Prevalence of Medical Cannabis Use and Associated Health Conditions Documented in Electronic Health Records Among Primary Care Patients in Washington State

Abstract

Key Points Question Among primary care patients, what is the prevalence of electronic health record documentation of medical cannabis use and health conditions for which cannabis use might have benefits and risks? Findings In this cross-sectional study of 185 565 patients, 2% had past-year medical cannabis use documented in their electronic health records. Among patients with documented medical cannabis use, 44.5% had documented health conditions for which cannabis use might confer benefits, and 54.5% had conditions for which it might confer risks. Meaning These findings suggest that primary care practitioners should be prepared to discuss potential risks as well as potential benefits of cannabis use with patients.

Medical conditions of primary care patients with documented cannabis use and cannabis use disorder in electronic health records: a case control study from an academic health system in a medical marijuana state

“…Conversely, it is possible that some of this association is due to people with medical conditions using cannabis to manage or alleviate their symptoms [ 13 , 37 – 39 ]. These findings indicate a stronger association between cannabis use and medical diagnoses than that found by Matson et al [ 17 ] in their study of EHR data from Washington State. These differences may be attributable to the fact that unlike Washington State, California was a medical marijuana state at the time of this study, but had not yet legalized cannabis use generally.…”

“…Under one percent of the sample in this study had documentation of CU or CUD in their EHR, compared to studies of EHR data from Washington State, which found EHR-documented cannabis use rates between 15 and 22% [ 16 , 17 ]. Some of this difference may be due to higher levels of adult CU, frequent cannabis use, and CUD in states like Washington that allow non-medical marijuana use [ 23 ].…”

“…Lapham and colleagues [ 16 ] analyzed data from a large integrated healthcare system in Washington State from 2015 to 2016, and found that mental health disorders, depression symptoms, tobacco use, unhealthy alcohol use, illicit drug use, and substance use disorders were associated with increased cannabis use. Matson and colleagues [ 17 ] recently analyzed EHR data from a large integrated healthcare system in Washington State from 2017 to 2018 to measure the prevalence of documented medical cannabis use and its association with health conditions for which cannabis use could be potentially beneficial or harmful. They found that patients who had documented medical use of cannabis had higher prevalence of diagnoses for both conditions that could be adversely impacted or helped by cannabis use when compared to non-medical users and non-users [ 17 ].…”

“…Matson and colleagues [ 17 ] recently analyzed EHR data from a large integrated healthcare system in Washington State from 2017 to 2018 to measure the prevalence of documented medical cannabis use and its association with health conditions for which cannabis use could be potentially beneficial or harmful. They found that patients who had documented medical use of cannabis had higher prevalence of diagnoses for both conditions that could be adversely impacted or helped by cannabis use when compared to non-medical users and non-users [ 17 ].…”

“…The goal of this paper is to complement the work of Campbell et al [ 15 ] and Matson et al [ 17 ] by analyzing EHR data from California between 2013 and 2017, when cannabis was only legal for medical use. As of May 2021, 18 states in the United States (U.S.) [ 24 ] and countries across the world—including the United Kingdom [ 25 ], Australia [ 26 ], and many nations in continental Europe [ 27 ] and South America [ 28 ] — allowed for medical cannabis use, but not adult (non-medical) cannabis use.…”