June 9, 2022

A team of Drexel researchers 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). Thirty young adult cannabis users were qualitatively interviewed in Los Angeles in 2020 and 2021 and were categorized in three distinct groups: three current medical cannabis patients with medical cannabis recommendations; six non-patient users without medical recommendations; and 21 MCP-to-NPU users who previously had medical recommendations but became non-patient users following legalized recreational use.

The results found that the main reason why medical cannabis patients remained patients was due to greater acceptance of cannabis and lower prices afforded to patients. 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 within the legal recreational market and the barriers of finding a physician, completing an annual exam, and annual fees for medical cannabis patients drove many to purchasing cannabis from unregulated legacy-market dispensaries. Overall, the legalization of cannabis for recreational use led to decisions to transition out of a medical cannabis patient’s status, destigmatization of cannabis use, increased prices of cannabis, and increased sourcing of cannabis from the unregulated legacy market.

As legalizing cannabis for recreational use gains nationwide popularity, these results reveal that it is important to consider the impact of this policy on cannabis use broadly and as it relates to participation in a medical cannabis program by young adults reporting the highest rates of cannabis use compared to other age groups. Additional research is needed on the stigma that cannabis users face after legalization, as some medical cannabis patients felt they were still respected more with a cannabis recommendation. Given the high number of medical cannabis patients and non-patient users turning to illegal-market sources, additional research is needed to ensure that policies do not have negative unintended outcomes, such as cannabis legalization leading to more people purchasing low quality or contaminated cannabis products from unregulated sources. However, there is little data to show the difference in quality between medical grade cannabis, recreational cannabis, and unregulated, legacy-market cannabis.