Findings from the survey of New Mexico medical marijuana users shed new light on their conditions, their frequency of use, and methods of consumption.
In August and September of 2013, the New Mexico Department of Health (NMDH) conducted a mail and telephone survey of 698 randomly selected individuals who were active in the state’s medical cannabis program. To my knowledge, this may be the first statewide, random survey of medical cannabis users. To my knowledge, their findings have not been published outside of their report, which can be downloaded here. In this post, I’ll be summarizing and comment on their findings.
- Average age of respondents: 49.9 years
- 61% male, 38.0% female, and 1% other/non-response
- 58% White, 29% Hispanic, 3% Black, 3% American/Alaskan Native, 4% Other, 3% non-response.
The average age of residents in Albuquerque, NM is 38.4 years, so these medical cannabis users may be a bit older than the general population . Males look to be over-represented (the state is 50/50 male-female). By race/ethnicity, New Mexico is between 46-48% Hispanic or Latino, 2-3% Black, and about 9% American/Alaskan Native . Therefore, Hispanics and American/Alaskan Natives may be under-represented in this sample. However, it is unclear whether these groups are less likely to be registered medical cannabis users, less likely to participate in the survey, or both.
 Albuquerque Economic Development (http://www.abq.org/Demographics.aspx, last accessed May 19, 2016)
 US Census (http://www.census.gov/quickfacts/table/PST045215/35, last accessed May 19, 2016)
Qualifying Medical Conditions
The survey listed 16 eligible medical conditions for medical cannabis. Respondents were asked to select only one condition. Most (35%) indicated post-traumatic stress disorder (PTSD), followed closely by chronic pain (32%). The next most common responses were ‘other’ (6%) and cancer (5%). Based on all registered medical cannabis patients in the system, patients with PTSD were under-represented in the survey (43%).
New Mexico is one of the few medical cannabis states that allow for PTSD as a qualifying condition. In other states, chronic pain is usually the most cited condition, although for this survey respondents were asked to select only one condition, while numbers reported from other states may allow the patient to indicate more than one condition . Had the survey allowed patients to indicate more than one condition, the proportion with chronic pain or other conditions would likely be higher.
 Bowles, D. W. (2012). Persons Registered for Medical Marijuana in the United States. Journal of Palliative Medicine, 15(1), 9–11. doi:10.1089/jpm.2011.0356
Medical cannabis patients surveyed reported using an average of 9.7 grams of cannabis per week. One in three (35%) said they were consuming more cannabis in the last three months. These patients indicated using more cannabis 5.7 times during this 3 month period, consuming an average of 6.4 grams. It is not quite clear if patients are referring to their total consumption or consumption in excess of their usual amount.
These results show that about a third are consuming more cannabis over time. This could indicate increased tolerance among patients and could put them at risk for a cannabis use disorder (CUD). A 2011 study of medical cannabis patients in California found that three-fourths (76%) of patients used 7 grams or less per week . Patients in the New Mexico survey would seem to be consuming greater amounts, although the average could be skewed by outliers.
 Reinarman, C., Nunberg, H., Lanthier, F., & Heddleston, T. (2011). Who are medical marijuana patients? Population characteristics from nine California assessment clinics. Journal of Psychoactive Drugs, 43(2), 128–35. doi:10.1080/02791072.2011.587700
Types of Cannabis Consumed
Respondents were asked about the methods they used to consume cannabis. While the report does not indicate prevalence, based on average amounts, smoking was the most common method (8.6 grams), followed by eating (5.4 grams), vaporizing (4.5 grams), and topicals (3.9). Note: Since the amount of cannabis contained in topicals was difficult for respondents to estimate, numbers indicated how many times they used rather than in grams.
Studies are only starting to examine differences by the method of consumption. A recent paper by Schauer and colleagues , found that 16% of cannabis users surveyed had consumed it by eating/drinking, and 7.6% had used vaporizers. However, the survey sampled cannabis users the general population with 10% reporting exclusive medicinal use and 36% reporting mixed medicinal/recreational use. A paper in press by Johnson at al.  will report estimates of consumption methods among high school students in Colorado. Their findings suggest about 5% ingest cannabis as their usual method and 6% vaporize. Among a sample of Californian medical cannabis users, most (86%) smoked, a quarter (24%) consumed cannabis orally, and less vaporized (22%) or used topicals (3%) .
 Schauer, G. L., King, B. A., Bunnell, R. E., Promoff, G., & McAfee, T. A. (2016). Toking, Vaping, and Eating for Health or Fun: Marijuana Use Patterns in Adults, U.S., 2014. American Journal of Preventive Medicine, 50(1), 1–8. doi:10.1016/j.amepre.2015.05.027
 Johnson RM, Brooks-Russell A, Ma M, Fairman BJ, Tolliver R, Levinson A. (In Press). Usual Modes of Marijuana Consumption Among High School Students in Colorado, US. Journal of Studies on Alcohol and Drugs.
Patients were asked about whether they had purchased cannabis from a Licensed Non-Profit Producer (LNPP) and whether they had a Personal Production License (PPL) to grow cannabis.
Most (80%) had purchased cannabis from an LNPP within the last three months. They purchased an average of 10 grams of cannabis per week, which translates to 40 grams per month and 524 grams per year. When patients could not obtain cannabis from an LNPP, half the time (52%) the primary reason was because the LNPP was out of product, but about 1 in 5 (19%) said they could not afford it at the time. Only about a third (29%) were actively using their PPL to grow cannabis.
This indicates that patients prefer to purchase cannabis rather than grow it. It also seems to show that patients are purchasing enough cannabis to last them for a week. The main reason patients could not obtain cannabis was either because of a lack of product or funds. This could mean that as cannabis production increases to meet demand and prices fall due to increased production, levels of use might increase among patients.
Almost all of the respondents surveyed (98%) said that the program was beneficial. Based on the wording of the question, it is unclear if patients are referring to the medicinal benefit of cannabis, aspects of the program, or something else.
As stated earlier, this may be the first study of a statewide, random sample of medicinal cannabis users. Therefore, these findings are of interest. However, one of the main limitations is the study’s low participation rate. Less than a third (31%) of those randomly chosen to participate did so, and only a quarter (25%) gave complete surveys. This means that the sample may not be totally representative of medicinal cannabis users in the state, particularly by race/ethnicity and qualifying condition, as noted above. Additionally, because this population likely suffers from poor health, the most severely disabled medicinal cannabis patients may be less likely to participate in surveys such as this and could be likewise under-represented.
Another limitation is that these findings are descriptive, meaning it is unclear whether demographic and other factors surveyed (e.g., qualifying condition) might be associated with frequency of use or cannabis purchase behaviors. For example, do patients with PTSD use more cannabis than patients with chronic pain? Nonetheless, the findings are interesting and an example of the types of public health research that can be accomplished by states with similar medical cannabis programs. It would be encouraging to see other states follow suit.