Differences in Cannabis Use Characteristics, Routines, and Reasons for Use Among Individuals With and Without a Medical Cannabis Card

Public Health Significance This study demonstrated that individuals with and without a medical cannabis card believed cannabis, in general, effectively treated myriad physical and psychiatric conditions and that Indica and Sativa cannabis strains produced primarily stimulating and sedating subjective effects, respectively. However, access to objective information about different cannabis products was limited and support when deciding which products to use for medical purposes was lacking. As recreational and medical cannabis use increases in the U.S., the proliferation of novel cannabis products is expected to continue. Understanding cannabis product preferences and use patterns may inform public health and policy decisions. This study investigated similarities and differences in cannabis use patterns, product preferences, and beliefs about cannabis' subjective effects and therapeutic benefits among individuals with and without a medical cannabis card (MCC). Participants with an MCC completed individual interviews (N = 25; 40% male). Participants without an MCC completed focus groups (N = 31; 6-7 participants/group; 72% male). All sessions followed a semistructured agenda. Participants were queried about their use routines, reasons for using cannabis, and perceptions and experiences of subjective cannabis effects. Thematic analysis of coded transcripts revealed that MCC participants had structured, daily cannabis use routines whereas non-MCC participants' use routines were less structured. Product information including strain and cannabinoid composition were important to MCC participants whereas non-MCC participants primarily evaluated quality based on perceptual (e.g., olfactory) cues. Regardless of MCC status, participants reported misconceptions about cannabis' therapeutic benefits and agreed that the two primary cannabis strains-Indica and Sativa-produced primarily sedative and stimulant effects, respectively. Results have clinical, public health, and policy implications surrounding cannabis recommendation guidelines and ways providers can relay accurate information to patients seeking medical cannabis. Future research assessing demographic and geographic differences in cannabis product preferences and beliefs about medical cannabis use is warranted. Further, quantitative research is needed to evaluate whether cannabis' therapeutic value differs across products.