Dispensaries and Medical Marijuana Certifications and Indications: Unveiling the Geographic Connections in Pennsylvania, USA

Annemarie G Hirsch; Eric A Wright; Cara M Nordberg; Joseph DeWalle; Elena L Stains; Amy L Kennalley; Joy Zhang; Lorraine D Tusing; Brian J Piper

doi:10.1159/000537841

Dispensaries and Medical Marijuana Certifications and Indications: Unveiling the Geographic Connections in Pennsylvania, USA

Med Cannabis Cannabinoids. 2024 Feb 20;7(1):34-43. doi: 10.1159/000537841. eCollection 2024 Jan-Dec.

Authors

Annemarie G Hirsch¹, Eric A Wright², Cara M Nordberg¹, Joseph DeWalle¹, Elena L Stains³, Amy L Kennalley³, Joy Zhang⁴, Lorraine D Tusing², Brian J Piper³

Affiliations

¹ Department of Population Health Sciences, Geisinger, Danville, PA, USA.
² Center for Pharmacy Innovation and Outcomes, Geisinger, Danville, PA, USA.
³ Geisinger Commonwealth School of Medicine, Scranton, PA, USA.
⁴ Department of Health and Societies, University of Pennsylvania, Philadelphia, PA, USA.

Abstract

Introduction: Pennsylvania opened its first medical marijuana (MMJ) dispensary in 2018. Qualifying conditions include six conditions determined to have no or insufficient evidence to support or refute MMJ effectiveness. We conducted a study to describe MMJ dispensary access in Pennsylvania and to determine whether dispensary proximity was associated with MMJ certifications and community demographics.

Methods: Using data from the Pennsylvania Department of Health, we geocoded MMJ dispensary locations and linked them to US Census Bureau data. We created dispensary access measures from the population-weighted centroid of Zip Code Tabulation Areas (ZCTAs): distance to nearest dispensary and density of dispensaries within a 15-min drive. We evaluated associations between dispensary access and the proportion of adults who received MMJ certification and the proportion of certifications for low evidence conditions (amyotrophic lateral sclerosis, epilepsy, glaucoma, Huntington's disease, opioid use disorder, and Parkinson's disease) using negative binomial modeling, adjusting for community features. To evaluate associations racial and ethnic composition of communities and distance to nearest dispensary, we used logistic regression to estimate the odds ratios (OR) and 95% confidence intervals (CI), adjusting for median income.

Results: Distance and density of MMJ dispensaries were associated with the proportion of the ZCTA population certified and the proportion of certifications for insufficient evidence conditions. Compared to ZCTAs with no dispensary within 15 min, the proportion of adults certified increased by up to 31% and the proportion of certifications for insufficient evidence decreased by up to 22% for ZCTAs with two dispensaries. From 2018 to 2021, the odds of being within five miles of a dispensary was up to 20 times higher in ZCTAs with the highest proportions of individuals who were not White (2019: OR: 20.14, CI: 10.7-37.8) and more than double in ZCTAs with the highest proportion of Hispanic individuals (2018: OR: 2.81, CI: 1.51-5.24), compared to ZCTAs with the lowest proportions.

Conclusions: Greater dispensary access was associated with the proportions of certified residents and certifications for low evidence conditions. Whether these patterns are due to differences in accessibility or demand is unknown. Associations between community demographics and dispensary proximity may indicate MMJ access differences.

Keywords: Dispensary; Evidence-based medicine; Geospatial; Marijuana; Medical cannabis.

Grants and funding

This study was funded by the Story of PA, Clinical Registrant through the Geisinger Academic Clinical Research Center. The funder had no role in the design, data collection, data analysis, and reporting of this study.