One out of six primary care patients said they used marijuana in a survey of cannabis use, with many saying their use was primarily for medical reasons. The study by researchers at the University of California Los Angeles also found that a third of cannabis consumers reported weed at levels that put them at moderate or high risk of cannabis use disorder.

The research, which was published by JAMA Open Network on Wednesday, suggests that many cannabis consumers use the drug for medicinal purposes, despite characterizing their use as recreational. The researchers behind the study say the findings indicate a need for routine cannabis screenings of primary care patients. Currently, few healthcare systems offer screenings for cannabis use in the primary care setting.

“Patients may not tell their primary care providers about their cannabis use, and their doctors may not ask about it,” lead author Dr. Lillian Gelberg, professor of family medicine at the David Geffen School of Medicine at UCLA and of health policy and management at the UCLA Fielding School of Public Health, said in a statement to UCLA Health.  “Not asking patients about their cannabis use results in a missed opportunity for opening up doctor-patient communication regarding use of cannabis generally and for management of their symptoms.”

In 2020, the U.S. Preventive Services Task Force recommended that primary care physicians screen their adult patients for the use of cannabis and other substances. The following year, the researchers who conducted the study launched a self-administered survey on cannabis use and medical cannabis use as part of the UCLA Health medical system’s universal electronic health record. Patients complete the survey via the system’s online portal as part of the pre-visit screening before visits for primary care.

UCLA Health is one of only a few healthcare systems that ask patients to complete a voluntary cannabis use assessment as part of the pre-visit process for primary care patients. UCLA Health uses the WHO Alcohol Substance Involvement Screening Test (ASSIST) to assess cannabis use.

The researchers used anonymized health record data collected by UCLA Health between January 2021 and May 2023 to determine the prevalence of cannabis use and the reasons patients are using the drug and to identify other factors that correlate with cannabis use. Approximately 176,000 patients completed the survey, including almost 30,000 (17%) who said they were cannabis users. Among those who self-reported cannabis use, 35% had results that suggested a moderate or high risk of cannabis use disorder.

Among cannabis users, 40% had consumed weed once or twice during the previous three months, 17% used marijuana monthly, a quarter (25%) used cannabis every week and nearly a fifth (19%) used weed on a daily or near-daily basis.

Nearly half (47%) of respondents said that they used cannabis medicinally. However, 76% used weed to manage symptoms such as mental health symptoms or stress (56%), sleep (56%) and pain (37%). Additionally, most patients who said they used marijuana recreationally had also used it to manage a symptom at some point in their lives.

The researchers note that the study had limitations, including a reliance on self-reported data. Additionally, while cannabis is legal in California, the stigma attached to the plant may mean that some patients did not fully disclose their cannabis use. The survey data was collected during the Covid-19 pandemic when the use of cannabis may have been higher than it would have been otherwise.

However, “given the high rates of cannabis use and medical cannabis use that we found in this large urban healthcare system, it is essential that healthcare systems implement routine screening of all primary care patients,” the researchers wrote.  “Integrating screening efforts to include information regarding cannabis use for symptom management could help enhance the identification and documentation of medical cannabis usage, particularly in the healthcare context.”

Dr. Benjamin Caplan, M.D., the author of The Doctor-Approved Cannabis Handbook, cited other shortcomings of the study, including its focus on cannabis use disorder. He says that the test used by the researchers is designed to assess multiple substance use disorders and lacks a detailed focus on cannabis users’ specific characteristics. 

Despite these and other study limitations, Caplan commended the researchers for “acknowledging important opportunities, like the need for informed conversations.” 

“Healthcare providers must integrate discussions about cannabis use into routine care, allowing patients to communicate their experiences openly,” he wrote in an email to High Time. “Doctors need to understand why patients choose cannabis over conventional treatments and be informed about both the risks and benefits of cannabis. This will lead to better management strategies and support systems for cannabis users, whether their use is medical or non-medical.”

Caplan added that the study “reveals a key takeaway: even patients within primary care are heavily reliant on cannabis for symptom relief. This underscores a critical issue that is seen throughout our medical system, which is that doctors are not adequately meeting patients’ needs for managing anxiety, sleeplessness, pain, and other symptoms. That is important news that isn’t discussed loudly enough.”

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In a recent campaign stop in California, President Joe Biden said that people in other countries are paying 40-60% less than what Americans are paying for prescription drugs. A fact-checker recently approved his claim, affirming that Americans are indeed paying double for prescription drugs compared to prices in other countries.

“If I put you on Air Force One with me, and you have a prescription—no matter what it’s for, minor or major—and I flew you to Toronto or flew to London or flew you to Brazil or flew you anywhere in the world, I can get you that prescription filled for somewhere between 40 to 60% less than it costs here,” Biden said at a Feb. 22 campaign reception in Los Altos, California, where he was joined by Vice President Kamala Harris.

WLRN, which can be found on 91.3 FM in Florida, partnered with PolitiFact to fact-check politicians and the claims that they make while on the campaign trail. Biden’s comments last month were ranked “mostly true” by fact-checkers, reports WUWF, and NPR member station.

Biden then cited provisions in the 2022 Inflation Reduction Act to lower prescription drug prices, including capping insulin at $35 per month for Medicare enrollees. Lawmakers also put a limit on older Americans’ out-of-pocket prescription costs to $2,000 per year starting in 2025. 

The law also authorizes Medicare to negotiate prices directly with drug makers for 10 prescription drugs, and the list is expected to grow.

There’s a growing body of evidence to suggest that overall, U.S. prescription drug prices are significantly higher, sometimes two to four times, compared with prices in other industrialized nations. Generic drugs, however, are an anomaly and are typically cheaper in the U.S. compared with other countries. 

A recent study by Rand found that across all drugs, U.S. prices were 2.78 times higher than prices in 33 other countries, based on 2022 data. The divide was largest for brand-name drugs, with U.S. prices averaging 4.22 times higher than those in the other nations. After adjusting for manufacturer-funded rebates, U.S. prices for brand-name drugs remained more than three times higher than prices in other countries. 

“The analysis used manufacturer gross prices for drugs because net prices—the amounts ultimately retained by manufacturers after negotiated rebates and other discounts are applied—are not systematically available,” a press release about the report said.

A series of other studies show that in the U.S., people are paying more than any other peer countries for brand-name drugs, and it’s not offset enough by generic drug prices.

Drug patents and exclusivity are other factors keeping U.S. drug prices higher than in other countries.

Other Politicians Agree Prescription Drug Costs Are Too High

Last February, Sen. Bernie Sanders (I-Vermont) issued a report slamming the U.S. prices of drugs and executive pay of three major drug manufacturers—Johnson & Johnson (J&J), Merck, and Bristol Myers Squibb—just before a hearing.

The CEOs of all three drug manufacturers had to appear before a hearing to be grilled by Sanders, prepared by staff associated with the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP Committee). The New York Times reports that they testified on their behalf Feb. 8, telling their side of the story.

Americans pay the most for life-saving drugs compared to other countries, the senator’s report summarized—by far. In some cases, Americans are paying nearly 10 times the price as what Germans pay. Sanders’ detailed report outlines how the three companies are spending more on executive pay and stock buybacks than drug research and development (R&D).

“The United States pays, by far, the highest prices in the world for prescription drugs,” the report reads, written by staff and headed by Sanders as Chair. “At a time when one out of four Americans cannot afford the medicine their doctors prescribe, ten large pharmaceutical companies made over $112 billion in profits in 2022 while paying their chief executives exorbitant compensation packages and spending billions of dollars on stock buybacks and dividends to make their wealthy stockholders even richer.”

Sens. Maggie Hassan (D-NH) and Bob Menendez (D-N.J.) voted last July to advance a bipartisan bill she personally helped develop to reduce the rocketing cost of prescription drugs and the way pharmacy managers benefit from rising drug prices. 

The Modernizing and Ensuring PBM Accountability (MEPA) Act, which passed the Finance Committee July 26 on a bipartisan basis, reduces the cost incentive for pharmacy benefit managers (PBMs) to prioritize more expensive drugs because they receive higher payouts for higher priced drugs.

The MEPA Act would scale back incentives to jack up prescription drug prices at pharmacies. The legislation shows that lawmakers understand change is needed regarding sky-high drug prices.

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After analyzing available survey data, researchers at the University of Michigan said that 12.1% of adults in the United States aged 50-80 reported using cannabis in the past year. 

“Among those who reported cannabis use, 34.2% reported using cannabis products 4 or more days per week,” the researchers said.

The researchers analyzed data extracted from the National Poll on Healthy Aging, which they described as “a nationally cross-sectional survey that asked U.S. adults ages 50-80 in January 2021 about their cannabis use in the past year.”

(The poll is sponsored by the Institute for Healthcare Policy and Innovation at the University of Michigan.)

The researchers noted that “multivariable logistic regression was used to identify demographic and health characteristics associated with cannabis use” for their analysis.

“More than one in 10 U.S. adults aged 50-80 used cannabis in the 1st year of the COVID-19 pandemic, and many used cannabis frequently. As access to and use of cannabis continue to increase nationally, clinicians and policymakers should monitor and address the potential risks among older adults,” the researchers wrote in their conclusion.

The researchers noted that “cannabis use was less likely among people who identified as Hispanic ethnicity or as ‘other’ races compared with non-Hispanic white respondents.”

Cannabis has proven useful to many older individuals, who have turned to pot to mitigate chronic pain and other ailments that accompany aging. 

“It is not surprising that a rising percentage of adults consider cannabis to be a viable option in their later years. Many older adults struggle with pain, anxiety, restless sleep, and other conditions for which cannabis products often mitigate. Many older adults are also well aware of the litany of serious adverse side-effects associated with available prescription drugs, like opioids or sleep aids, and they perceive medical cannabis to be a practical and potentially safer alternative,” NORML Deputy Director Paul Armentano said in response to the University of Michigan survey.

Other pieces of survey data have illustrated the same trend. 

Earlier this year, The Hill reported on a survey showing that the “share of over-65 Americans who have used marijuana nearly tripled in a decade, from 11 percent in 2009 to 32 percent in 2019,” and that “more than half of the 60-64 demographic reported cannabis use, another sharp increase.”

“Cannabis consumption among older adults reached 35 percent in 2021. But the pandemic affected the survey methodology, researchers said, possibly skewing the results,” The Hill reported. “The graying of cannabis culture signals broadening social acceptance of marijuana, which is now available for recreational use in 23 states. It is also a generational story about the aging baby boomers, a generation that grew up in an era of psychotropic experimentation.  Cannabis use, for many older Americans, is less about getting high and more about getting sleep. And pain relief. And calm.”

Another way to put it: more Americans –– young, old and middle aged –– are using cannabis than any time before, a natural consequence of the wave of legalization that has swept over the country in the last decade.

Gallup confirmed as much earlier this year. In August, the venerable pollster released findings showing that “half of Americans (50%) say they have tried marijuana at some time, a new high point for this behavior that has been inching up over the past quarter century.”

“While essentially unchanged from the 49% and 48% readings in 2021 and 2022, respectively, the new figure is statistically higher than the 45% in 2017 and 2019 who said they had tried marijuana,” Gallup reported. 

“In answer to a separate question intended to measure current behavior, about one in six Americans (17%) say they ‘smoke marijuana.’ This is also a new high in Gallup’s trend since 2003, albeit similar to the 16% recorded a year ago. These findings are from Gallup’s annual Consumption Habits survey, conducted July 3-27. The proportion of Americans who say they smoke marijuana has more than doubled since 2013, when Gallup first asked the question. That year, 7% said they did. Gallup’s much longer trend on ever having tried marijuana shows that experimentation increased sharply in the first decade after the initial measure. Between 1969 and 1977, it jumped 20 percentage points, from 4% to 24%. It rose another nine points, to 33%, by 1985, but thereafter stalled at under 40% until 2015, when it ticked up to 44%. It remained at about that level through 2019 but then rose to 49% in 2021, roughly where it is today. Over that same period, Gallup recorded a significant increase in the U.S. public’s support for legalization of marijuana, which has grown from 12% in 1969 to 68% today.”

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According to a recent Gallup poll, there’s a significant change in Americans’ sentiment toward the nation’s handling of the illegal drug problem and its casualties. According to this survey, which has been tracking public opinion since 1972, a majority of U.S. adults, a whopping 52%, now believe that the country is falling behind in its efforts to manage the illegal drug issue, Gallup reports. 

While High Times readers may think, well, of course, the feds are failing; this poll marks the first instance in its history where such a negative majority opinion has been recorded. Before 2019, their polling showed that Americans were optimistic that the country was making progress combating illegal drugs, with the approval stats clocking in at 41%. 

The latest results reveal that only 24% of the participants maintain that the U.S. has made progress in this area, setting a new low in the trend. Additionally, 23% of respondents believe the situation has remained static. 

The central villain in this story is fentanyl and other synthetic opioids, which has caused drug overdose fatalities to spike. According to USAFacts, in 2022, 73,654 people died from a fentanyl overdose in the U.S. This is more than double the amount of deaths from three years prior in 2019. Fentanyl deaths have increased every year for the past decade. 

However, as much as drug enthusiasts would love to blame fentanyl, there are other culprits in play. Gallup reports that since 2019, there has been an escalation in overdose cases associated with other drugs, including cocaine and methamphetamines.

America’s view on handling illegal drugs shows a divide among political parties — and presidents. Republicans do not think that progress is being made. A mere 12% of Republicans responded that they felt we were headed in the right direction, while 75% feel we’re regressing. The Democrats were much more optimistic. 40% answered that they consider the situation improving, compared to 27% who think it’s worsening. Independents clocked in somewhere in the middle, with 22% seeing progress and 52% feeling that the situation is going down the drain.

Gallup reports that voters may be more likely to respond positively based on who is in the White House, which explains why the Democrats were more glass-half-full than the Republicans. And, of course, Republicans are historically more conservative about drug use. Even though some of the liberal’s most loathed figures, such as Matt Gaetz, a U.S. representative from Florida, are joining leftist hero Alexandria Ocasio-Cortez, aka AOC, the U.S. representative for New York’s 14th congressional district, in the right to help pass pro-psychedelic and cannabis legislation. Most recently, Gaetz proposed an amendment to the National Defense Authorization to cease cannabis testing for military members. 

Conservative Dan Crenshaw of Texas, a former Navy SEAL, is also pushing for changes to drug policy. In July 2023, Crenshaw and AOC hosted a press conference recognizing progress with a provision in the National Defense Authorization Act (NDAA) that directs the Secretary of Defense to conduct a clinical report on psychedelic treatment in military treatment facilities. 

Despite a tendency to feel better about things when your party is president, the Democrats aren’t thrilled with Biden. The same data from Gallup shows that Democrats responded less positively reading the illegal drug situation under Biden than Republicans did under Trump in 2019. 

Biden has been careful to walk the tightrope of acting pro-cannabis legalization without following through. “I believe the president has displayed a regressiveness for cannabis policy,” said AOC in July. “And if there’s a regressiveness toward cannabis policy, it’s likely to be worse on anything else,” she added. 

While both voters and lawmakers are let down by Biden’s failure to reschedule cannabis, according to the Gallup poll, 74% of U.S. adults see the government’s failure to address casualties from illegal drugs as “extremely or very serious.” This is up from 64% in 2021. The highest concern was recorded in 2000, when the question was first asked, clocking in at 83%. 

Interestingly, while Americans are upset with the national handling of illicit drugs, they voice less concern in their local areas. 35% rate it as extremely serious (19%) or very serious (16%). This figure is almost equivalent to the record 34% in 2000. 

In light of the terrifying increase in overdose deaths from fentanyl and other opioids, in addition to deaths from substances such as cocaine, the American public has never been more pessimistic regarding the government’s handling of illegal drugs, even if they don’t carry that same concern in their hometowns, where it may be harder to criticize. 

Perhaps most importantly, this data shows that drug policy will shape the upcoming 2024 presidential election in numerous ways. To start, there is pressure to decriminalize cannabis on a federal level. A new Gallup poll published on November 8 showed that an estimated 68% of Americans, or seven out of every ten individuals, said “yes” to the poll questions, “Do you think the use of marijuana should be legal, or not?,” as High Times reports. And now, additionally, as this latest poll shows, voters also want a leader who can stop the deadly drugs from taking any more American lives. If AOC is right about Biden, and he isn’t cut out for the task, voters must consider that Trump could once again find his way into the White House. 

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Four U.S. nationals have been convicted of smuggling cannabis into the United Kingdom and now face time behind bars for their crimes, according to statements made by law enforcement officials. The convictions follow a rash of marijuana smuggling attempts made last month at London’s Heathrow Airport that resulted in the arrests of nine Americans in the span of a week.

On Friday, the U.K.’s National Crime Agency (NCA) announced that three Americans were convicted of charges of importing class B drugs. In one case, 24-year-old Barrington Walters of Los Angeles, and Mandy Silowka, 34, of Princeton, New Jersey, were detained at Heathrow Airport by Border Force personnel after arriving on the same United Airlines flight from Los Angeles International Airport on January 17. Officers discovered 33 kilos (more than 72 pounds) of herbal cannabis in luggage belonging to Walters and another 26.5 kilos (more than 58 pounds) of weed in Silowka’s suitcase.

The pair were interviewed by NCA investigators and subsequently charged with importing class B drugs. On February 23, Silowka and Walters admitted their roles in the smuggling plot at Isleworth Crown Court in London and were convicted of the charges against them. Silowka received a 12-month custodial sentence, and Walters was given a 10-month jail term.

The next day, Kiara Lanee Malone, 31, a clothing boutique owner from St. Louis, Missouri, also pleaded guilty to charges of importing class B drugs. Following her conviction in Isleworth Crown Court on Friday, she was remanded into custody and is scheduled to be sentenced on April 5.

Malone was arrested at Heathrow Airport on January 10 after arriving on a flight from Los Angeles when Border Force officers discovered 27.5 kilos (just over 60 pounds) of cannabis in her luggage. Malone told investigators that she was traveling to the U.K. for cosmetic procedures and admitted to bringing the bags, but said that she had been given the luggage by another person and thought that they contained clothing.

“These cases serve as further warnings to those who think they can get away with smuggling drugs into the U.K.,” NCA Heathrow Branch Commander Andy Noyes said in a statement from the law enforcement agency on February 24. “No matter what you might get told by those organizing these trips, you will get caught, and as these individuals will tell you, you will face jail time. The NCA and our partners in Border Force are determined to do all we can to target drugs couriers, and disrupt the international organized crime groups involved in drug trafficking.”

Last week’s cases followed the conviction of U.S. national Zered Akolo, a 26-year-old photographer from Antioch, California who was arrested at Heathrow Airport shortly after arriving on a flight from Los Angeles on January 16. Border Force officers searched his two checked bags and found 47 kilos (more than 103 pounds) of cannabis. Despite having luggage tags bearing his name, Akolo initially told investigators that the bags were not his. 

After questioning by NCA investigators, he was charged with attempting to import class B drugs. At a hearing at Isleworth Crown Court on Thursday, February 16, Akolo pleaded guilty to importing class B drugs and was sentenced to 32 months in prison.

“Akolo was foolish in the extreme to think he could get away with a brazen drug smuggling trip like this. As a result he faces a long period of time away from friends and family in a British jail,” Noyes said in a statement from the NCA on February 16. “I hope this case serves as a warning to others who would consider acting as drug mules for organized criminal gangs – it isn’t worth taking the chance.”

Nine Americans Arrested On Smuggling Charges In January

The convictions follow the arrests of nine Americans on drug smuggling charges at Heathrow Airport in just one week’s time in January. The smuggling attempts came as government officials engaged in a renewed debate over cannabis policy in the U.K. In July of last year, then-Home Secretary Priti Patel announced proposed new sanctions on users of cannabis and other drugs that include the confiscation of driver’s licenses and passports under a new three-strikes policy for illicit drug use. 

“Drugs are a scourge across society. They devastate lives and tear communities apart,” Patel said in a statement from the government. “Drug misuse puts lives at risk, fuels criminality and serious and violent crime and also results in the grotesque exploitation of young, vulnerable people.”

Under the proposal, which was detailed in a white paper drafted by the Home Office, those caught with illegal recreational drugs would face fines and mandatory drug education. They could also be banned from nightclubs and other entertainment venues.

Three months later, U.K. Home Secretary Suella Braverman revealed that she was considering tightening the classification of cannabis under the nation’s drug laws over concerns that marijuana is a gateway drug and can lead to serious health problems. Braverman’s review followed calls from law enforcement leaders to reclassify cannabis as a Class A drug, the same category assigned to substances including heroin, cocaine, and ecstasy.

But then last month, a group of police chiefs in the United Kingdom announced a plan to effectively decriminalize the possession of drugs including cannabis and cocaine. If adopted by the government, the use and possession of small amounts of recreational drugs would be treated as a public health issue for first-time offenders, rather than a criminal offense subject to prosecution and jail time or other punishment.

The proposals, which were developed by the National Police Chiefs’ Council (NPCC) and the College of Policing, would effectively decriminalize the possession of Class A drugs including cocaine and Class B substances such as marijuana. Under the plan, individuals caught with illegal drugs would be offered an opportunity to attend drug education or treatment programs, rather than being subjected to prosecution.

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A new poll released on Tuesday shows that nearly nine out of 10 Americans believe that cannabis should be legal in some form, with a strong majority saying that recreational marijuana should be legalized for adults. The survey, which was conducted by the Pew Research Center last month, was published online on November 22 after being administered during the first half of October.

The results of the poll, which were essentially unchanged from a similar survey conducted in April 2021, showed that 88% of American adults surveyed believe that marijuana should be legalized. More than half (59%) said that medical marijuana and adult-use cannabis should be legal, while nearly a third (30%) said that cannabis should be legalized for medicinal use only. Only one in 10 respondents said that marijuana should be illegal in all cases.

Support For Legalization Varied By Age

Support for recreational marijuana legalization was sharply divided by the age of the poll’s respondents, with only 30% of those 75 and older believing that all forms of cannabis should be legalized. By contrast, 72% of those 18 to 29 years old said that both recreational marijuana and medical cannabis should be legalized, while 62% of respondents age 30 to 49 said the same. Just over half (54%) of adults aged 50 to 64 said both recreational and medical marijuana should be legal and 53% aged 65 to 74 agreed.

The new survey also found varying levels of support for marijuana legalization based on the political affiliation of respondents. Nearly three-fourths (73%) of Democrats and Democratic-leaning independents said that they believed that marijuana should be legal for both recreational and medical use and another 21% said that only medical marijuana should be legalized. Among liberal Democrats, 84% said both forms of cannabis should be legal, while nearly two-thirds (63%) of moderate and conservative Democrats said that they held the same view.

However, less than half (45%) of Republicans and independent voters who lean Republican said both medical marijuana and adult-use cannabis should be legal, with an additional 39% saying only medical marijuana should be legalized. A majority (60%) of moderate and liberal Republicans said that both medical and recreational marijuana should be legalized, while less than four out of 10 (37%) conservative Republicans said both forms of cannabis should be legal. 

Poll Taken After Presidential Pardons Announced

The new poll was conducted after President Joe Biden announced on October 6 that he would pardon all federal convictions for simple marijuana possession and encouraged state governors around the country to take similar action. At the same time, the president directed the U.S. attorney general and the head of the Department of Health and Human Services to examine the rescheduling of cannabis under federal drug laws. 

About three weeks following the completion of the survey, voters in five states decided on ballot measures to legalize recreational marijuana in the November midterm elections. The legalization bids succeeded in Maryland and Missouri, while similar proposals in Arkansas, North Dakota, and South Dakota were rejected by voters.

The new Pew Research Center poll, which was conducted October 10 through 16, also identified different levels of support for marijuana legalization among different racial groups. A majority of white (60%) and Black (68%) adults were in favor of ending the prohibition on both medical marijuana and adult-use cannabis. By contrast, less than half of both Hispanic (49%) and Asian (48%) respondents said that they were in favor of full legalization.
The survey’s overall results are similar to a recently released Gallup Poll that also showed strong support for legalizing marijuana. In that survey, which was taken between October 3 and October 20 and did not differentiate between medical cannabis and recreational marijuana, more than two-thirds (68%) of respondents said that they favored legalization, tying a record high for the poll. A Monmouth Universtiy poll released last month showed similar support.

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