As someone who has been researching and writing on medical cannabis for years, a question I have long sought the answer to is whether approving recreational marijuana puts a damper on medical cannabis. In other words, do medical cannabis users switch to buying their products on the recreational market once that market is legalized?
A recently published study looking at medical cannabis enrollment numbers seems to suggest just that. The study is by no means conclusive, but it does offer sufficient evidence to suggest that state medical cannabis programs decline when recreational marijuana is approved.
38 States Allow Medical Cannabis
At the current time, thirty-eight states and the District of Columbia allow medical cannabis consumption. Utah is one such state. According to Utahmarijuana.org, any adult diagnosed with a qualifying condition can apply for a medical cannabis card. Obtaining a card gives a patient access to medical cannabis products at pharmacies scattered throughout the state.
Because Utah does not allow recreational marijuana, anyone wishing to use medical cannabis legally must go through the proper channels. A patient must consult with a medical provider willing to recommend cannabis. He must submit an electronic application and pay a fee to get his card. Finally, the patient must renew his card every year – which requires a follow-up visit with the medical provider and a renewal fee.
When the medical market is the only option, patients are willing to jump through the hoops to get and maintain their cards. They are also willing to pay higher prices on the medical market. But what happens when a state legalizes recreational marijuana?
A Decline in Medical Enrollment
The previously mentioned study revealed that medical cannabis enrollment increased by 610% between 2016 and 2022. Researchers from the University of Michigan, working with the CDC and VA, looked at data from thirty-seven states (California was excluded) to come up with their numbers. Ironically, the same study showed a decline in medical cannabis enrollment in most states with legal recreational marijuana.
Just two of the fifteen states with legal recreational marijuana saw patient registrations increase over the study term: Massachusetts and Maine. The remaining thirteen states saw dramatic decreases in patient enrollment. The biggest drop was in Arizona, where researchers noted just under 296,000 medical cannabis patients in 2020. The number had fallen to just under 130,000 in 2022.
The reasons cited by researchers pretty much confirm everything I have suspected for the last few years. When given the choice between relatively hassle-free recreational marijuana and a more challenging medical market, patients will forgo medical cannabis registration and purchase their products from recreational dispensaries.
Quality Isn’t an Issue
State lawmakers often cite the rationale of higher quality products for maintaining both recreational and medical programs. As the thinking goes, medical cannabis will be of higher quality because it is being used to treat something like pain or PTSD. Patients do not seem to be buying it.
Cost is a pretty significant factor in driving purchase decisions. If recreational marijuana costs less, that is what patients are going to buy. Likewise, patients are less willing to invest time and money in both medical appointments and registration fees if they can get cheaper recreational marijuana.
We now have evidence pointing to the possibility that approving recreational marijuana puts the damper on medical cannabis. I suspect that the medical market will cease completely if Washington ever decides to fully legalize marijuana. What would be the point of maintaining a costly and highly regulated medical market, a market that patients would have no incentive to support?
