Kevin Boehnke and coauthors (Feb 2019) describe the indications of licensed medical marijuana users in several states and compare those indications to evidence of efficacy. According to estimates from the National Survey on Drug Use and Health (NSDUH) for 2013–15, in medical marijuana states, approximately 2.5 percent of Americans older than age twelve used medical marijuana in the past year.1 However, the authors’ results imply that medical marijuana use—at least, licensed use—is much less common than the NSDUH reports. Within eighteen states studied for 2016, they found just 641,176 licensed medical marijuana users (0.4 percent prevalence).
This discrepancy merits investigation. If the true prevalence of medical marijuana use is closer to the authors’ licensed user counts, this strengthens the argument that medical marijuana cannot possibly account for the population health improvements reported in ecological studies.2 If the true prevalence is closer to the NSDUH estimates, states might not be capturing how medical marijuana is accessed or used.
Unlike data from the NSDUH, the authors’ licensed user counts are not intended to calculate national prevalence: Six states with operational medical marijuana programs in 2016 (California, Connecticut, Maryland, Maine, Ohio, and Washington) were omitted due to incomplete data. However, for these omitted states to balance the authors’ counts with NSDUH estimates, the states would need to have had approximately 6.2 million medical marijuana users (5.3 percent prevalence). In that case, omitted states appear vastly different from included states, and with almost ten times as many omitted users as studied users, the authors’ results might not be extrapolatable nationally.
NOTES
- 1 . Medical marijuana users are more likely to use prescription drugs medically and nonmedically. J Addict Med. 2018;12(4):295–99. Crossref, Medline, Google Scholar
- 2 . Medical marijuana, not miracle marijuana: some well-publicized studies about medical marijuana do not pass a reality check. Addiction. 2019 Feb 11. [Epub ahead of print]. Google Scholar