Abstract
Objectives. To investigate characteristics of data reported in US medical cannabis registries across states.
Methods. Data included 2021 medical cannabis registry reports from 34 states, Puerto Rico, and the District of Columbia (hereafter, states) with active medical cannabis programs. The data from the reports were manually coded into domains and subcategories, including information related to patients (e.g., number, demographics), authorizing clinicians, sales (e.g., content, revenue), license tracking, and health and safety outcomes.
Results. Among 36 states, 97% reported total patient number and 75% reported number of authorizing clinicians. Least reported subcategories included patient race/ethnicity (8%), adverse events (11%), therapeutic benefits (6%), and product recalls (6%). States that recently legalized medical cannabis (2013–2018) reported a higher number of subcategories overall, with a median of 11 versus 8 for early adopting states (1996–2012). More medical-use states reported data on authorizing clinicians compared with nonmedical adult-use states but were otherwise similar.
Conclusions. Medical cannabis state registries generally reported data on consumers, clinicians, and sales rather than health and safety outcomes. More comprehensive and uniform medical cannabis public health surveillance is needed. (Am J Public Health. 2024;114(S8):S685–S693. https://doi.org/10.2105/AJPH.2024.307728)
Globally, medical cannabis (MC) has become increasingly legal and available over the past 30 years, with numerous countries, states, provinces, and territories passing legislation allowing use of cannabis to treat medical conditions and symptoms. In the United States, 38 states and the District of Columbia (hereafter, referred to as states) have legalized MC as of October 2023,1 and as of 2020, there were nearly 3 million MC patients in the United States—4.4 times the number of patients registered in 2016.2 Federally, cannabis is classified as a Schedule I substance, designating it as a drug with no accepted medical use and a high potential for abuse.3
This mismatch between state and federal laws has resulted in a patchwork of state-level MC legislation with varying medical requirements. A recent investigation proposed a medicalization of cannabis law standardization scale to help understand the degree to which state MC laws align with typical medical practices.4 This study showed that while some state programs are quite medicalized (e.g., requiring tracking of MC patients in prescription drug monitoring programs, clinician‒patient relationships, manufacturing and testing requirements, product labeling), others establish minimal provisions. These requirements tend to differ by when states adopted MC laws, with early adopters having fewer medicalized laws that provided legal protection for individuals who receive recommendation from a clinician to use cannabis medically, while later adopters have more medicalized laws that involve creating new agencies to oversee production, testing, and sales of cannabis products.5 Furthermore, the passage of adult-use cannabis laws has caused further changes to state regulatory structures, such as the development of new agencies for adult-use cannabis products.
Thus, there is considerable heterogeneity in state-operated MC patient registries, with decisions about who develops, runs, and implements such registries being determined at the state level depending on the specific state statutes, resulting in considerable variability between how such registries operationalized.5 MC patient registries have the potential to improve surveillance through more robust monitoring of adverse events from MC products, tracking use patterns over time, and linking use data with therapeutic health outcomes—all of which would help inform public health efforts around safety as well as provide useful data for clinical trials with cannabis and cannabinoids. In 2020, 26 of 35 states with legal MC reported total patient number and 19 reported qualifying medical conditions (e.g., cancer, nausea/vomiting, epilepsy), with chronic pain identified as the most common qualifying condition.2 However, states do not use a standard format for publishing registry data, with some states publishing extensive reports and others publishing minimal information (e.g., patient number).
The Department of Health and Human Services recently recommended rescheduling cannabis from Schedule I to Schedule III, which acknowledges the potential medical benefits of cannabis.6 This recommendation highlights the need to develop a baseline understanding of MC registry report data content and quality. Doing so would highlight data gaps that may then be addressed by improving data collection both within registries and through development of appropriate and useful public health surveillance measures, which could ultimately reduce potential adverse events among those who use MC. Thus, our primary objective was to describe MC registry report data elements collected by US states with active MC laws. Given reported differences in state MC laws based on when they passed and modifications that may occur with the advent of adult use cannabis legislation, we also described associations between these factors and state data elements.
METHODS
We collected MC registry data from 34 states, Puerto Rico, and the District of Columbia (hereafter, states) with active medical cannabis programs in 2021. We obtained data from publicly available reports, departmental Web sites, and data requests from governmental departments overseeing MC programs.2,7 We defined registry data as reports generated by states with MC laws that track the various aspects of implementation of these laws, including information on patients (number, qualifying condition), authorizing clinicians, sales, and health outcomes. Given our use of patient qualifying condition data in other reports,2,7 we supplemented these registry data with a Freedom of Information Act request for this information from 1 state (Ohio). When our coding process began in January 2023, we had complete MC registry report data from nearly all states through 2021, which acted as the primary year of our source documentation. For states that did not have 2021 data available, we deferred to the most recent year with available data (2020 or 2022), assuming data elements in the report from the most recent year would be similar. These states were Alaska (2020), New York (2022), Pennsylvania (2022), and West Virginia (2022).
Data Extraction and Coding Scheme
We first conducted an initial review of the state registry reports to identify relevant subcategories of data available. Twenty-five subcategories emerged, which included number of patients by gender, age, and race/ethnicity; number and type of clinicians authorizing medical cannabis at the state level; county-level data for number of patients, authorizing clinicians, caregivers, and dispensaries; pounds and fluid ounces of product sold, total revenue, average consumer price, cannabinoid content (indicated by inclusion of different cannabinoids or levels of potency), and product type; number of dispensaries and cultivation or grower facilities; tracking of dispensary licenses, cultivation licenses, patient cards, qualifying conditions, and number of patients; and adverse events, therapeutic benefits, and recalls. These were then categorized into the following overarching domains: demographics, authorizing clinicians, county-level licensee data, sales data, production data, tracking, and health and safety outcomes (Box 1).
BOX 1—
Domains and Subcategories Identified in State Medical Cannabis Registry Reports: 34 US States and the District of Columbia, 2021
| Domain | Subcategories: Included in State Reports and Resources |
| Demographics | 1. Gender of medically certified patients |
| 2. Age range of medically certified patients | |
| 3. Race/ethnicity of medically certified patients | |
| Authorizing clinicians | 1. Number of clinicians recommending medical cannabis |
| 2. Certification or specialty of clinicians recommending medical cannabis | |
| County-level licensee data | 1. Patients by county |
| 2. Clinicians by county | |
| 3. Caregivers by county | |
| 4. Dispensaries by county | |
| Sales data | 1. Total pounds sold of solid products (e.g., flower, edibles) |
| 2. Total fluid ounces sold of liquid products (e.g., vape liquid, tincture) | |
| 3. Total revenue from all products ($) | |
| 4. Average price of medical cannabis in a dispensary | |
| 5. Product composition in terms of different cannabinoids (CBD vs THC) | |
| 6. Different types of products sold (e.g., vape cartridges, flower, tincture) | |
| Production data | 1. Number of dispensaries |
| 2. Number of cultivation/grower facilities | |
| Tracking | 1. A log of dispensary licenses, applications, and renewals |
| 2. A log of cultivation licenses, applications, and renewals | |
| 3. A log of patient cards, applications, and renewals | |
| 4. Medically certified patients by qualifying conditions | |
| 5. Total number of patients that have been certified to purchase medical cannabis | |
| Health and safety outcomes | 1. Number of adverse events associated with medical cannabis use |
| 2. Tracking of therapeutic benefits of medical cannabis use | |
| 3. Number of product recalls |
Note. CBD = cannabidiol; THC = delta-9-tetrahydrocannabinol. For states that did not have 2021 data available, we deferred to the most recent year with available data (2020 or 2022), assuming data elements in the report from the most recent year would be similar. These states were Alaska (2020), New York (2022), Pennsylvania (2022), and West Virginia (2022).
To determine what domains and subcategories were included in each state’s report, 2 coders (R. S., F. G.) individually assessed and extracted relevant data from available MC sources. Extracted data were compared, and any discrepancies were resolved via discussion or input from a third team member (K. F. B.). After the formation of the initial data set, the extracted data were reassessed to confirm alignment with the codebook. During this round of data quality control, state Web sites were checked to include any additional publicly available data sources.
Analysis Plan
We calculated the median number and range of subcategories reported by states overall. For each subcategory, we calculated the number and percentage of states reporting that particular subcategory. Next, we performed subgroup analyses. We first divided states according to year of MC legalization; states that legalized MC between 1996 and 2012 were considered early adopting states and were compared with those that legalized MC between 2013 and 2018 to form 2 approximately equally sized groups. Next, we divided states by whether they had legalized cannabis for nonmedical adult use (hereafter, adult use) versus only for medical use. All states in this analysis that legalized cannabis for adult use also legalized cannabis for medical use. States were categorized as legal adult use if adult-use marketplace sales started by December 31, 2021, and were otherwise categorized as MC only. As noted previously, data from 2022 reports were used for New York, Pennsylvania, and West Virginia. Pennsylvania and West Virginia remain medical-only states. New York legalized adult cannabis use and began sales in 2022; however, because sales did not begin until December 29, 2022, New York was categorized as medical only for this analysis. The number of subcategories reported by each state is also presented on a map of the United States (Figure 1). Statistical testing was not included as we had a census of medical cannabis state reports so there was no sampling error.
FIGURE 1—
Map of States by Number of Subcategories Listed in State Medical Cannabis Registry Reports: 2021
RESULTS
Overall, we extracted MC registry data from 34 states, Puerto Rico, and the District of Columbia. Two thirds of registries were housed within state departments of health, 11% were in independent cannabis agencies, and the rest were housed in various departments such as finance, consumer protection, commerce, or fish and wildlife. Overall, 53% registries reported data from vertically integrated regulatory systems while 47% reported data from seed-to-sale retail systems. The domains and subcategories identified are displayed in Box 1, with individual state results displayed in Table A (available as a supplement to the online version of this article at https://ajph.org). Examples of language extracted from reports for each subcategory are reported in Table B (available as a supplement to the online version of this article at https://ajph.org).
Only 2 of the 36 states (6%) reported a subcategory in every domain (Table A). The most commonly reported subcategories were in the tracking, authorizing clinicians, and production data domains (Table 1). The most commonly reported subcategories were total number of patients (97% of states), number of dispensaries (83%), number of clinicians (75%), number of cultivation or grower facilities (58%), and qualifying conditions (58%). In contrast, the subcategories that were reported least included recalls (11%), cannabinoid content (8%), number of patients by race/ethnicity (6%), adverse events (6%), and therapeutic benefits (6%).
TABLE 1—
Number and Percentage of States That Reported Each Subcategory in State Medical Cannabis Registry Reports Overall and by Medical Cannabis Legalization Year: 34 US States, Puerto Rico, and the District of Columbia, 2021
| Subcategory by Domain | All States (n = 36), No. (%) or Median (Range) | States With 1996–2012 Legalization Year (n = 19), No. (%) or Median (Range) | States With 2013–2018 Legalization Year (n = 17), No. (%) or Median (Range) |
| Median no. of subcategories | 10 (2‒15) | 8 (2‒15) | 11 (3‒15) |
| Demographics | |||
| Patients by gender | 10 (27.8) | 6 (31.6) | 4 (23.5) |
| Patients by age range | 16 (44.4) | 8 (42.1) | 8 (47.1) |
| Patients by race/ethnicity | 2 (5.6) | 0 (0.0) | 2 (11.8) |
| Authorizing clinicians | |||
| No. of clinicians | 27 (75.0) | 12 (63.2) | 15 (88.2) |
| Breakdown by type of clinician | 14 (38.9) | 1 (5.3) | 13 (76.5) |
| County-level licensee data | |||
| Patients by county | 19 (52.8) | 11 (57.9) | 8 (47.1) |
| Clinicians by county | 11 (30.6) | 2 (10.5) | 9 (52.9) |
| Caregivers by county | 6 (16.7) | 5 (26.3) | 1 (5.9) |
| Dispensaries by county | 20 (55.6) | 9 (47.4) | 11 (64.7) |
| Sales data | |||
| Amount of product sold, lbs | 10 (27.8) | 5 (26.3) | 5 (29.4) |
| Amount of product sold, fluid oz | 2 (5.6) | 2 (10.5) | 0 (0.0) |
| Total revenue, $ | 16 (44.4) | 7 (36.8) | 9 (52.9) |
| Average consumer price, $ | 5 (13.9) | 1 (5.3) | 4 (23.5) |
| Cannabinoid content | 3 (8.3) | 0 (0.0) | 3 (17.6) |
| Product type | 17 (47.2) | 5 (26.3) | 12 (70.6) |
| Production data | |||
| No. of dispensaries | 30 (83.3) | 16 (84.2) | 14 (82.4) |
| No. of cultivation/grower facilities | 21 (58.3) | 9 (47.4) | 12 (70.6) |
| Tracking | |||
| Active dispensary licenses | 15 (41.7) | 9 (47.4) | 6 (35.3) |
| Active cultivation licenses | 9 (25.0) | 4 (21.1) | 5 (29.4) |
| Active patient cards | 20 (55.6) | 11 (57.9) | 9 (52.9) |
| Qualifying conditions | 21 (58.3) | 10 (52.6) | 11 (64.7) |
| Total number of patients | 35 (97.2) | 19 (100.0) | 16 (94.1) |
| Health and safety outcomes | |||
| Adverse events | 2 (5.6) | 0 (0.0) | 2 (11.8) |
| Therapeutic benefits | 2 (5.6) | 0 (0.0) | 2 (11.8) |
| Recalls | 4 (11.1) | 2 (10.5) | 2 (11.8) |
Note. Legalization year is date medical cannabis use legislation passed. The following states were included in this table: legalization year 1996–2012: Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, and Washington State; legalization year 2013–2018: Arkansas, Florida, Illinois, Louisiana, Maryland, Minnesota, Missouri, New Hampshire, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Puerto Rico, Utah, Virginia, and West Virginia. For states that did not have 2021 data available, we deferred to the most recent year with available data (2020 or 2022), assuming data elements in the report from the most recent year would be similar. These states were Alaska (2020), New York (2022), Pennsylvania (2022), and West Virginia (2022).
States that most recently legalized MC use (between 2013 and 2018) reported a higher number of subcategories overall, with a median of 11 (range = 3–15) versus 8 (range = 2–15) for early adopting MC-use states. In terms of specific subcategories, a higher proportion of states that legalized more recently reported number of clinicians (88% vs 63% in early adopting states) and clinician specialty (77% vs 5%), as well as data on product type (71% vs 26%; Table 1). A higher percentage of early adopting states also reported patient, clinician, and dispensary data by county.
More MC-use states reported the number of clinicians (80% vs 64% of adult-use states) and clinician specialty (56% vs 0%) compared with adult-use states (Table 2). However, the number of subcategories reported overall was similar between the 2 categories, with MC states reporting a median of 10 (range = 3–15) and adult-use states reporting a median of 9 (range = 2–15). Of note, all but 1 of the adult-use states were early adopters of MC-use legislation (i.e., they fell into the 1996–2013 category in Table 1).
TABLE 2—
Number and Percentage of States That Reported Each Subcategory in State Medical Cannabis Registry Reports by Adult Use Cannabis Legalization Status: 34 US States, Puerto Rico, and the District of Columbia, 2021
| Subcategory by Domain | Medical-Use States (n = 25), No. (%) or Median (Range) | Adult-Use States (n = 11), No. (%) or Median (Range) |
| Median no. of subcategories | 10 (3‒15) | 9 (2‒15) |
| Demographics | ||
| Patients by gender | 6 (24.0) | 4 (36.4) |
| Patients by age range | 10 (40.0) | 6 (54.5) |
| Patients by race/ethnicity | 2 (8.0) | 0 (0.0) |
| Authorizing clinicians | ||
| No. of clinicians | 20 (80.0) | 7 (63.6) |
| Breakdown by type of clinician | 14 (56.0) | 0 (0.0) |
| County-level licensee data | ||
| Patients by county | 11 (44.0) | 8 (72.7) |
| Clinicians by county | 10 (40.0) | 1 (9.1) |
| Caregivers by county | 2 (8.0) | 4 (36.4) |
| Dispensaries by county | 16 (64.0) | 4 (36.4) |
| Sales data | ||
| Amount of product sold, lbs | 7 (28.0) | 3 (27.3) |
| Amount of product sold, fluid oz | 0 (0.0) | 2 (18.2) |
| Total revenue, $ | 11 (44.0) | 5 (45.5) |
| Average consumer price, $ | 4 (16.0) | 1 (9.1) |
| Cannabinoid content | 3 (12.0) | 0 (0.0) |
| Product type | 12 (48.0) | 5 (45.5) |
| Production data | ||
| No. of dispensaries | 21 (84.0) | 9 (81.8) |
| No. of cultivation/grower facilities | 17 (68.0) | 4 (36.4) |
| Tracking | ||
| Active dispensary licenses | 8 (32.0) | 7 (63.6) |
| Active cultivation licenses | 6 (24.0) | 3 (27.3) |
| Active patient cards | 12 (48.0) | 8 (72.7) |
| Qualifying conditions | 15 (60.0) | 6 (54.5) |
| Total no. of patients | 24 (96.0) | 11 (100.0) |
| Health and safety outcomes | ||
| Adverse events | 2 (8.0) | 0 (0.0) |
| Therapeutic benefits | 2 (8.0) | 0 (0.0) |
| Recalls | 2 (8.0) | 2 (18.2) |
Note. States were categorized as adult use if adult-use marketplace sales started by December 31, 2021, and were otherwise categorized as medical cannabis‒use only. The following states were included in this table: medical-use states: Arkansas, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Louisiana, Maryland, Minnesota, Missouri, Montana, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Puerto Rico, Rhode Island, Utah, Vermont, Virginia, West Virginia; adult-use states: Alaska, Arizona, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Washington State. For states that did not have 2021 data available, we deferred to the most recent year with available data (2020 or 2022), assuming data elements in the report from the most recent year would be similar. These states were Alaska (2020), New York (2022), Pennsylvania (2022), and West Virginia (2022). As noted previously, a cutoff of December 31, 2021, was used to determine legalization status. Pennsylvania and West Virginia remain medical-only states. New York legalized adult cannabis use and began sales in 2022; however, because sales did not begin until December 29, 2022, New York was categorized as medical only for this analysis.
There were no discernable geographic clusters based on the number of subcategories reported (Figure 1).
DISCUSSION
To our knowledge, this is the first comprehensive overview of data described in US state MC registry reports. We show that reports included important information such as the number of patients, clinicians, and medical dispensaries. However, critical data on MC use are overwhelmingly absent, as few states reported cannabinoid content of products sold, cannabis-associated outcomes (e.g., safety), and other important factors that are essential for proper pharmacovigilance. Heterogeneity in data presented makes it difficult to develop a national picture of MC use. As the national cannabis legal landscape and marketplace rapidly evolves, accurate and timely surveillance of MC-associated policies, use, and adverse events are needed.8
In 1996, California became the first state to legalize cannabis use for medical purposes. As of late 2023, nearly three quarters of the US population lives in a state that allows medical or adult cannabis use, and all except 3 states (Idaho, Nebraska, and Kansas) have some form of a cannabis access program, such as a cannabidiol (CBD) or low-delta-9-tetrahydrocannabinol (THC) marketplace.1 When states enact cannabis legalization, they often look to policy and lessons learned from states that have previously adopted cannabis legalization to write their cannabis policy.9 With regard to the state MC registry reports in this study, although we do not see major differences in the subcategories that are reported between early and more recent legalizers of MC use, those states with recent legalization included more subcategories (median = 11) compared with states with early legalization (median = 8). This finding is promising from a public health perspective because increased data transparency can better equip public health decision-makers and practitioners to make data-informed decisions to protect the public.
While there were few differences between MC registry reports from states with only MC use versus those with adult cannabis use, 1 notable difference was that a higher proportion of MC-use states included subcategories on authorizing clinicians (i.e., number of clinicians, clinicians by category). We hypothesize that as MC states enact adult use legislation, less emphasis is placed on the subcategories that report on medical aspects, such as clinician-focused subcategories. This finding aligns with previous research that indicates MC patient enrollment typically declines when states transition from medical use to adult use.2,10 One proposed reason for this is that following legalization of adult use, persons using cannabis for medical reasons may not be willing to complete medical cannabis registration (e.g., visit the doctor or pay associated fees).10 State programs may discontinue reporting clinician-associated variables as registration visits decline.
Limitations
Data on health and safety outcomes, including adverse event reports and product recalls, were notably lacking in state reports. Currently, public health decision-makers and practitioners must rely on national surveys (e.g., National Survey on Drug Use and Health),11,12 syndromic surveillance,13 or state or regional poison control systems to monitor limited forms of cannabis use and suspected adverse events. Often, these tools are limited because of timeliness, self-reporting, lack of space or resources for adding cannabis questions, or rely on reporting from health care organizations, which often miss a critical segment of the population. Consequently, state- and national-level decision-makers must rely on outdated and incomplete data, pieced together from many different sources and different time periods. Improving health and safety outcome data on MC state reports could fill a key gap in surveillance of adverse events associated with MC use. By collecting and accurately reporting adverse events of cannabis use on public-facing MC registry reports, more timely response to potentially harmful products and a better understanding of unforeseen harms associated with cannabis use could be achieved, especially as new products are quickly emerging in the marketplace.
Besides the lack of reporting on cannabis adverse events, the current study identified other important information that is rarely reported in MC registry reports, such as types of products sold, cannabinoids and concentrations sold, and race/ethnicity of patients. Reporting on the types of products sold could serve to increase understanding of the patterns of use among those who use MC and could provide data for state policy comparison studies. Few states reported on the cannabinoid and THC concentration make-up of products sold. Again, inclusion of such information could potentially help clinicians better understand the health effects of MC use. To better study the risks and benefits of cannabis use, and to better protect those at potential increased risk from harms associated with cannabis use, reliable data on race and ethnicity are also needed.
Public Health Implications
Cannabis’s classification as a Schedule I substance under the Controlled Substances Act has resulted in challenges in conducting research on the health and safety of commercially available cannabis products. There are only 4 Food and Drug Administration‒approved cannabinoid products (oral capsules and liquid)14 and a handful of federally licensed cannabis grow facilities in the United States, in contrast to hundreds of MC products with variable cannabinoid content and ingestion methods that are legal at the state level. Unfortunately, most current MC state registry reports focus on the number of consumers, sales, and authorizing clinicians rather than on informing medical care or public health efforts through pharmacovigilance. There is a strong need to improve reporting to include data on health outcomes and adverse effects associated with MC product use, as well as information on product recalls. This is an especially important area for growth, because while there is currently no federally mandated oversight over MC products, potential future changes to cannabis scheduling may necessitate such changes.6 Such efforts could also be undertaken independently by states, as demonstrated by studies in Minnesota, Florida, and Illinois conducting large observational studies of MC patients.15–18
Limitations
We collected data from MC registry reports created independently by each state; therefore, the ability to obtain each MC registry report sometimes proved challenging. Some reports were easily accessible while 1 state required Freedom of Information Act requests. Consequently, it was not possible to continuously update the study if a state released more recent reports. Second, the 7 domains were created to capture all the most prevalent data elements identified in the MC registry reports. However, there may be other domains that become available over time that may be relevant to include. Third, there may be additional subgroupings other than MC legalization year and presence of adult use cannabis laws that may be useful for comparison. Finally, the regulatory oversight for medical cannabis programs varies by state, with some states creating an agency specifically for cannabis while others are set up within existing health department structures. Oversight for the retail component may also be overseen by different agencies than for patient registrations, especially in states with concurrent adult-use laws, thus affecting what data are found in medical cannabis registry reports. There are also many potential additional sources of heterogeneity (e.g., the presence of prescription drug monitoring programs, degree of medicalization of the MC law) that may affect the data elements reports.
Conclusions
In this study, we identified 7 domains to characterize data included on MC registry reports, such as information about the patients, authorizing clinicians, production, sales, and health and safety outcomes. Generally, MC registry data elements were heterogeneous, with most states reporting total numbers of patients, authorizing clinicians, dispensaries, and grow facilities. Of the 36 states included in this study, only 2 included data from each of the 7 domains. These findings point to the importance of standardizing reporting requirements of MC programs to inform public health. More comprehensive data and timely reporting could provide a more comprehensive understanding of MC-use behaviors and associated adverse events and could limit potential harms associated with MC use.
ACKNOWLEDGMENTS
K. F. Boehnke’s effort on this project was partially covered by grant funding from the National Institute on Drug Abuse (K01DA049219).
Note. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
CONFLICTS OF INTEREST
K. F. Boehnke has received grant funding from Tryp Therapeutics and Journey Biosciences for a clinical trial of psilocybin-assisted therapy and sits on a data safety and monitoring board for an ongoing clinical trial with Vireo Health (unpaid). He has received grant funding from the National Institute on Drug Abuse and the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health. He has also received grant funding from the State of Michigan Veteran Marijuana Research Program. K. F. Boehnke has received speaking fees for lectures from the Medical Cannabis Research Advocacy Alliance, Provide Holy Cross Medical Center, the Southern Pain Society, and the Michigan Center of Clinical Systems Improvement. K. F. Boehnke received an honorarium for developing a podcast on fibromyalgia with Viatris Inc.
HUMAN PARTICIPANT PROTECTION
No institutional review board oversight was required as this study used publicly available data sets without any identifiable information. This activity was reviewed by CDC, deemed research not involving human participants, and was conducted consistent with applicable federal law and CDC policy.
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