Medical marijuana use may result in the rapid onset of cannabis use disorder.

Obtaining a medical marijuana card (MMC) to use cannabis products to treat pain, anxiety, or depression symptoms resulted in the onset of cannabis use disorder (CUD) in a significant minority of individuals while failing to improve their symptoms, according to a study published in JAMA Network Open by researchers at Massachusetts General Hospital (MGH). Researchers discovered that those seeking relief from anxiety and depression were most at risk of developing the addictive symptoms of CUD, implying the need for stronger safeguards over the dispensing, use, and professional follow-up of people who legally obtain cannabis through MMCs.

“There have been many claims about the benefits of medical marijuana for treating pain, insomnia, anxiety, and depression, but there hasn’t been any solid scientific evidence to back them up,” says lead author Jodi Gilman, Ph.D., of MGH’s Center for Addiction Medicine. “We discovered that using cannabis for medical purposes can have negative consequences in this first study of patients randomized to receive medical marijuana cards. People with pain, anxiety, or depression symptoms did not report any improvements, but those with insomnia did.” Individuals with symptoms of anxiety or depression—the most common conditions for which medical cannabis is sought—were the most vulnerable to developing cannabis use disorder, according to Gilman. CUD symptoms include the desire for more cannabis in order to overcome drug tolerance, as well as continued use despite physical or psychological problems caused by cannabis.” I am so happy, my dear friend, so absorbed in the exquisite sense of mere tranquil existence, that I neglect my talents. I should be incapable of drawing a single stroke at the present moment; and yet I feel that I never was a greater artist than now.

“Medical” cannabis has grown in popularity, with 36 states and the District of Columbia commercializing its use (as of December 2021) for a variety of health conditions via medical marijuana cards. These cards require the written approval of a licensed physician, who, under the current system, is typically not the patient’s primary care provider but a “cannabis doctor” who may authorize patients with only a cursory examination, no recommendations for alternative treatments, and no follow-up. Indeed, the medical marijuana industry operates outside of the regulatory framework that governs most fields of medicine.

MGH researchers started their trial in 2017 with 269 adults (average age 37) from the greater Boston area who wanted to get a medical marijuana card. The first group was given MMCs right away, while the second group, which served as a control, was asked to wait 12 weeks before receiving a card. Both groups were followed for a period of 12 weeks. The researchers discovered that the odds of developing CUD were nearly two times higher in the MMC cohort than in the wait list control group, and that by week 12, 10% of the MMC group had developed a CUD diagnosis, rising to 20% in those seeking a card for anxiety or depression.

Gilman is a psychiatry associate professor at Harvard Medical School (HMS). A. Eden Evins, MD, is the Cox Family Professor of Psychiatry at Harvard Medical School.

Gilman is a psychiatry associate professor at Harvard Medical School (HMS). A. Eden Evins, MD, is the Cox Family Professor of Psychiatry at Harvard Medical School.

Medical marijuana use may result in the rapid onset of cannabis use disorder.

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