While recreational and medical legalization is sweeping the country, a recent study revealed that enrollment in medical-only programs quadrupled between 2016 and 2020.

The study on U.S. medical cannabis trends also looked at qualifying conditions listed by patients, and revealed that enrollment increased in states with only medical cannabis. States that also offer recreational cannabis use declined or stayed the same. Overall, chronic pain was the most common condition reported on applications. 

This research project, titled “U.S. Trends in Registration for Medical Cannabis and Reasons for Use From 2016 to 2020” and published with Annals of Internal Medicine, was spearheaded by lead author Kevin Boehnke, an expert on chronic pain at University of Michigan. His goal with the study was to look specifically at medical enrollment, not cannabis use overall, to determine cannabis trends. 

During his work on the study, he asked himself, “How many people are using cannabis for pain? Why are people actually using [medical cannabis]?”

With these questions in mind, Boehnke began a years-long look into what this enrollment and cannabis use looked like, using public data available from reports and state websites, meeting notes, state officials, and documents he got access to thanks to the Freedom of Information Act. He was specifically interested in what the trends looked like as they shifted under the changing medical and recreational laws across the country. 

He also published another study on the issue in 2019, “Qualifying Conditions Of Medical Cannabis License Holders In The United States,” in HealthAffairs, but this new study has an even broader scope with more access to data. 

“These changing state policies have dramatic effects on how many people might be using cannabis for medical purposes or how they might be able to do so,” Boehnke says regarding the study, according to STAT News. 

STAT News also spoke to Byron Adinoff, a drug addiction researcher and president of Doctors for Cannabis Regulation, about the study. He was happy about the results, and hopes to see more studies that highlight how key medical cannabis treatment can be. While he admits that he, like many doctors, was hesitant for a long time about prescribing medical cannabis, his views have changed as information like this becomes available. 

“I didn’t really buy into it, but, you know, after you talk to several hundred people who have benefited from it, you start to think maybe there’s something to it,” he says. “Hopefully it will get organized medicine and physicians individually to pay increasing attention to this issue,” he added.

Another substantial piece of data was how much patient enrollment increased in Oklahoma. In that state, there was more than a significant jump to report. According to the study, one in 10 residents of the state are medical cannabis patients, a record high number. This could be because the state does not require specific medical conditions to qualify for a medical card. They can get medical cannabis for any conditions a doctor deems reasonable.

All other medical states in the U.S. at this time have a list of qualifying conditions for what patients are eligible for when it comes to medical cannabis. Chronic pain is allowed in most states, so it’s no surprise that it’s at the top of the list for what patients are medicating for. 

STAT News also spoke to Silvia Martins, an epidemiologist at Columbia University specializing in substance use, who hopes this study can lead to more confidence in how cannabis can treat chronic pain. 

“Even for chronic pain, we need more evidence, but for other types of conditions, we need even more evidence,” she says regarding the information in the study. 

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