2.7 Million Medical Marijuana Users in the US According to New Data

There are approximately 2.7 million adult medical marijuana users according to recent data from the US National Survey on Drug Use and Health (NSDUH). This estimate is based on a household survey of almost 68,000 people 12 year and older, covering all 50 states and the District of Columbia.

Approximately 29.8 million adults use marijuana each year. Those who had used marijuana in the past year were asked, “Was any of your marijuana use in the past 12 months recommended by a doctor or other health care professional?” About 9.1% (2.7 million) said they had used some medical marijuana in the last year, while 5.1% (1.7 million) had only used medical marijuana.

The estimated number of medical marijuana users in the US is higher than a previously reported estimate of 1.1 million based on the number of registered medical marijuana patients (http://medicalmarijuana.procon.org/view.resource.php?resourceID=005889).


Cigarillo use increases estimates of teen smoking rates by half

New findings from the Monitoring the Future Study (links to PDF) show that when cigarillos (i.e., small cigars) are counted along with cigarettes, rates of tobacco smoking are higher by 67%. For example, rates of tobacco smoking among 8th, 10th, and 12th graders are 6.7% when only counting cigarettes, but after counting cigarillo use, the rate jumps to 11.2%. Cheap cigar and cigarillo use has increased over the past decade, while cigarette use has declined. Therefore, this finding is important to the degree teens are simply shifting to smoking different tobacco products. My suspicion is that much of the rise in cigarillo use is due to marijuana blunt smoking. However, there has been little published on the degree to which teens smoke cigarillos unmodified vs. modified for blunts, or the levels of nicotine exposure from blunt smoking. Both are areas of my active research.

Medical Marijuana Rose Faster in States with Dispensaries


Medical marijuana registrations rose faster in states with dispensaries, but only since 2009 when the federal government indicated it would stop raiding dispensaries complying with state medical marijuana laws. This is one of several interesting findings from a recently published study in the journal of Drug and Alcohol Dependence (link). [Update: A  copy of the article is available via Academic.edu or Researchgate links on my Publications page or at the side menu.]

Since 1996, 23 states and the District of Columbia have passed medical marijuana laws. In many of these states, patients must register in order to obtain medical marijuana. Using these data, a researcher at Johns Hopkins Bloomberg School of Public Health examined trends in medical marijuana participation over time since 2001 in 13 of these states and DC.

Findings show that prior to 2009, states reported relatively low levels of participation in medical marijuana programs. For example, states like Colorado had no more than 1.3 medical marijuana patients per every 1,000 adults. Then, in early 2009, the US Justice Department announced it would no longer treat individuals complying with state medical marijuana laws as a top priority for prosecution.

Rates of medical marijuana participation soon skyrocketed in states allowing dispensaries. By mid-2011, numbers in Colorado peaked at 34 per 1,000, and were even higher in Montana (41 per 1,000). In Michigan, which passed a medical marijuana law in late 2009, rates reached almost 16 per 1,000 by September 2011.

States that prohibited medical marijuana dispensaries saw much less increase. For example, through 2011, Hawaii had fewer than 10 per 1,000, and Alaska, Arizona, Rhode Island, and Vermont had fewer than 5 per 1,000. Oregon was the only state without dispensaries that had rates above 10 per 1,000.

Both Colorado and Montana passed legislation in mid-2011 that restricted dispensaries and patient access. In Colorado, dispensaries had to become licensed with the state and a moratorium on new licenses was put into effect. Recommending physicians also had to certify a bona fide patient-physician relationship. Medical marijuana participation rates dropped following these measures to 21 per 1,000 by the end of the year, but recovered to their current levels of 28 per 1,000.

In Montana, the drop in rates was more pronounced. Not only did the state remove the profit-motive for dispensaries, it also required patients seeking medical marijuana for chronic pain to prove an underlying cause. Following these changes, participation plummeted to a low of 9 per 1,000 in 2013, but has since risen to about 15 per 1,000. Rates dropped particularly among patients 21-30 years of age.

Participation also fell slightly in Michigan after the State Supreme Court declared dispensaries illegal in 2013. However, many continue to operate within the state.

In states that report numbers by gender, men continue to be more likely to participate in medical marijuana programs. However, in states like Colorado, Arizona, and Rhode Island, women appear to be catching up, and states that have had medical marijuana the longest (e.g., Alaska and Oregon) have numbers closer to equality.

In states that report numbers by age, many states show a large proportion of medical marijuana patients in their 50s (e.g., AK, MT, NV, OR, RI, VT). However, Colorado and Arizona have higher proportion of patients in young adulthood (i.e., 18-30). This suggests that medical marijuana is popular among both young adult and Baby Boomer groups.

The main caveat to these findings is that the data come from state-run medical marijuana registry programs with mandatory registration requirements. Therefore, states that operate only voluntary registries (i.e., California and Maine) or have no registry (i.e., Washington) could not be included in this study.

Trends in registered medical marijuana participation across 13 US states and District of Columbia.

Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/26686277?dopt=Abstract

Site Progress

Update: I’ve been able to import some older Blogger posts, which is the good news. However, keep in mind that some documents and files referenced in those older posts may not be accessible on the new WordPress site. I am working on getting these documents migrated over.

Greetings! Several pages of the site are up and running, including a short bio, my CV, list of publications, funding, and presentations. In the Bio section you’ll find a short description of myself and contact information. My CV page is where you can view my curriculum vitae or download a copy. Publications lists all of my current publications with easy access to Pubmed abstracts and/or a direct download of the journal article. The Funding page details my current and past research funding support. If you’d like samples of my recent presentations, lectures, or posters, please visit the Presentations page.

The last two sections not currently completed are Research Statement and Teaching Statement. The research statement will be an overview of my past, current, and future research accomplishments, agenda, and direction. The teaching statement will outline my teaching philosophy and goals for educating both undergraduates and graduate students.

Under Construction

Greetings! If you happened to stumble upon my website here, and you are wondering why it looks so dreadful, it is because I’m in the process of putting it together. When finished, what should you expect to find?

  1. My bio
  2. My CV
  3. Research and teaching statements
  4. Links to publications, posters, and conference presentations
  5. Updates on my current research projects
  6. News and thoughts relevant to the drug epidemiology and public health
  7. Funding (meager as it is)
  8. A Youtube page linking video presentations and tutorials
  9. Current book readings and past recommendations

Stay tuned.


The New York Times Editorial Board Calls for Marijuana Legalization

“It took 13 years for the United States to come to its senses and end Prohibition, 13 years in which people kept drinking, otherwise law-abiding citizens became criminals and crime syndicates arose and flourished. It has been more than 40 years since Congress passed the current ban on marijuana, inflicting great harm on society just to prohibit a substance far less dangerous than alcohol.

The federal government should repeal the ban on marijuana.

We reached that conclusion after a great deal of discussion among the members of The Times’s Editorial Board, inspired by a rapidly growing movement among the states to reform marijuana laws.”

The paper plans on highlighting several facets of their decision, including the effects of marijuana prohibition on the criminal justice system, health, and regulation.

FDA To Evaluate Marijuana For Potential Reclassification As Less Dangerous Drug

From The Huffington Post:

“The feds could actually soften their stance a little when it comes to weed.

The Food and Drug Administration is reviewing the medical evidence surrounding the safety and effectiveness of marijuana, a process that could lead to the agency downgrading the drug’s current status as a Schedule I drug, the most dangerous classification.”

Marijuana Might Make You a Worse Driver Than Alcohol Does

From The New Republic:

“Supporters of legal marijuana, medical or otherwise, are fond of pointing out that marijuana is less deadly than alcohol. Even President Obama’s deputy drug czar admitted as much in February. That doesn’t mean pot is harmless: USA Today reported Tuesday that marijuana’s role in traffic fatalities tripled between 2000 and 2010, according to Columbia University researchers. But driving stoned is still safer than driving drunk, right? Don’t be so sure.”

With some calling for legalization of marijuana for recreational purposes like Colorado and Washington, I’m especially concerned with impaired driving when both alcohol and marijuana are used together. As the article points out:

“The researchers concluded that the percentage of TOL [time out of lane] was not significantly affected by either alcohol or marijuana alone, but that it was much higher when both substances were used together.”

Will drivers under the legal limit for blood alcohol level (BAC) but also under the influence of marijuana perceive themselves as too impaired to drive, and result in more potentially fatal traffic accidents? Time and data will tell.

Poster: Cannabis May Exacerbate Depression-Attributable Functional Impairment Among Recently Active Depression Cases

Next week (June 17th) I will be presenting a poster based on my PhD dissertation work at the College on Problems of Drug Dependence (CPDD) conference in San Juan, Puerto Rico. I will be in San Juan for the CPDD conference from June 14th to 19th.

Poster Session: July 17, 2014
Poster #: 203
Brian J Fairman, James C Anthony; Epidemiology and Biostatistics, Michigan
State University, East Lansing, MI

Aims: Among the suspected health hazards of prolonged cannabis smoking is an increase in the occurrence of a depression syndrome. Clinically significant occupational and social impairments are known to be attributed to depression. We surmise that co-occurring cannabis problems might affect these impairment levels. The aim is to estimate this hypothesized cannabis effect on this facet of the lives of depression cases. 

Methods: After nationally representative sampling and recruitment, computerized self-interviews of the U.S. National Surveys of Drug Use and Health identified depression cases with recent episodes (n=13,743). Depression-related impairment was measured using a modified Sheehan Disability Scale (SDS). Features of CP were items tapping DSM-IV criteria for cannabis use disorders. Latent variable analysis was conducted in Mplus to regress a continuous depression impairment trait on a CP trait, with covariate adjustments.
Results: One-fourth of these depression cases attributed severe to very severe functional impairments to their mood disturbances, with more pronounced impairments in relationships and social life domains. At higher levels of CP there was greater depression-related impairment (beta=0.2; 95% CI= 0.1,0.3). Findings could not be accounted for by model covariates or by depression occurring prior to cannabis onset (i.e., self-medication hypothesis).
Conclusions: Our evidence points to a more impairment-laden depression with impairments in work, home-life, and social relationships when depression co-occurs with problematic cannabis smoking. Randomized clinical trials with cannabis cessation outcomes may be required to produce more definitive evidence of this possible effect of cannabis problems on depression severity.
Financial Support: NIDA T32DA021129 (BJF); K05DA015799 (JCA).
Click on the link below to download a copy of the poster in PDF format:

Download CPDD 2014 Poster

Hear my commentary for this poster on YouTube:

Starting Post-Doc Position @ John Hopkins in July 2014

I am pleased to announce that I recently accepted a post-doctoral fellowship position in the Drug Dependence Epidemiology Training (DDET) program at the John Hopkins Bloomberg School of Public Health in Baltimore, MD.


I am very excited about this opportunity, which will begin June 30th with plans for relocation to the Baltimore area in early to mid-July.