Barriers to accessing medical cannabis persist in certified patients despite its perceived symptom relief: a brief survey study

Abstract Medical cannabis legalization offers patients access to regulated cannabis to manage symptoms. Yet, concurrent availability of regulated adult-use cannabis and unregulated cannabis present certified patients with multiple options for obtaining cannabis. Through chart review and phone surveys, this study investigated whether patients certified for medical cannabis purchased regulated medical cannabis or purchased non-medical cannabis (adult-use or unregulated) among patients certified by Montefiore Medical Center's Medical Cannabis Program (MMCP) from April 2022-November 2022 in the Bronx, New York. We also aimed to determine perceived symptom relief of medical cannabis versus non-medical cannabis, and whether they differ. We hypothesized that certified patients would report barriers to medical cannabis and subsequent use of non-medical cannabis. We also hypothesized that despite this, participants would find that medical cannabis offered greater perceived symptom relief versus non-medical cannabis. We reviewed 402 charts and surveyed 99 patients. Nearly half of surveyed patients (49%) reported purchasing non-medical cannabis. The most reported barriers to purchasing medical cannabis were cost (32.4%) and convenience (27.0%). In linear regression analysis, perceived symptom relief of medical cannabis was rated higher than non-medical cannabis (β=0.939, p=0.038). Nearly half (46%) of surveyed patients who purchased medical cannabis reduced or stopped other medications. These findings suggest that despite increased symptom relief with medical cannabis, accessibility challenges may drive patients towards non-medical cannabis. This study highlights the need for policies that improve medical cannabis accessibility, to ensure equitable access to regulated products that target patients’ symptoms.