Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program

Abstract Background Medical Cannabis (MC) is authorized in numerous state-legislated programs to treat approved medical conditions. Notwithstanding MC access, some participants continue to use cannabis purchased outside of a state licensed MC pharmacy, otherwise known as illicit medicinal cannabis (...

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Main Authors: Carter Reeves, Lirit Franks, A. Taylor Kelley, Michael Incze, Adam J. Gordon, Ziji Yu, Eden Flake, Gerald Cochran
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Cannabis Research
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Online Access:https://doi.org/10.1186/s42238-025-00284-w
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author Carter Reeves
Lirit Franks
A. Taylor Kelley
Michael Incze
Adam J. Gordon
Ziji Yu
Eden Flake
Gerald Cochran
author_facet Carter Reeves
Lirit Franks
A. Taylor Kelley
Michael Incze
Adam J. Gordon
Ziji Yu
Eden Flake
Gerald Cochran
author_sort Carter Reeves
collection DOAJ
description Abstract Background Medical Cannabis (MC) is authorized in numerous state-legislated programs to treat approved medical conditions. Notwithstanding MC access, some participants continue to use cannabis purchased outside of a state licensed MC pharmacy, otherwise known as illicit medicinal cannabis (IMC), to treat their medical conditions. Identifying barriers and contributors to MC use and motives for IMC use can promote safety, improve program design, and inform future research efforts. Methods This exploratory analysis utilized baseline survey data from a convenience sample-based prospective cohort evaluation of newly registered (< 6 months) adult participants in Utah’s MC program who had been diagnosed with chronic pain, post-traumatic stress disorder, and/or cancer. Participants completed surveys assessing physical and mental health, program experience, and barriers and contributors to MC access. We employed descriptive analysis, chi-squared analysis, and logistic regression to identify factors influencing IMC use. Results Among 273 MC program participants screened for eligibility, 227 were enrolled in the cohort evaluation, and 211 participants completed the baseline survey. Approximately 1 in 10 survey respondents (N = 24, 11.9%) reported IMC use within the past two weeks. Participants accessing IMC were 40.5 years old, 58.3% male, 70.8% employed, and 87.5% white. Participants using IMC reported barriers to MC, including product cost (n = 19, 79%) and assurance of adequate supply (n = 11, 45.8%) as the most common motives for IMC use. Participants who reported experiencing MC access barriers were significantly more likely to report IMC use than those reporting no barriers (Odds Ratio (OR) = 4.73, p <.001). Participants using IMC reported lower levels of trust in (p <.04) and reliance (p <.02) upon the state program and less reliance on MC pharmacists (p’s < 0.01). However, participants who relied on the state program for MC information were less likely to report IMC use (Adjusted Odds Ratio AOR = 0.16, p <.05). Conclusions In a state MC program, barriers related to MC access and cost indicated a significant increase in the likelihood of IMC use, while reliance on the state program for MC information indicated a significant decrease in the likelihood of IMC use. Future research can explore how increasing affordable access to MC and availability of reliable information may affect IMC use.
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spelling doaj-art-62bf6552ee4b474792c044c78382dc902025-08-20T03:06:04ZengBMCJournal of Cannabis Research2522-57822025-07-017111010.1186/s42238-025-00284-wUnderstanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis programCarter Reeves0Lirit Franks1A. Taylor Kelley2Michael Incze3Adam J. Gordon4Ziji Yu5Eden Flake6Gerald Cochran7Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineDivision of General Internal Medicine, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineProgram for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of MedicineAbstract Background Medical Cannabis (MC) is authorized in numerous state-legislated programs to treat approved medical conditions. Notwithstanding MC access, some participants continue to use cannabis purchased outside of a state licensed MC pharmacy, otherwise known as illicit medicinal cannabis (IMC), to treat their medical conditions. Identifying barriers and contributors to MC use and motives for IMC use can promote safety, improve program design, and inform future research efforts. Methods This exploratory analysis utilized baseline survey data from a convenience sample-based prospective cohort evaluation of newly registered (< 6 months) adult participants in Utah’s MC program who had been diagnosed with chronic pain, post-traumatic stress disorder, and/or cancer. Participants completed surveys assessing physical and mental health, program experience, and barriers and contributors to MC access. We employed descriptive analysis, chi-squared analysis, and logistic regression to identify factors influencing IMC use. Results Among 273 MC program participants screened for eligibility, 227 were enrolled in the cohort evaluation, and 211 participants completed the baseline survey. Approximately 1 in 10 survey respondents (N = 24, 11.9%) reported IMC use within the past two weeks. Participants accessing IMC were 40.5 years old, 58.3% male, 70.8% employed, and 87.5% white. Participants using IMC reported barriers to MC, including product cost (n = 19, 79%) and assurance of adequate supply (n = 11, 45.8%) as the most common motives for IMC use. Participants who reported experiencing MC access barriers were significantly more likely to report IMC use than those reporting no barriers (Odds Ratio (OR) = 4.73, p <.001). Participants using IMC reported lower levels of trust in (p <.04) and reliance (p <.02) upon the state program and less reliance on MC pharmacists (p’s < 0.01). However, participants who relied on the state program for MC information were less likely to report IMC use (Adjusted Odds Ratio AOR = 0.16, p <.05). Conclusions In a state MC program, barriers related to MC access and cost indicated a significant increase in the likelihood of IMC use, while reliance on the state program for MC information indicated a significant decrease in the likelihood of IMC use. Future research can explore how increasing affordable access to MC and availability of reliable information may affect IMC use.https://doi.org/10.1186/s42238-025-00284-wMedical CannabisMarijuanaIllicit useBarriersContributorsMotives
spellingShingle Carter Reeves
Lirit Franks
A. Taylor Kelley
Michael Incze
Adam J. Gordon
Ziji Yu
Eden Flake
Gerald Cochran
Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
Journal of Cannabis Research
Medical Cannabis
Marijuana
Illicit use
Barriers
Contributors
Motives
title Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
title_full Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
title_fullStr Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
title_full_unstemmed Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
title_short Understanding motives for illicit medicinal cannabis use: an exploratory analysis in a medical cannabis program
title_sort understanding motives for illicit medicinal cannabis use an exploratory analysis in a medical cannabis program
topic Medical Cannabis
Marijuana
Illicit use
Barriers
Contributors
Motives
url https://doi.org/10.1186/s42238-025-00284-w
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