“I Feel Validated”: Participation in a Medical Cannabis Program in the Context of Legalized Recreational Use

Abstract

We examined the effects of California’s 2016 law legalizing cannabis for recreational use among young adult medical cannabis patients (MCP) and non-patient users (NPU). Three groups of young adult cannabis users (n = 30) were qualitatively interviewed in Los Angeles between 2020-21: current MCP (n = 3), who always had a medical cannabis recommendation, NPU (n = 6), who never had a recommendation, and MCP-to-NPU (n = 21), who had a recommendation in the past. MCP remained MCP due to greater acceptance of cannabis and lower prices afforded to MCP. MCP-to-NPU and NPU remained NPU due to increased acceptance of cannabis use within their community, greater legal security, and no compelling need for a medical cannabis recommendation. Price increases drove many to purchasing cannabis from unregulated black-market dispensaries. The legalization of cannabis for recreational use led to decisions to transition out of MCP status, destigmatization of cannabis use, increased prices of cannabis, and increased sourcing of cannabis from the black-market.

Keywords

cannabis medical cannabis qualitative research legalization young adults

Get full access to this article

View all access options for this article.

References

Amroussia

Watanabe

Pearson

J. L.

(2020). Seeking safety: A focus group study of young adults’ cannabis-related attitudes, and behavior in a state with legalized recreational cannabis. Harm Reduction Journal, 17, 1–7. https://doi.org/10.1186/s12954-020-00442-8

Athey

Boyd

Cohen

(2017). Becoming a medical marijuana user: Reflections on becker’s trilogy--learning techniques, experiencing effects, and perceiving those effects as enjoyable. Contemporary Drug Problems, 44(3), 212–231. https://doi.org/10.1177/0091450917721206

Biernacki

Waldorf

(1981). Snowball sampling: Problems and techniques of chain referral sampling. Sociological Methods & Research, 10(2), 141–163. https://doi.org/10.1177/004912418101000205

Brenan

(2020). Support for legal marijuana inches up to new high of 68%. Gallup. https://news.gallup.com/poll/323582/support-legal-marijuana-inches-new-high.aspx (Accessed 17 May 2021).

Burggren

A. C.

Shirazi

Ginder

London

E. D.

(2019). Cannabis effects on brain structure, function, and cognition: considerations for medical uses of cannabis and its derivatives. The American Journal of Drug and Alcohol Abuse, 45(6), 563–579. https://doi.org/10.1080/00952990.2019.1634086

CA.gov. Cannabis Legislation . (2021). https://cannabis.ca.gov/cannabis-legislation/ (Accessed 5 April 2021).

Compassionate Use Act of 1996 . (1996). https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum = 11362.5.&lawCode = HSC

Dills

Goffard

Miron

Partin

(2021). The effect of state marijuana legalizations: 2021 update. Cato Institute. https://www.cato.org/policy-analysis/effect-state-marijuana-legalizations-2021-update (Accessed 5 April 2021).

Fitzcharles

M. A.

Rampakakis

Sampalis

Shir

Cohen

Starr

Häuser

(2020). Medical cannabis use by rheumatology patients following recreational legalization: A prospective observational study of 1000 patients in Canada. ACR Open Rheumatol, 2(5), 286–293. https://doi.org/10.1002/acr2.11138

10.

Golub

Johnson

B. D.

Dunlap

(2007). The race/ethnicity disparity in misdemeanor marijuana arrests in new york city. Criminology & public policy, 6(1), 131–164. https://doi.org/10.1111/j.1745-9133.2007.00426.x

11.

Gross

J. J.

John

O. P.

(2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348

12.

Hall

Lynskey

(2016). Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction, 111(10), 1764–1773. https://doi.org/10.1111/add.13428

13.

Hathaway

A. D.

Comeau

N. C.

Erickson

P. G.

(2011). Cannabis normalization and stigma: Contemporary practices of moral regulation. Criminology & Criminal Justice, 11(5), 451–469. https://doi.org/10.1177/1748895811415345

14.

Hawke

L. D.

Henderson

(2021). Legalization of cannabis use in Canada: Impacts on the cannabis use profiles of youth seeking services for substance use. Journal of Substance Abuse Treatment, 126, 108340. https://doi.org/10.1016/j.jsat.2021.108340

15.

Jensen

E. L.

Roussell

(2016). Field observations of the developing legal recreational cannabis economy in Washington State. Int J Drug Policy, 33, 96–101. https://doi.org/10.1016/j.drugpo.2016.02.023

16.

Lankenau

S. E.

Fedorova

E. V.

Reed

Schrager

S. M.

Iverson

Wong

C. F.

(2017). Marijuana practices and patterns of use among young adult medical marijuana patients and non-patient marijuana users. Drug and Alcohol Dependence, 170, 181–188. https://doi.org/10.1016/j.drugalcdep.2016.10.025

17.

Lankenau

S. E.

Kioumarsi

Reed

McNeeley

Iverson

Wong

C. F.

(2018). Becoming a medical marijuana user. Int J Drug Policy, 52, 62–70. https://doi.org/10.1016/j.drugpo.2017.11.018

18.

Los Angeles County Department of Public Health, O. o. H. A. a. E . (2021). Recent trends in marijuana use in Los Angeles county. http://publichealth.lacounty.gov/ha/docs/2015LACHS/LA_Health_Briefs_2018/CannabisBrief_FINAL.pdf (Accessed 4 April 2021).

19.

Macintyre

Ellayway

(2000). Ecological approaches: Rediscovering the role of the physical and social environment. In Berkman

L. F.

Kawachi

(Eds.), Social epidemiology (pp. 332–348). USA: Oxford University Press.

20.

Mahamad

Wadsworth

Rynard

Goodman

Hammond

(2020). Availability, retail price and potency of legal and illegal cannabis in Canada after recreational cannabis legalisation. Drug and Alcohol Review, 39(4), 337–346. https://doi.org/10.1111/dar.13069

21.

Osborne

G. B.

Fogel

(2017). Perspectives on cannabis legalization among canadian recreational users. Contemporary Drug Problems, 44(1), 12–31. https://doi.org/10.1177/0091450916670393

22.

Procon.org . (2018). Number of legal medical Marijuana Patients. https://medicalmarijuana.procon.org/number-of-legal-medical-marijuana-patients/ (Accessed 5 April 2021).

23.

Reed

Kioumarsi

Ataiants

Fedorova

E. V.

Iverson

Wong

C. F.

Lankenau

S. E.

(2020). Marijuana sources in a medical marijuana environment: dynamics in access and use among a cohort of young adults in Los Angeles, California. Drugs (Abingdon Engl), 27(1), 69–78. https://doi.org/10.1080/09687637.2018.1557595

24.

Romero

(2019). California’s cannabis black market has eclipsed its legal one. NBC News. https://www.nbcnews.com/news/us-news/california-s-cannabis-black-market-has-eclipsed-its-legal-one-n1053856 (Accessed 13 May 2021).

25.

Satterlund

T. D.

Lee

J. P.

Moore

R. S.

(2015). Stigma among California’s medical marijuana patients. Journal of Psychoactive Drugs, 47(1), 10–17. https://doi.org/10.1080/02791072.2014.991858

26.

Smart

Pacula

R. L.

(2019). Early evidence of the impact of cannabis legalization on cannabis use, cannabis use disorder, and the use of other substances: Findings from state policy evaluations. The American Journal of Drug and Alcohol Abuse, 45(6), 644–663. https://doi.org/10.1080/00952990.2019.1669626

27.

Substance Abuse and Mental Health Services Administration (SAMHSA) . (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National survey on drug use and health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). https://store.samhsa.gov/product/key-substance-use-and-mental-health-indicators-in-the-united-states-results-from-the-2019-national-survey-on-Drug-Use-and-Health/PEP20-07-01-001 (Accessed 8 April 2022).

28.

Von Korff

Koepsell

Curry

Diehr

(1992). Multi-level analysis in epidemiologic research on health behaviors and outcomes. American Journal of Epidemiology. 135(10):1077–1082, https://doi.org/10.1093/oxfordjournals.aje.a116207,

29.

Watters

J. K.

Biernacki

(1989). Targeted sampling: Options for the study of hidden populations*. Social Problems, 36(4), 416–430. https://doi.org/10.2307/800824

30.

Wong

C. F.

Silva

Kecojevic

Schrager

S. M.

Bloom

J. J.

Iverson

Lankenau

S. E.

(2013). Coping and emotion regulation profiles as predictors of nonmedical prescription drug and illicit drug use among high-risk young adults. Drug and Alcohol Dependence, 132(1–2), 165–171. https://doi.org/10.1016/j.drugalcdep.2013.01.024