Medical Reasons for Marijuana Use, Forms of Use, and Patient Perception of Physician Attitudes Among the US Population

Patrick M Azcarate; Alysandra J Zhang; Salomeh Keyhani; Stacey Steigerwald; Julie H Ishida; Beth E Cohen

doi:10.1007/s11606-020-05800-7

Medical Reasons for Marijuana Use, Forms of Use, and Patient Perception of Physician Attitudes Among the US Population

J Gen Intern Med. 2020 Jul;35(7):1979-1986. doi: 10.1007/s11606-020-05800-7. Epub 2020 Apr 6.

Authors

Patrick M Azcarate^{1

2

3}, Alysandra J Zhang^{4

5

6}, Salomeh Keyhani^{7

4

5

6}, Stacey Steigerwald^{4

6}, Julie H Ishida^{8

9}, Beth E Cohen^{7

5

6}

Affiliations

¹ Department of Internal Medicine, University of California, San Francisco, San Francisco, CA, USA. pazcarate@ucsd.edu.
² Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA. pazcarate@ucsd.edu.
³ Cardiovascular Medicine, University of California San Diego, San Diego, USA. pazcarate@ucsd.edu.
⁴ Northern California Institute for Education and Research, San Francisco VA Medical Center, San Francisco, CA, USA.
⁵ Department of Medicine, UCSF Division of General Internal Medicine, San Francisco VA Medical Center, San Francisco, CA, USA.
⁶ San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
⁷ Department of Internal Medicine, University of California, San Francisco, San Francisco, CA, USA.
⁸ Department of Medicine, UCSF Division of Nephrology, San Francisco VA Medical Center, San Francisco, CA, USA.
⁹ Department of Nephrology, University of California, San Francisco, San Francisco, CA, USA.

Abstract

Background: The use of marijuana for medical purposes is increasing in parallel with expanding legalization and decreased public perception of harm. Despite this increase in use, it is unclear which medical conditions patients are attempting to treat with marijuana and whether they are communicating with medical providers about their use.

Objective: To understand the medical reasons for marijuana use, forms of marijuana used for medical purposes, and disclosure of use to physicians.

Design: National, probability-based online survey.

Setting: The USA, 2017.

Participants: 16,280 US adults.

Main measure: Proportion of US adults who agreed with a statement.

Key results: A total of 9003 participants completed the survey (55% response rate). Five hundred ninety-one (7% of US adults) reported using marijuana for medical purposes. The most common medical reasons for marijuana use were anxiety (49%), insomnia (47%), chronic pain (42%), and depression (39%). The most common forms of use for all medical conditions were smoking and edibles, followed by vaping, concentrate, and topical. We found women were more likely to use marijuana for posttraumatic stress disorder, sleep, anxiety, and migraines. We did not find substantial variation in medical reasons for marijuana use by race. Among those using marijuana for medical purposes, 21% did not have a doctor. Among those with doctors, 33% did not inform them, 28% reported their doctor was neutral on their use, 32% reported their doctor was supportive, and 8% reported their doctor was not supportive. Those who lived in states where medical marijuana was illegal were less likely to disclose use to their doctor.

Limitation: The online format of the survey may have caused selection bias. Wording of the questions may have affected interpretation. Doctors were not queried directly, rather participants were asked about their perception of doctor attitudes.

Conclusion: Americans are using marijuana to treat medical conditions despite lack of evidence of efficacy.

Keywords: anxiety; cannabis; chronic pain; depression; medical marijuana.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Attitude
Female
Humans
Marijuana Smoking* / epidemiology
Marijuana Use* / epidemiology
Perception
Physicians*
United States / epidemiology

Abstract

Publication types

MeSH terms

Grants and funding