

Keywords: Cannabis use behaviors; Marijuana as a therapeutic; Medical cannabis; Medical marijuana.

Fig. 1.

Illustration of the frequency of self-reported main reasons for using MC among 632 respondents who used MC in Florida in 2022. Survey respondents were asked to identify all health conditions they have been diagnosed with by a healthcare professional from a list of 27 health conditions. For each health condition, only those with a diagnosis were asked if their health condition was the main reason for using MC. Percentages shown in the figure express the percentage of participants who self-reported each health condition as one of the main reasons for using MC denominated by the total sample. Percentages do not add to 100% as survey respondents were allowed to select all conditions that applied as a main reason for using MC (not mutually exclusive). Conditions with less than 10 responses are not shown in the figure. Other health conditions included 14 arthritis, 22 other musculoskeletal pain, 14 gastrointestinal disorders (e.g., irritable bowel syndrome, gastroparesis), 18 neurological disorders, 10 other psychiatric disorders (e.g., obsessive-compulsive disorder), and 21 miscellaneous (e.g., hypothyroidism, polycystic ovary disease). ADHD, attention-deficit hyperactivity disorder; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; MC, medical cannabis; N, number; not applicable; PTSD, post-traumatic stress disorder.

Fig. 2.

The top five most frequently self-reported reasons for using MC by sex at birth among 632 survey respondents (396 females and 236 males) who used MC in Florida in 2022. Percentages were rounded to the first integer. MC, medical cannabis; N, count; PTSD, post-traumatic stress disorder.

Fig. 3.

The top five most frequently self-reported reasons for using MC by age groups among 632 survey respondents (396 females and 236 males) who used MC in Florida in 2022. Percentages were rounded to the first integer. Age was missing for four respondents, not included in this figure. MC, medical cannabis; N, count; PTSD, post-traumatic stress disorder.

Fig. 4.

Heatmap depicting distributions of self-reported reasons for MC use per reported qualifying condition among 632 respondents who used cannabis in 2022 in Florida. Total column percentages do not add to 100% as responses are not mutually exclusive. Qualifying conditions and health conditions reported as the main reasons for using MC with a cell count less than ten are not displayed. The heatmap brackets are set at 20%. ADHD, attention-deficit hyperactivity disorder; HIV/AIDS, human immunodeficiency virus/acquired immunodeficiency syndrome; MC, medical cannabis; N, number; PTSD, post-traumatic stress disorder.

Fig. 5.

Illustration of the perceived impact of MC on the top ten most frequently self-reported medical conditions among 632 survey respondents in Florida in 2022. For each condition, the denominator for percentages is the number of respondents who reported being diagnosed with that condition by a healthcare provider. Percentages are rounded to the first integer. *A qualifying condition for MC in Florida, USA. ADHD, attention-deficit hyperactivity disorder; MC, medical cannabis; N, number of respondents; PTSD, post-traumatic stress disorder.