Is There a Doctor in the House? Patient Experiences Regarding Information-Seeking and Provider Advice in New Jersey’s Medicinal Cannabis Program

Is There a Doctor in the House? 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Patient Experiences Regarding Information-Seeking and Provider Advice in New Jersey’s Medicinal Cannabis Program Omar Kawam, Dina M. Gales, Suzanne Borys, Anna Kline This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8758519/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Background : To ensure medical oversight in an environment of rapidly expanding medicinal cannabis use, states have established a framework of state-sponsored medicinal cannabis programs (MCPs), with regulatory standards governing qualifying medical conditions and care-monitoring by authorized health providers. Whether MCP regulations strengthen medical oversight, however, is unclear, given the notable lack of research into health communications and provider practices within MCPs. This paper addresses this gap by providing information from the patient’s perspective about medical information-seeking and advice within New Jersey’s MCP, including the types of cannabis-related medical advice patients desired, sources of information and the factors affecting the receipt or non-receipt of medical guidance from MCP-authorized providers. Methods : Adult (18+) registered medicinal cannabis users (n = 228) were recruited for this online study as part of a larger, population-based, statewide survey of New Jersey cannabis users conducted in 2022–2023. Respondents were questioned about medical advice sought and received with respect to dosage, side effects, tolerance, withdrawal symptoms and strains. Descriptive statistics, chi-square analysis, ANOVA and multivariable logistic regression were used as appropriate to describe patients’ information-seeking behaviors and identify factors associated with receiving advice from MCP-authorized health providers. Results : Findings revealed a sizeable communication gap between patients and their MCP-affiliated providers. Only 52% received advice from their provider in any of the five topic areas studied while dispensary staff provided information to 85% of patients. The primary driver of patient-provider non-communication was online certification with a medicinal cannabis specialty provider. Patients certified by a cannabis specialist in person or by an established provider, such as their primary care provider, were three-four times more likely to have received information than patients certified online. Primary care providers, however, were significantly underrepresented among MCP-authorized providers. Women, patients over age 50 and patients with PTSD were also less likely than others to receive provider advice. Conclusions : While some states require in-person only certification and monitoring, New Jersey and other states permit all medical monitoring to be conducted virtually. More stringent state requirements surrounding MCP provider training, patient certification and care management may enhance medical oversight while ensuring safer cannabis use and more effective outcomes. Figures Figure 1 Figure 2 Introduction By 2025, medicinal cannabis (MC) had been legalized in forty states, three territories, and the District of Columbia. 1 Although the evidence base is sparse, emerging research has found potential therapeutic benefits of cannabis for a number of medical and psychiatric disorders, including certain chronic pain conditions, muscle spasticity, chemotherapy-induced nausea, social anxiety and PTSD. 2–4 Any potential medicinal benefits of cannabis, however, are offset by a number of troubling medical, psychiatric and cognitive side effects, including the risk of cannabis use disorder. 5,6 Further, many MC patients use cannabis in conjunction with, or as a replacement for, prescribed medications, 3,7,8 a practice which, in the absence of medical monitoring, may lead to disease recurrence and/or drug-cannabis interactions, particularly in older adults with co-morbid conditions. 10,11 The risk of unwanted medical outcomes is further exacerbated by the increasing potency of cannabis products, with the THC content of some products marketed to medicinal users exceeding 70%. 12 The use of highly potent forms of MC and its attendant medical and psychological risks highlight the need for medical oversight of patients who use cannabis therapeutically. The creation of state-regulated Medicinal Cannabis Programs (MCP) represents an attempt by states to promote such oversight. In New Jersey, for example, physicians must certify that patients have a qualifying medical condition, establish treatment plans and conduct regular follow-up visits to monitor patient progress and response to therapy. 13 The extent to which such MCP regulatory requirements actually strengthen medical supervision of MC patients, however, is unclear, given the notable lack of research into health communications and provider practices within state-sponsored MCPs. Much current research into health provider attitudes, knowledge and practices surrounding MC, has involved surveys of mostly non-MCP-affiliated health practitioners, 7, 14–19 while surveys of cannabis-using patients frequently focus on disclosure of cannabis use to health providers, especially primary care providers (PCPs) who are typically also non-MCP-affiliated. 7, 16 These studies show that, in general, health providers have mixed opinions about cannabis' therapeutic value and feel they lack knowledge about its use, 15,18 while patients hesitate to disclose cannabis use to providers due to stigma and/or perceptions of limited provider knowledge. 7,16 Although ambivalence and non-involvement of non-MCP-affiliated health providers in patients’ MC care is not surprising, state regulations require greater engagement of providers authorized to provide this care. The few studies focused specifically on MCP-authorized providers, however, describe similar limitations. Kaplan and colleagues (2020), for example, found that Washington State MCP-affiliated providers were unfamiliar with the state’s qualifying medical conditions or the regulations governing cannabis’ medicinal use, while those with active MCP patients failed to universally adhere to all state MC care management requirements. Although the number of studies focused on MCP-authorized providers is limited, even fewer quantitative studies have examined medical oversight from the perspective of MCP patients. One small, qualitative study of MCP patients in Pennsylvania 20 however, found that most respondents reported receiving little or no education on the use of cannabis from their certifying healthcare providers. The dearth of studies on the quality and content of communication between MCP patients and the providers responsible for their care constitutes a significant gap in current research. Especially lacking is information on the extent to which MCP patients receive basic guidance about appropriate dosages and products, management of side effects or the development of tolerance, information that is central to the patient’s ability to utilize MC safely and achieve the best possible medical outcomes. This paper attempts to address some of these research gaps by providing information from the patient’s perspective about medical information-seeking and advice within New Jersey’s MCP (NJMCP). Specifically, this study aims to answer the following questions: What sources of medical advice, including health providers and non-medical sources, do New Jersey MCP patients turn to for guidance about their MC use? What types of information do patients identify as important for effective MC use and which sources have provided this information? What patient-level and physician-level factors are associated with obtaining MC-related information from certifying physicians? Methods Participants in the current study were recruited as part of a large, population-based survey of New Jersey cannabis users (the New Jersey Cannabis Use Survey (CUS)) 21 conducted in 2022–2023. CUS participants were recruited from the 2023 New Jersey Survey of Drug Use and Health (NJSDUH), 22 a population-based survey of New Jersey adults (age 18+) conducted periodically by the NJ Division of Mental Health and Addiction Services (n = 22,700). All NJSDUH participants who reported cannabis use in the past 12 months were redirected upon survey completion to a Rutgers website where they were invited to participate in the CUS. Of the 4,333 NJSDUH respondents reporting past-year cannabis use, 1,796 (41%) completed the CUS. Of these, 228 were actively enrolled in the NJMCP and provided the data on which the current paper is based. More detailed information on NJSDUH and CUS survey methods can be found at Borys et al., 2024 and Borys et al., 2025. Measures Status as a licensed medical cannabis card holder was measured with a yes/no item asking if the participant had been registered as a patient in the NJMCP in the past 12-months. Our outcome measure, receipt of information from a certifying health provider, was obtained by asking respondents, “Did any of the following sources give you information about marijuana strains, dosage, side effects, tolerance or withdrawal symptoms?” Respondents who reported their certifying provider as a source of at least one category of advice were coded as having received information. A similar strategy was followed to measure receipt or non-receipt of advice from other sources (other health providers; dispensary staff; internet; other cannabis users; family and/or friends). To measure types of desired information, respondents were asked: “Do you feel you need more information in any of the following areas to make your treatment more effective (Check all that apply)?” Responses included: best strains for my condition; proper dosage; management of side effects, tolerance and withdrawal. Circumstances surrounding MCP certification and enrollment included questions pertaining to year of enrollment, MCP referral source (self-referred; friends/family; PCP; other health provider), and type of certifying provider (PCP; other established health provider; new provider seen only for certification). Respondents seen by a new provider were asked if their certifying visit occurred online or in person. Qualifying medical conditions were measured by asking respondents to select all that apply from a current list of New Jersey MCP qualifying conditions. Additionally, respondents were asked to select the condition they considered their primary, or “most troublesome” condition. Measures of cannabis use practices included items asking frequency of use in the last three months (none, 1x/month or less, 2-3x/month, 1-2x/week, 3-5x/week, daily or almost daily), primary mode of administration (smoke, vape, capsules/tablets, store-bought edibles, homemade edibles, infused beverages, tinctures, oil syringes/pastes, other), primary cannabis strain used (indica-dominant, sativa-dominant, or hybrid/equal use of both), and recreational use of cannabis (“Have you ever used marijuana for non-medical/recreational purposes?”). Additional items included check-off lists of acute adverse side effects experienced and questions regarding developing tolerance. Problem cannabis use was measured using the 19-item Marijuana Problem Scale (MPS), a widely used measure of negative life consequences associated with cannabis use in the previous three months. Respondents are prompted to rate each potential problem as either “no problem, “minor problem” or “major problem.” In psychometric testing, the instrument has shown good internal reliability (alpha = 0.88) and test-retest reliability (r = 0.81 and 0.73). 23 A total MPS severity score was obtained by summing all items in the scale. Perceived effectiveness of MC was measured by asking respondents to rate MC effectiveness in treating their primary qualifying condition on a scale of 0%-100%. Finally, standard measures of demographic characteristics obtained information on age, gender, race/ethnicity, marital status, education and employment. Data Analysis We used descriptive statistics to characterize the sample as a whole. We then used analysis of variance and chi-square analysis, as appropriate, to describe and compare MCP participants who did and did not receive information about MC use from their certifying provider on all relevant measures. To further explore factors associated with information receipt, we entered all independent variables showing a bivariate relationship with the dependent variable ( p =.10) into a multivariable logistic regression analysis, while controlling for age, race and ethnicity. All variables presented in descriptive tables as categorical, such as perceived effectiveness of MC and MPS problem scores, were treated as continuous variables in the bivariate and multivariable analyses. Results Demographic Characteristics As shown in Table 1 , participants had a mean age of 45 and were mostly White (65.5%) and female (63.2%). More than half were married or living as married (58.4%). Respondents were well-educated, with 30.1% having some college education and 54.4%, a college degree or higher. Only 50% were employed full-time, while 30.1% were unemployed and not actively looking for work due to disability, retirement, student status or other reasons. MCP Enrollment Characteristics Only 7.5% of participants had enrolled in New Jersey’s MCP before 2018, the year medicinal cannabis expansion began in NJ. The majority enrolled in 2018–2020 (41.7%) and 2021–2023 (50.9%). Most participants (59.2%) were self-referred to the MCP, with only 8.3% referred by their PCP and 15.4%, by a health provider other than their PCP. Most participants (65.4%) obtained MCP certification from a new provider specifically seen for that purpose. Only 11.8% were certified by their PCP and 22.8% by an established provider other than their PCP. Among participants who saw a new provider, most (62.1%) completed the certification visit online, not in person. Participants reported a range of conditions for which medical cannabis was sought, with most respondents reporting more than one condition. The most common conditions were anxiety (70.2%) and chronic pain (53.1%), followed by post-traumatic stress disorder (PTSD) (22.8%), migraines (16.2%), inflammatory bowel disease (7.9%), cancer (3.9%), and multiple sclerosis (3.5%). Characteristics of Medicinal Cannabis Use Daily cannabis use was reported by 59.2% of patients, while 29.8% used monthly but not daily and 11.0% used once a month or less. On days they used cannabis, 43.6% reported using once a day, 35.5%, two to three times per day, and 21.1%, three or more times per day. The most frequent administration route was smoking (48.7%), followed by edibles and beverages (24.6%) and vaping (21.1%). Other routes, such as tinctures, pills, or syringes, were less commonly used (5.7%). Most participants reported using hybrid strains or both sativa and indica-dominant strains equally to treat their primary qualifying condition (55.9%). Indica-dominant strains were used by 28.6%, and sativa-dominant strains, by 15.5%. In terms of negative side effects, 26.3% of respondents experienced at least one adverse effect in the past 12 months, including panic reactions (8.8%), faintness/dizziness (7.9%), disassociation or depersonalization (7.0%), paranoia (6.6%), nausea or vomiting (6.1%) and depression (4.4%). Nearly a quarter (23.2%) of respondents developed a tolerance to MC. More than half (52.6%) used cannabis recreationally as well as medicinally and 9.2% reported one or more major problems associated with cannabis use on the Marijuana Problem Scale (MPS). However, over half of respondents (50.9%) reported no problems and 39.9% reported minor problems only. Overall, the majority (84.2%) of MCP patients rated MC as 50% or more effective in treating their primary qualifying condition, with 22.8% rating it as 90% effective or higher. [Insert Table 1 Here] Sources and Content of Information on MC Use As shown in Fig. 1 , the most frequently consulted source of information overall was dispensary staff (84.6%), followed by the internet (61.0%) and the patient’s friends and family (53.9%). Certifying health providers were no more likely to provide information (52.2%) than friends and family. Only 14.9% received information from another established provider, such as their PCP or medical specialist. When asked about types of information patients felt they needed to better manage their conditions (Fig. 2 ) respondents most frequently mentioned information on cannabis strains (50.0%), followed by proper dosage (39.9%) and managing tolerance (36.8%). Somewhat fewer patients were concerned with managing side effects (25.9%) and withdrawal symptoms (25.0%). As shown in Table 2 , dispensary staff were the most frequent information source for respondents’ two top informational needs, strains (81.6%) and dosage (58.8%). Certifying health providers were substantially less likely to provide advice on strains (38.2%) and dosage (36.4%). Only 6.6% received information on strains, and 7.5% on dosage, from a health provider other than their certifying provider. Information on tolerance, the third highest informational priority, was obtained by comparable proportions of patients from the internet (24.6%), the certifying provider (24.6%), and dispensary staff (24.1%). Information on side effects was most frequently obtained from dispensary staff (37.7%), the certifying provider (34.2%) and the internet (33.8%), while information on withdrawal was obtained from the internet (19.7%), the certifying provider (13.2%) and dispensary staff (12.7%). Table 2 Types of Advice on Use of Medicinal Cannabis Patients Received from Each Information Source Advice Source Type of MC Advice Received Strain (% of Patients) Dosage (% of Patients) Tolerance (% of Patients) Side Effects (% of Patients) Withdrawal (% of Patients) Dispensary Staff 81.6 58.8 24.1 37.7 12.7 Internet 54.8 36.0 24.6 33.8 19.7 Social Network 48.2 31.1 17.5 21.5 10.1 Certifying Provider 38.2 36.4 24.6 34.2 13.2 Other Established Health Provider 6.6 7.5 6.6 9.2 5.3 Correlates of Receipt of MC Information from Certifying Health Providers As shown in Table 3 , African Americans were significantly more likely than other racial/ethnic groups to receive advice ( X 2 = 8.52; p=.036) , while there was a non-significant trend for patients aged 50 + to be less likely than younger patients to receive advice ( X 2 = 4.44; p=.109). The type of certifying provider was highly related to information receipt, with low information being more likely among patients certified online by a new provider compared to those certified by their PCPs, other established providers or new providers in person ( X 2 = 9.09; p=.028). Similarly, the patient’s qualifying medical condition was related to advice, with patients having PTSD as their primary condition being less likely to receive advice than those with other qualifying conditions ( X 2 = 9.97; p=.019). Advice was also associated with preferred cannabis strains, with patients using sativa-dominant strains being less likely to have received advice than those using indica-dominant or hybrid strains ( X 2 = 8.97; p=.011). Patients who received provider advice were also more likely to give MC higher ratings of effectiveness in treating their primary qualifying conditions ( X 2 = 5.29; p=.022). Not related to provider advice was gender, marital status, education or employment, year of MCP enrollment, the mode of cannabis delivery, frequency of cannabis use, recreational use, development of tolerance, side effects or problem use. [Insert Table 3 Here] Multivariate Analysis of Factors Associated with Receipt of Health Provider Advice Multivariable analysis (Table 4 ) showed that receipt of information was most likely among males (AOR = 2.44; 95% CI = 1.23–4.83; p =.010) and Black patients (AOR = 4.08; 95% CI = 1.18–14.15; p =.027), but significantly less likely among older patients aged 50+ (AOR = 0.38; 95% CI = 0.19–0.79; p =.009) and patients whose primary qualifying condition was PTSD (AOR = 0.09; 95% CI = 0.02–0.41; p =.002). Table 4 Multivariable Logistic Regression Estimating Correlates of Receipt of Health Provider Advice About Medicinal Cannabis Use Variable AOR (95% CI) p Demographic Characteristics Male 2.44 (1.23–4.83) .010 50 and Older 0.38 (0.19–0.79) .009 Non-Hispanic Black 4.08 (1.18–14.15) .027 Primary Qualifying Condition Anxiety 0.51 (0.21–1.24) .137 Pain 0.73 (0.30–1.73) .469 PTSD 0.09 (0.02–0.41) .002 Type of Certifying Provider PCP 3.73 (1.25–11.14) .018 Medical Specialist/Other Established Provider 3.11 (1.35–7.16) .008 MC Specialist Seen in Person 4.09 (1.78–9.39) < .001 Preferred Strain for Primary Qualifying Condition Indica-Dominant 2.97 (1.02–8.65) .046 Hybrid 3.76 (1.41–10.04) .008 Perceived Effectiveness of MCP for Qualifying Condition 1.02 (1.00-1.03) .020 Nagelkerke R 2 .294 *Reference Categories (in order): Female/Other; Younger Than 50; White, Hispanic or Other Ethnicity; All Other Qualifying Conditions; MC Specialist Provider Seen Online Only; Sativa-Dominant In terms of MCP enrollment characteristics, provider advice was significantly more likely among patients certified by PCPs (AOR = 3.73; 95% CI = 1.25–11.14; p =.018), other established providers (AOR = 3.11; 95% CI = 1.35–7.16; p =.008) or new providers seen in person (AOR = 4.09; 95% CI = 1.78–9.39; p <.001) compared to patients certified by a new provider online. In terms of cannabis use characteristics, provider advice was significantly associated with preferred cannabis strain. Compared to patients who used sativa-dominant strains, patients who received advice were more likely to use hybrid (AOR = 3.76; 95% CI = 1.41–10.04; p =.008) or indica-dominant strains (AOR = 2.97; 95% CI = 1.02–8.65; p =.046). Finally, receiving provider advice was positively associated with higher ratings of cannabis’ therapeutic effectiveness (AOR = 1.02; 95% CI = 1.00-1.03; p =.020). Discussion This study of medical oversight and patient information-seeking in New Jersey's MCP revealed a sizeable communication gap between patients and their certifying providers. Overall, only 52% of patients received provider advice in at least one of the five topic areas studied, compared to nearly 85% who received advice from dispensary staff. Further, more patients received advice from dispensary staff than from providers in areas considered basic to the prescribing of controlled medications, 24–26 such as appropriate dosages (58.5% vs. 36.4%) and the management of side effects (37.7% vs. 34.2%). This finding is similar to findings of Kaplan et al. (2020), who found that less than half of MC certifying providers in Washington State “always” or “very often,” discussed how to use cannabis or recommended product types. Although Sajdeya et al. (2021) found somewhat greater communication in Florida’s MCP, only 62% of certifying providers “often” or “always” provided specific recommendations about dosage. Additionally, only 12% of MCP patients were certified for the program by their PCP, reflecting a well-documented hesitancy among PCPs nationally to recommend or support cannabis treatment. 7,15,27 Studies suggest this hesitancy may reflect limited formal training, uncertain evidence of MC effectiveness, regulatory ambiguity, and/or liability concerns. 28 Compounding the disengagement of PCPs from patients’ MC care is a notable lack of care coordination between PCPs and MC-certifying providers. 29 This is especially concerning in the context of medication substitution. In one Michigan study, 86% of cannabis users reported substituting cannabis for their prescribed medication, with 44% of those who substituted reporting no PCP knowledge of the substitution and 69% reporting some communication gaps. 7 As a result, medicinal cannabis has become siloed from patients’ routine health care, impeding the integration of medicinal cannabis into mainstream medical practice while reducing opportunities for medication management, monitoring of benefits or side effects, and coordinated care of complex conditions. Filling the information gaps for cannabis users, findings show that dispensary staff became patients’ primary sources of advice, rendering them the de facto medical counselors for MC patients. Other studies have noted the prominent informational role of dispensary workers, despite their variable medical training. 30–32 While dispensary staff generally offer recommendations based on product familiarity, 31,33 patient reliance on non-medical information sources raises concerns about unverified recommendations, 32 financial conflicts of interest to sell products, 34 absence of ongoing medical assessment of patients, and potential drug-cannabis interactions. 35 In multivariable analysis, the type of certifying provider and the circumstances surrounding the certification process were key to whether MC patients received health provider advice. Over 65% of patients in the current study were certified by a new provider who marketed MC specialty services online. While many specialists have established, office-based medical practices in the state (e.g. family practice or pain clinics), others provide exclusively online certification services through national medical cannabis “clinics.” In the current study, 62% of MC specialist patients completed their certification visit online. In multivariable analysis, online certification was a key driver of patient-provider non-communication. Patients certified by their PCP, another established provider, or an MC specialist in person , were three to four times more likely to have received provider advice than patients certified online. While online certification visits do not necessarily imply future online-only assessments, many of the largest MC specialty clinics that certify New Jersey patients, such Compassionate Care Clinics of America, offer telehealth services only. 36 Patient demographic characteristics were also found to significantly influence patient-provider communication, with women and patients aged 50 and older being significantly less likely than others to receive health provider advice. These findings parallel larger trends toward gender and age bias in medical communications and treatment across a range of medical specialties. 37–42 The clinical consequences of such disparities may be significant. Adults aged 50+, for example, are adopting cannabis at a faster rate than younger age groups 43 yet remain at greater risk of falls 44 and cannabis-drug interactions, given their higher rates of multimorbidity and multiple medication use. 45 Women are more likely to have cannabis-related medical problems, 46–47 experience a faster onset of cannabis use disorder 48–50 and suffer more severe adverse medical, psychological and functional consequences from addictive disorders than men, including more severe withdrawal symptoms. 51 These findings thus suggest a significant gap in the medical monitoring of two vulnerable populations for whom MC use may pose an especially high risk. In contrast, Black patients were found to be four times as likely to receive provider guidance as other racial/ethnic groups, a finding consistent with at least one other study in which Black oncology patients reported greater comfort than White patients in discussing MC with their providers. 52 Rates of cannabis use have been rising faster among Black Americans than Whites, with increases also noted among Black patients with conditions commonly treated by MC, such as epilepsy, irritable bowel syndrome and chronic pain. 53–54 Additionally, studies suggest that Black Americans experience lower pain thresholds than Whites yet are more likely to encounter providers who either underestimate their pain or have insufficient resources to adequately diagnose and treat it. 54 These factors may not only increase Black patients’ desire to use cannabis for pain management, but their higher pain levels may prompt greater assertiveness in seeking information from MC providers. Patients with PTSD were notably less likely to receive provider advice than those with other qualifying conditions. While the reasons for this gap are unclear, studies show that PTSD patients who use cannabis are more likely than PTSD patients with no cannabis use to have mental health comorbidities, lower cognitive functioning, reliance on avoidance coping strategies and, despite greater psychiatric problems, no corresponding increase in mental health treatment engagement. 55 This tendency toward avoidance and reduced care-seeking may partially explain the lower levels of patient-provider communication among cannabis-using PTSD patients. Our multivariate analysis also showed a preference for indica and hybrid strains over sativa strains among patients who received provider advice. Although there is some evidence that sativa and indica strains as popularly defined produce different subjective and physiological effects, 56–58 the validity of the popular strain distinction has been questioned due, in part, to the extensive hybridization of modern products. 59–60 Presumed differences in the physiological effects of sativa and indica, however, appear on numerous cannabis-related websites, 61 and dispensary staff often recommend indica and/or hybrid strains over sativa strains for chronic pain, anxiety and insomnia. 32, 62 Given our incomplete understanding of the effects of phytocannabinoids on human physiology, 63 it is possible that certifying providers’ recommendations are influenced by popularized ideas about strains. Sajdeya et al. (2021) for example, found that 93% of MC providers in Florida obtained information about cannabis from online sources and 90%, from cannabis dispensary staff. Although lack of communication between patients and their certifying providers was pervasive, our analysis showed that patients who received advice rated their cannabis treatment as more effective than patients who received no advice. This finding is consistent with that of Clobes et al. (2025), who found higher treatment efficacy ratings among patients who collaborated with a cannabis clinician or whose PCP knew of their cannabis use. Communication and guidance from healthcare providers may thus positively influence patients’ satisfaction and, ultimately, their treatment outcomes, potentially through clearer expectations, better usage instructions, and/or increased confidence in the treatment plan. While a limited research base and lack of standard clinical protocols reduce the ability of MC-prescribing clinicians to provide clear clinical recommendations, consensus-based MC practice guidelines have emerged in recent years, including protocols for treating specific medical conditions, guidelines for low-risk use, and recommendations for core clinician competencies for MC prescribing and management. 65–67 However, wide variations in state regulations governing MC may contribute to patient-provider communication gaps by reducing provider incentives to participate in evidence-based learning opportunities and/or to conduct office-based certification and assessment visits. Many states, including New Jersey, require no CME or other training for MC-authorized providers, 68 thus reducing the level of medical expertise in those areas in which standards and evidence do exist. Similarly, while some states, such as Florida, require patients and providers to be physically present in the same room during patient certification visits and annual assessments, 29 many states, including New Jersey, permit all patient-provider communications to be conducted online, 69 a practice this study found significantly reduces patient-provider communication in all areas of cannabis prescribing and monitoring. The current study results thus suggest that more stringent state requirements surrounding MCP provider training, patient certification and care management may enhance medical oversight while insuring safer MC use and more effective treatment outcomes. Limitations Our sample included only 228 participants and thus may not represent all patients enrolled in New Jersey’s MCP. 70 However, the sample was derived from a population-based, representative sample of New Jersey cannabis users 22 and includes respondents from all 21 New Jersey counties whose distribution of qualifying medical conditions closely matches those of MCP enrollees statewide. Demographically, however, study respondents were somewhat more likely than all enrollees to be female (63% vs. 47%) and under age 50 (68% vs. 56%), possibly reflecting a tendency for lower participation of males and older adults in online surveys generally. 71 (See Additional File 1 for demographic characteristics and qualifying medical conditions). Further, the experiences of current survey respondents are unlikely to reflect those of MC patients nationally, given the wide divergence in state MCP regulations and practices. Because this was a cross-sectional survey, associations between patient characteristics and receipt of medical advice do not imply causality. Also, recall bias may have affected reporting of past cannabis use practices as well as MC-related communications with health providers. Despite these limitations, this is one of the few quantitative surveys to measure patient-provider communications in MC programs from the perspective of patients. Further, it is one of the first to document the negative effects of MCP telehealth certifications and assessments on information-sharing between patients and their providers, with the findings arguing for changes in state regulatory requirements involving provider education and oversight of MC patients. Declarations Ethics approval and consent to participate : The current study was approved by the Rutgers Institutional Review Board (IRB). All participants completed an informed consent prior to participating in any study activities. Consent for publication: Not applicable. Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests : The authors declare that they have no competing interests. Funding : Funding for this study was provided by the Division of Mental Health and Addiction Services, New Jersey Department of Human Services (DMHAS). Suzanne Borys, Assistant Division Director of DMHAS, assisted in editing the manuscript. Authors' contributions : OK contributed to conceptualization of the paper, literature reviews, writing and editing the manuscript and developing policy implications. DG contributed to the data analysis, literature reviews, manuscript editing and preparation of the manuscript for publication. SB contributed to manuscript editing. AK contributed to conceptualization of the paper, data analysis, writing, editing, preparing the manuscript for publication and developing policy implications. Acknowledgements : We would like to acknowledge the survey research firm, SSRS, for assistance with the data collection for this paper. References Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2022 National Survey on Drug Use and Health. Rockville (MD): SAMHSA; 2025. National Conference of State Legislatures. State medical cannabis laws. 2025 [cited 2026 Jan 5]. Retrieved from: https://www.ncsl.org/health/state-medical-cannabis-laws. Boehnke KF, Sinclair R, Gordon F, Hosanagar A, Roehler D, Smith T, Hoots B. Trends in U.S. medical cannabis registrations, authorizing clinicians, and reasons for use from 2020 to 2022. Ann Intern Med. 2024; 177(4). https://doi.org/10.7326/M23-11. 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Tables Table 1 Sample Demographic Characteristics and Characteristics of Medical Cannabis Program Enrollment and Medical Cannabis Use Demographic Characteristics MCP Patients ( n = 228) % or Mean (SD) Mean Age 45.19 (14.43) Gender Male 35.1 Female 63.2 Gender Minority 1.8 Race/Ethnicity White 65.5 African American 9.3 Hispanic 18.1 Other 7.1 Marital Status Married or Living As 58.4 Never Married 22.6 Divorced/Separated/Widowed 19.0 Education Less Than High School or High School Grad 15.5 Some College 30.1 College Grad+ 54.4 Employment Status Full-Time 50.0 Part-Time 12.8 Unemployed, Looking 7.1 Unemployed, Other (Retired, disabled, student, etc.) 30.1 MCP Enrollment Characteristics Year of MCP Enrollment 2017 or before 7.5 2018–2020 41.7 2021–2023 50.9 Who First Suggested MC as Treatment The Patient 59.2 Friends/Family 17.1 Primary Care Provider 8.3 Other Specialist/Clinician 15.4 Who Certified Patient for MC Primary Care Provider 11.8 Other Specialist/Clinician 22.8 New Provider for MCP Certification 65.4 Medical Enrollment Visit Type 1 Saw the Provider in Person 37.9 Saw the Provider Online Only 62.1 Patient Qualifying Conditions for MC Card Anxiety 70.2 Chronic Pain 53.1 Post Traumatic Stress Disorder 22.8 Migraines 16.2 Inflammatory Bowel Disease 7.9 Cancer 3.9 Multiple Sclerosis 3.5 Other 2 9.6 Medical Cannabis Use Frequency of MC Use in the Last Three Months Once a Month or Less 11.0 Greater Than Monthly, but Not Daily 29.8 Daily 59.2 Frequency of MC Use on Days Used Once a Day 43.6 2–3 Times a Day 35.5 3 + Times a Day 21.1 Most Frequent Mode of MC Administration in Last 12 Months Smoking (Joint Pipe, Bong) 48.7 Edibles and Beverages 24.6 Vaping (Cartridge or Bud) 21.1 Other (Tinctures, Pills, Syringe) 5.7 Cannabis Strains Preferred for Treating Primary Qualifying Condition Overall Sativa Dominant 15.5 Indica Dominant 28.6 Hybrid Strains or Used Sativa and Indica Equally 55.9 Perceived Effectiveness of Cannabis in Treating Primary Qualifying Condition Less than 50% Effective 15.8 50%-75% Effective 36.0 76%-89% Effective 25.4 90%+ Effective 22.8 Acute Adverse Side Effects of MC Experienced in the Last 12 Months Experienced Any Adverse Side Effects 26.3 Panic Reactions 8.8 Feeling Faint/Dizzy 7.9 Disassociation/Depersonalization 7.0 Paranoia 6.6 Nausea/Vomiting 6.1 Depression 4.4 Flashbacks 1.3 Hallucinations 0.9 Other 4.8 Developed a Tolerance to Medical Cannabis 23.2 Uses Cannabis Recreationally AND Medicinally 52.6 Marijuana Problem Scale Responses No problems on all items 50.9 One or more minor problems but no major problems 39.9 One or more major problems 9.2 1 MCP patients who saw a new provider for MCP Certification only (n = 145) 2 Opioid Use Disorder, Dysmenorrhea, Seizure Disorder, Glaucoma, HIV or AIDs, Intractable Skeletal Spasticity, Muscular Dystrophy Table 3 Bivariate Associations Between MCP Patient Characteristics and Receipt of Health Provider Advice about Medical Cannabis Received Health Provider Advice about Medical Cannabis ( n = 127) Did NOT Receive Health Provider Advice about Medical Cannabis ( n = 101) Demographic Characteristics Mean or % (SD) Mean or % (SD) X 2 or F p Age 4.44 .109 18–35 28.6 28.4 36–49 42.0 30.3 50+ 29.4 41.3 Sex 1.39 .238 Male 38.7 31.2 Female/Other 61.3 68.8 Race/Ethnicity 8.52 .036 White 59.3 72.2 Black 14.4 3.7 Hispanic 18.6 17.6 Other 7.6 6.5 Marital Status 3.95 .139 Married or Living as Married 52.5 64.8 Never Married 27.1 17.6 Divorced/Widowed/Separated 20.3 17.6 Education 3.33 .189 Less Than High School or High School Grad 19.5 11.1 Some College 27.1 33.3 College + 53.4 55.6 Employment 0.31 .858 Full-Time 48.3 51.9 Part-Time 13.6 12.0 Unemployed 38.1 36.1 MCP Enrollment Characteristics Certifying Health Provider 9.09 .028 Primary Care Provider 14.3 9.2 Medical Specialist or Other Established Provider 25.2 20.2 MC Specialist Seen in Person 30.3 21.1 MC Specialist Seen Online Only 30.3 49.5 Primary Qualifying Medical Condition 9.97 .019 Anxiety 36.1 37.6 Pain 34.5 36.7 PTSD 3.4 11.9 Other 26.1 13.8 Year Enrolled in MCP 2.16 .141 2013–2020 53.8 44.0 2021 or later 46.2 56.0 Cannabis Use Characteristics Preferred Strain for Primary Qualifying Condition 8.97 .011 Sativa 8.8 23.2 Indica 28.9 28.3 Hybrid or Equal Use of Both 62.3 48.5 Most Frequent Mode of Delivery 2.07 .558 Smoke 52.1 45.9 Vape 17.6 24.8 Eat or Drink 25.2 25.7 Other 5.0 3.7 Frequency of Medical Cannabis Use 0.87 .647 Monthly or Less 11.8 10.1 More than Monthly but Less Than Daily 31.9 27.5 Daily 56.3 62.4 Recreational Use 0.01 .922 Uses Recreationally AND Medicinally 52.9 52.3 Uses Medicinally Only 47.1 47.7 Developed Tolerance to Cannabis 2.14 .143 Yes 19.3 27.5 No 80.7 72.5 Mean Number of Adverse Effects from Cannabis Use 0.39 (0.90) 0.58 (0.99) 2.32 .129 Perceived Effectiveness of Cannabis in Treating Primary Qualifying Condition 74.08 (20.78) 67.05 (25.30) 5.29 .022 Mean Score on Marijuana Problem Scale (MPS) Score 1.53 (3.23) 1.82 (3.18) 0.46 .501 Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8758519","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":587775487,"identity":"863cbd90-42fb-44f7-a35c-6b3ccbe643f0","order_by":0,"name":"Omar Kawam","email":"","orcid":"","institution":"Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School","correspondingAuthor":false,"prefix":"","firstName":"Omar","middleName":"","lastName":"Kawam","suffix":""},{"id":587775489,"identity":"ba553328-4078-402a-ae3e-3a9b9b85f7a4","order_by":1,"name":"Dina M. Gales","email":"","orcid":"","institution":"Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School","correspondingAuthor":false,"prefix":"","firstName":"Dina","middleName":"M.","lastName":"Gales","suffix":""},{"id":587775491,"identity":"8187893a-c798-48da-94f9-da5f02f9edbd","order_by":2,"name":"Suzanne Borys","email":"","orcid":"","institution":"New Jersey Department of Human Services","correspondingAuthor":false,"prefix":"","firstName":"Suzanne","middleName":"","lastName":"Borys","suffix":""},{"id":587775493,"identity":"59da2962-b9e1-4936-8158-f36f5ab846c7","order_by":3,"name":"Anna Kline","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDElEQVRIiWNgGAWjYBACCXbGBhAtB8QJKDIQcWxamCFSxnAtPIS1QOhEuAKCWiSbmdsefKi5k759RsLTjT8Y7iXu51987OMPBhvZDQewa5FmZmw3nHHsWe6cGwlpt3kYihN7JJ4lz+ZhSDPGpUWOmbFNmoftcO4MaaAWoH+AWs4YA117OBGvlj//DqdLALXc/AHWcv4z4w+G/zi1SIO0MLYdTgBpucED0sLfwwwMgwM4tUg2M7ZJ9vYdNpwh/wDoF4ME454bbMbMPAbJxjNxaJE43v5M4se3w/ISPGeADqtIkG3vP/yY8UeFnWwfDi1IgCeBgcEAZAqQBjMIA3aoqfyETR8Fo2AUjIKRBQCYtl2ZzfApSAAAAABJRU5ErkJggg==","orcid":"","institution":"Rutgers, The State University of New Jersey, Robert Wood Johnson Medical School","correspondingAuthor":true,"prefix":"","firstName":"Anna","middleName":"","lastName":"Kline","suffix":""}],"badges":[],"createdAt":"2026-02-01 19:38:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8758519/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8758519/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102261440,"identity":"f6ea7533-4846-431e-b47f-0c2ed79575fb","added_by":"auto","created_at":"2026-02-10 00:39:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":24776,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSources of Medical Cannabis Information: Proportion of MCP Patients Who Received Information from Each Source\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8758519/v1/97be2c4747751c68b519184e.png"},{"id":102261439,"identity":"02a5677a-cd79-400c-b635-9ac65bb5b43e","added_by":"auto","created_at":"2026-02-10 00:39:44","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":25849,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eTypes of Information Desired to Make Treatment More Effective\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8758519/v1/bcf6c6f65d34b63012a2cc53.png"},{"id":102297986,"identity":"f052be4f-3be1-466d-81b4-e9d380bceb04","added_by":"auto","created_at":"2026-02-10 10:29:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1800439,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8758519/v1/e4ba9e39-56ec-4797-803b-29867f57bcf8.pdf"},{"id":102261441,"identity":"4bbaa526-0b42-49c6-9e4e-094fcb125014","added_by":"auto","created_at":"2026-02-10 00:39:44","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":15201,"visible":true,"origin":"","legend":"","description":"","filename":"AdditionalFile1SupplementalTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-8758519/v1/5aaa78f68f47ff5ddca871da.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Is There a Doctor in the House? Patient Experiences Regarding Information-Seeking and Provider Advice in New Jersey’s Medicinal Cannabis Program","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBy 2025, medicinal cannabis (MC) had been legalized in forty states, three territories, and the District of Columbia.\u003csup\u003e1\u003c/sup\u003e Although the evidence base is sparse, emerging research has found potential therapeutic benefits of cannabis for a number of medical and psychiatric disorders, including certain chronic pain conditions, muscle spasticity, chemotherapy-induced nausea, social anxiety and PTSD.\u003csup\u003e2\u0026ndash;4\u003c/sup\u003eAny potential medicinal benefits of cannabis, however, are offset by a number of troubling medical, psychiatric and cognitive side effects, including the risk of cannabis use disorder.\u003csup\u003e5,6\u003c/sup\u003e Further, many MC patients use cannabis in conjunction with, or as a replacement for, prescribed medications,\u003csup\u003e3,7,8\u003c/sup\u003e a practice which, in the absence of medical monitoring, may lead to disease recurrence and/or drug-cannabis interactions, particularly in older adults with co-morbid conditions.\u003csup\u003e10,11\u003c/sup\u003e The risk of unwanted medical outcomes is further exacerbated by the increasing potency of cannabis products, with the THC content of some products marketed to medicinal users exceeding 70%.\u003csup\u003e12\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe use of highly potent forms of MC and its attendant medical and psychological risks highlight the need for medical oversight of patients who use cannabis therapeutically. The creation of state-regulated Medicinal Cannabis Programs (MCP) represents an attempt by states to promote such oversight. In New Jersey, for example, physicians must certify that patients have a qualifying medical condition, establish treatment plans and conduct regular follow-up visits to monitor patient progress and response to therapy.\u003csup\u003e13\u003c/sup\u003e The extent to which such MCP regulatory requirements actually strengthen medical supervision of MC patients, however, is unclear, given the notable lack of research into health communications and provider practices within state-sponsored MCPs. Much current research into health provider attitudes, knowledge and practices surrounding MC, has involved surveys of mostly non-MCP-affiliated health practitioners,\u003csup\u003e7, 14\u0026ndash;19\u003c/sup\u003e while surveys of cannabis-using patients frequently focus on disclosure of cannabis use to health providers, especially primary care providers (PCPs) who are typically also non-MCP-affiliated.\u003csup\u003e7, 16\u003c/sup\u003e These studies show that, in general, health providers have mixed opinions about cannabis' therapeutic value and feel they lack knowledge about its use,\u003csup\u003e15,18\u003c/sup\u003e while patients hesitate to disclose cannabis use to providers due to stigma and/or perceptions of limited provider knowledge.\u003csup\u003e7,16\u003c/sup\u003e Although ambivalence and non-involvement of non-MCP-affiliated health providers in patients\u0026rsquo; MC care is not surprising, state regulations require greater engagement of providers authorized to provide this care. The few studies focused specifically on MCP-authorized providers, however, describe similar limitations. Kaplan and colleagues (2020), for example, found that Washington State MCP-affiliated providers were unfamiliar with the state\u0026rsquo;s qualifying medical conditions or the regulations governing cannabis\u0026rsquo; medicinal use, while those with active MCP patients failed to universally adhere to all state MC care management requirements. Although the number of studies focused on MCP-authorized providers is limited, even fewer quantitative studies have examined medical oversight from the perspective of MCP patients. One small, qualitative study of MCP patients in Pennsylvania\u003csup\u003e20\u003c/sup\u003e however, found that most respondents reported receiving little or no education on the use of cannabis from their certifying healthcare providers.\u003c/p\u003e \u003cp\u003eThe dearth of studies on the quality and content of communication between MCP patients and the providers responsible for their care constitutes a significant gap in current research. Especially lacking is information on the extent to which MCP patients receive basic guidance about appropriate dosages and products, management of side effects or the development of tolerance, information that is central to the patient\u0026rsquo;s ability to utilize MC safely and achieve the best possible medical outcomes. This paper attempts to address some of these research gaps by providing information from the patient\u0026rsquo;s perspective about medical information-seeking and advice within New Jersey\u0026rsquo;s MCP (NJMCP). Specifically, this study aims to answer the following questions:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat sources of medical advice, including health providers and non-medical sources, do New Jersey MCP patients turn to for guidance about their MC use?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat types of information do patients identify as important for effective MC use and which sources have provided this information?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eWhat patient-level and physician-level factors are associated with obtaining MC-related information from certifying physicians?\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eParticipants in the current study were recruited as part of a large, population-based survey of New Jersey cannabis users (the New Jersey Cannabis Use Survey (CUS))\u003csup\u003e21\u003c/sup\u003e conducted in 2022\u0026ndash;2023. CUS participants were recruited from the 2023 New Jersey Survey of Drug Use and Health (NJSDUH),\u003csup\u003e22\u003c/sup\u003e a population-based survey of New Jersey adults (age 18+) conducted periodically by the NJ Division of Mental Health and Addiction Services (n\u0026thinsp;=\u0026thinsp;22,700). All NJSDUH participants who reported cannabis use in the past 12 months were redirected upon survey completion to a Rutgers website where they were invited to participate in the CUS. Of the 4,333 NJSDUH respondents reporting past-year cannabis use, 1,796 (41%) completed the CUS. Of these, 228 were actively enrolled in the NJMCP and provided the data on which the current paper is based. More detailed information on NJSDUH and CUS survey methods can be found at Borys et al., 2024 and Borys et al., 2025.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eStatus as a licensed medical cannabis card holder was measured with a yes/no item asking if the participant had been registered as a patient in the NJMCP in the past 12-months.\u003c/p\u003e \u003cp\u003eOur outcome measure, receipt of information from a certifying health provider, was obtained by asking respondents, \u0026ldquo;Did any of the following sources give you information about marijuana strains, dosage, side effects, tolerance or withdrawal symptoms?\u0026rdquo; Respondents who reported their certifying provider as a source of at least one category of advice were coded as having received information. A similar strategy was followed to measure receipt or non-receipt of advice from other sources (other health providers; dispensary staff; internet; other cannabis users; family and/or friends).\u003c/p\u003e \u003cp\u003eTo measure types of desired information, respondents were asked: \u0026ldquo;Do you feel you need more information in any of the following areas to make your treatment more effective (Check all that apply)?\u0026rdquo; Responses included: best strains for my condition; proper dosage; management of side effects, tolerance and withdrawal.\u003c/p\u003e \u003cp\u003eCircumstances surrounding MCP certification and enrollment included questions pertaining to year of enrollment, MCP referral source (self-referred; friends/family; PCP; other health provider), and type of certifying provider (PCP; other established health provider; new provider seen only for certification). Respondents seen by a new provider were asked if their certifying visit occurred online or in person.\u003c/p\u003e \u003cp\u003eQualifying medical conditions were measured by asking respondents to select all that apply from a current list of New Jersey MCP qualifying conditions. Additionally, respondents were asked to select the condition they considered their primary, or \u0026ldquo;most troublesome\u0026rdquo; condition. Measures of cannabis use practices included items asking frequency of use in the last three months (none, 1x/month or less, 2-3x/month, 1-2x/week, 3-5x/week, daily or almost daily), primary mode of administration (smoke, vape, capsules/tablets, store-bought edibles, homemade edibles, infused beverages, tinctures, oil syringes/pastes, other), primary cannabis strain used (indica-dominant, sativa-dominant, or hybrid/equal use of both), and recreational use of cannabis (\u0026ldquo;Have you ever used marijuana for non-medical/recreational purposes?\u0026rdquo;). Additional items included check-off lists of acute adverse side effects experienced and questions regarding developing tolerance.\u003c/p\u003e \u003cp\u003eProblem cannabis use was measured using the 19-item Marijuana Problem Scale (MPS), a widely used measure of negative life consequences associated with cannabis use in the previous three months. Respondents are prompted to rate each potential problem as either \u0026ldquo;no problem, \u0026ldquo;minor problem\u0026rdquo; or \u0026ldquo;major problem.\u0026rdquo; In psychometric testing, the instrument has shown good internal reliability (alpha\u0026thinsp;=\u0026thinsp;0.88) and test-retest reliability (r\u0026thinsp;=\u0026thinsp;0.81 and 0.73).\u003csup\u003e23\u003c/sup\u003e A total MPS severity score was obtained by summing all items in the scale.\u003c/p\u003e \u003cp\u003ePerceived effectiveness of MC was measured by asking respondents to rate MC effectiveness in treating their primary qualifying condition on a scale of 0%-100%.\u003c/p\u003e \u003cp\u003eFinally, standard measures of demographic characteristics obtained information on age, gender, race/ethnicity, marital status, education and employment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eWe used descriptive statistics to characterize the sample as a whole. We then used analysis of variance and chi-square analysis, as appropriate, to describe and compare MCP participants who did and did not receive information about MC use from their certifying provider on all relevant measures. To further explore factors associated with information receipt, we entered all independent variables showing a bivariate relationship with the dependent variable (\u003cem\u003ep\u003c/em\u003e=.10) into a multivariable logistic regression analysis, while controlling for age, race and ethnicity. All variables presented in descriptive tables as categorical, such as perceived effectiveness of MC and MPS problem scores, were treated as continuous variables in the bivariate and multivariable analyses.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDemographic Characteristics\u003c/h2\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1\u003c/span\u003e, participants had a mean age of 45 and were mostly White (65.5%) and female (63.2%). More than half were married or living as married (58.4%). Respondents were well-educated, with 30.1% having some college education and 54.4%, a college degree or higher. Only 50% were employed full-time, while 30.1% were unemployed and not actively looking for work due to disability, retirement, student status or other reasons.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMCP Enrollment Characteristics\u003c/h3\u003e\n\u003cp\u003eOnly 7.5% of participants had enrolled in New Jersey\u0026rsquo;s MCP before 2018, the year medicinal cannabis expansion began in NJ. The majority enrolled in 2018\u0026ndash;2020 (41.7%) and 2021\u0026ndash;2023 (50.9%). Most participants (59.2%) were self-referred to the MCP, with only 8.3% referred by their PCP and 15.4%, by a health provider other than their PCP.\u003c/p\u003e \u003cp\u003eMost participants (65.4%) obtained MCP certification from a new provider specifically seen for that purpose. Only 11.8% were certified by their PCP and 22.8% by an established provider other than their PCP. Among participants who saw a new provider, most (62.1%) completed the certification visit online, not in person.\u003c/p\u003e \u003cp\u003eParticipants reported a range of conditions for which medical cannabis was sought, with most respondents reporting more than one condition. The most common conditions were anxiety (70.2%) and chronic pain (53.1%), followed by post-traumatic stress disorder (PTSD) (22.8%), migraines (16.2%), inflammatory bowel disease (7.9%), cancer (3.9%), and multiple sclerosis (3.5%).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eCharacteristics of Medicinal Cannabis Use\u003c/h2\u003e \u003cp\u003eDaily cannabis use was reported by 59.2% of patients, while 29.8% used monthly but not daily and 11.0% used once a month or less. On days they used cannabis, 43.6% reported using once a day, 35.5%, two to three times per day, and 21.1%, three or more times per day. The most frequent administration route was smoking (48.7%), followed by edibles and beverages (24.6%) and vaping (21.1%). Other routes, such as tinctures, pills, or syringes, were less commonly used (5.7%). Most participants reported using hybrid strains or both sativa and indica-dominant strains equally to treat their primary qualifying condition (55.9%). Indica-dominant strains were used by 28.6%, and sativa-dominant strains, by 15.5%.\u003c/p\u003e \u003cp\u003eIn terms of negative side effects, 26.3% of respondents experienced at least one adverse effect in the past 12 months, including panic reactions (8.8%), faintness/dizziness (7.9%), disassociation or depersonalization (7.0%), paranoia (6.6%), nausea or vomiting (6.1%) and depression (4.4%). Nearly a quarter (23.2%) of respondents developed a tolerance to MC. More than half (52.6%) used cannabis recreationally as well as medicinally and 9.2% reported one or more major problems associated with cannabis use on the Marijuana Problem Scale (MPS). However, over half of respondents (50.9%) reported no problems and 39.9% reported minor problems only.\u003c/p\u003e \u003cp\u003eOverall, the majority (84.2%) of MCP patients rated MC as 50% or more effective in treating their primary qualifying condition, with 22.8% rating it as 90% effective or higher.\u003c/p\u003e \u003cp\u003e \u003cb\u003e[Insert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e1\u003c/span\u003e \u003cb\u003eHere]\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSources and Content of Information on MC Use\u003c/h3\u003e\n\u003cp\u003eAs shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the most frequently consulted source of information overall was dispensary staff (84.6%), followed by the internet (61.0%) and the patient\u0026rsquo;s friends and family (53.9%). Certifying health providers were no more likely to provide information (52.2%) than friends and family. Only 14.9% received information from another established provider, such as their PCP or medical specialist.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen asked about types of information patients felt they needed to better manage their conditions (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) respondents most frequently mentioned information on cannabis strains (50.0%), followed by proper dosage (39.9%) and managing tolerance (36.8%). Somewhat fewer patients were concerned with managing side effects (25.9%) and withdrawal symptoms (25.0%).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e, dispensary staff were the most frequent information source for respondents\u0026rsquo; two top informational needs, strains (81.6%) and dosage (58.8%). Certifying health providers were substantially less likely to provide advice on strains (38.2%) and dosage (36.4%). Only 6.6% received information on strains, and 7.5% on dosage, from a health provider other than their certifying provider. Information on tolerance, the third highest informational priority, was obtained by comparable proportions of patients from the internet (24.6%), the certifying provider (24.6%), and dispensary staff (24.1%). Information on side effects was most frequently obtained from dispensary staff (37.7%), the certifying provider (34.2%) and the internet (33.8%), while information on withdrawal was obtained from the internet (19.7%), the certifying provider (13.2%) and dispensary staff (12.7%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTypes of Advice on Use of Medicinal Cannabis Patients Received from Each Information Source\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdvice Source\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eType of MC Advice Received\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrain\u003c/p\u003e \u003cp\u003e(% of Patients)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDosage\u003c/p\u003e \u003cp\u003e(% of Patients)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTolerance\u003c/p\u003e \u003cp\u003e(% of Patients)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSide Effects\u003c/p\u003e \u003cp\u003e(% of Patients)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWithdrawal\u003c/p\u003e \u003cp\u003e(% of Patients)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDispensary Staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInternet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e33.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Network\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCertifying Provider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Established Health Provider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eCorrelates of Receipt of MC Information from Certifying Health Providers\u003c/h3\u003e\n\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e, African Americans were significantly more likely than other racial/ethnic groups to receive advice (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;8.52; p=.036)\u003c/em\u003e, while there was a non-significant trend for patients aged 50\u0026thinsp;+\u0026thinsp;to be less likely than younger patients to receive advice (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;4.44; p=.109).\u003c/em\u003e The type of certifying provider was highly related to information receipt, with low information being more likely among patients certified online by a new provider compared to those certified by their PCPs, other established providers or new providers in person (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;9.09; p=.028).\u003c/em\u003e Similarly, the patient\u0026rsquo;s qualifying medical condition was related to advice, with patients having PTSD as their primary condition being less likely to receive advice than those with other qualifying conditions (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;9.97; p=.019).\u003c/em\u003e Advice was also associated with preferred cannabis strains, with patients using sativa-dominant strains being less likely to have received advice than those using indica-dominant or hybrid strains (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;8.97; p=.011).\u003c/em\u003e Patients who received provider advice were also more likely to give MC higher ratings of effectiveness in treating their primary qualifying conditions (\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u0026thinsp;\u003cem\u003e=\u0026thinsp;5.29; p=.022).\u003c/em\u003e\u003c/p\u003e \u003cp\u003eNot related to provider advice was gender, marital status, education or employment, year of MCP enrollment, the mode of cannabis delivery, frequency of cannabis use, recreational use, development of tolerance, side effects or problem use.\u003c/p\u003e \u003cp\u003e \u003cb\u003e[Insert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e3\u003c/span\u003e \u003cb\u003eHere]\u003c/b\u003e\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eMultivariate Analysis of Factors Associated with Receipt of Health Provider Advice\u003c/h2\u003e \u003cp\u003eMultivariable analysis (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e4\u003c/span\u003e) showed that receipt of information was most likely among males (AOR\u0026thinsp;=\u0026thinsp;2.44; 95% CI\u0026thinsp;=\u0026thinsp;1.23\u0026ndash;4.83; \u003cem\u003ep\u003c/em\u003e=.010) and Black patients (AOR\u0026thinsp;=\u0026thinsp;4.08; 95% CI\u0026thinsp;=\u0026thinsp;1.18\u0026ndash;14.15; \u003cem\u003ep\u003c/em\u003e=.027), but significantly less likely among older patients aged 50+ (AOR\u0026thinsp;=\u0026thinsp;0.38; 95% CI\u0026thinsp;=\u0026thinsp;0.19\u0026ndash;0.79; \u003cem\u003ep\u003c/em\u003e=.009) and patients whose primary qualifying condition was PTSD (AOR\u0026thinsp;=\u0026thinsp;0.09; 95% CI\u0026thinsp;=\u0026thinsp;0.02\u0026ndash;0.41; \u003cem\u003ep\u003c/em\u003e=.002).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable Logistic Regression Estimating Correlates of Receipt of Health Provider Advice About Medicinal Cannabis Use\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eDemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMale\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.44 (1.23\u0026ndash;4.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e50 and Older\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.38 (0.19\u0026ndash;0.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNon-Hispanic Black\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.08 (1.18\u0026ndash;14.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary Qualifying Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAnxiety\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.51 (0.21\u0026ndash;1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.137\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePain\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.73 (0.30\u0026ndash;1.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePTSD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.09 (0.02\u0026ndash;0.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eType of Certifying Provider\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePCP\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.73 (1.25\u0026ndash;11.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.018\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMedical Specialist/Other Established Provider\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.11 (1.35\u0026ndash;7.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMC Specialist Seen in Person\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.09 (1.78\u0026ndash;9.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePreferred Strain for Primary Qualifying Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eIndica-Dominant\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.97 (1.02\u0026ndash;8.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.046\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eHybrid\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.76 (1.41\u0026ndash;10.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceived Effectiveness of MCP for Qualifying Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.02 (1.00-1.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNagelkerke R\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e \u003cb\u003e.294\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e*Reference Categories (in order): Female/Other; Younger Than 50; White, Hispanic or Other Ethnicity; All Other Qualifying Conditions; MC Specialist Provider Seen Online Only; Sativa-Dominant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of MCP enrollment characteristics, provider advice was significantly more likely among patients certified by PCPs (AOR\u0026thinsp;=\u0026thinsp;3.73; 95% CI\u0026thinsp;=\u0026thinsp;1.25\u0026ndash;11.14; \u003cem\u003ep\u003c/em\u003e=.018), other established providers (AOR\u0026thinsp;=\u0026thinsp;3.11; 95% CI\u0026thinsp;=\u0026thinsp;1.35\u0026ndash;7.16; \u003cem\u003ep\u003c/em\u003e=.008) or new providers seen in person (AOR\u0026thinsp;=\u0026thinsp;4.09; 95% CI\u0026thinsp;=\u0026thinsp;1.78\u0026ndash;9.39; \u003cem\u003ep\u003c/em\u003e\u0026lt;.001) compared to patients certified by a new provider online.\u003c/p\u003e \u003cp\u003eIn terms of cannabis use characteristics, provider advice was significantly associated with preferred cannabis strain. Compared to patients who used sativa-dominant strains, patients who received advice were more likely to use hybrid (AOR\u0026thinsp;=\u0026thinsp;3.76; 95% CI\u0026thinsp;=\u0026thinsp;1.41\u0026ndash;10.04; \u003cem\u003ep\u003c/em\u003e=.008) or indica-dominant strains (AOR\u0026thinsp;=\u0026thinsp;2.97; 95% CI\u0026thinsp;=\u0026thinsp;1.02\u0026ndash;8.65; \u003cem\u003ep\u003c/em\u003e=.046). Finally, receiving provider advice was positively associated with higher ratings of cannabis\u0026rsquo; therapeutic effectiveness (AOR\u0026thinsp;=\u0026thinsp;1.02; 95% CI\u0026thinsp;=\u0026thinsp;1.00-1.03; \u003cem\u003ep\u003c/em\u003e=.020).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study of medical oversight and patient information-seeking in New Jersey's MCP revealed a sizeable communication gap between patients and their certifying providers. Overall, only 52% of patients received provider advice in at least one of the five topic areas studied, compared to nearly 85% who received advice from dispensary staff. Further, more patients received advice from dispensary staff than from providers in areas considered basic to the prescribing of controlled medications,\u003csup\u003e24\u0026ndash;26\u003c/sup\u003e such as appropriate dosages (58.5% vs. 36.4%) and the management of side effects (37.7% vs. 34.2%). This finding is similar to findings of Kaplan et al. (2020), who found that less than half of MC certifying providers in Washington State \u0026ldquo;always\u0026rdquo; or \u0026ldquo;very often,\u0026rdquo; discussed how to use cannabis or recommended product types. Although Sajdeya et al. (2021) found somewhat greater communication in Florida\u0026rsquo;s MCP, only 62% of certifying providers \u0026ldquo;often\u0026rdquo; or \u0026ldquo;always\u0026rdquo; provided specific recommendations about dosage.\u003c/p\u003e \u003cp\u003eAdditionally, only 12% of MCP patients were certified for the program by their PCP, reflecting a well-documented hesitancy among PCPs nationally to recommend or support cannabis treatment.\u003csup\u003e7,15,27\u003c/sup\u003e Studies suggest this hesitancy may reflect limited formal training, uncertain evidence of MC effectiveness, regulatory ambiguity, and/or liability concerns.\u003csup\u003e28\u003c/sup\u003e Compounding the disengagement of PCPs from patients\u0026rsquo; MC care is a notable lack of care coordination between PCPs and MC-certifying providers.\u003csup\u003e29\u003c/sup\u003e This is especially concerning in the context of medication substitution. In one Michigan study, 86% of cannabis users reported substituting cannabis for their prescribed medication, with 44% of those who substituted reporting no PCP knowledge of the substitution and 69% reporting some communication gaps.\u003csup\u003e7\u003c/sup\u003e As a result, medicinal cannabis has become siloed from patients\u0026rsquo; routine health care, impeding the integration of medicinal cannabis into mainstream medical practice while reducing opportunities for medication management, monitoring of benefits or side effects, and coordinated care of complex conditions.\u003c/p\u003e \u003cp\u003eFilling the information gaps for cannabis users, findings show that dispensary staff became patients\u0026rsquo; primary sources of advice, rendering them the de facto medical counselors for MC patients. Other studies have noted the prominent informational role of dispensary workers, despite their variable medical training.\u003csup\u003e30\u0026ndash;32\u003c/sup\u003e While dispensary staff generally offer recommendations based on product familiarity,\u003csup\u003e31,33\u003c/sup\u003e patient reliance on non-medical information sources raises concerns about unverified recommendations,\u003csup\u003e32\u003c/sup\u003e financial conflicts of interest to sell products,\u003csup\u003e34\u003c/sup\u003e absence of ongoing medical assessment of patients, and potential drug-cannabis interactions.\u003csup\u003e35\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn multivariable analysis, the type of certifying provider and the circumstances surrounding the certification process were key to whether MC patients received health provider advice. Over 65% of patients in the current study were certified by a new provider who marketed MC specialty services online. While many specialists have established, office-based medical practices in the state (e.g. family practice or pain clinics), others provide exclusively online certification services through national medical cannabis \u0026ldquo;clinics.\u0026rdquo; In the current study, 62% of MC specialist patients completed their certification visit online. In multivariable analysis, online certification was a key driver of patient-provider non-communication. Patients certified by their PCP, another established provider, or an MC specialist \u003cem\u003ein person\u003c/em\u003e, were three to four times more likely to have received provider advice than patients certified online. While online certification visits do not necessarily imply future online-only assessments, many of the largest MC specialty clinics that certify New Jersey patients, such Compassionate Care Clinics of America, offer telehealth services only.\u003csup\u003e36\u003c/sup\u003e\u003c/p\u003e \u003cp\u003ePatient demographic characteristics were also found to significantly influence patient-provider communication, with women and patients aged 50 and older being significantly less likely than others to receive health provider advice. These findings parallel larger trends toward gender and age bias in medical communications and treatment across a range of medical specialties.\u003csup\u003e37\u0026ndash;42\u003c/sup\u003e The clinical consequences of such disparities may be significant. Adults aged 50+, for example, are adopting cannabis at a faster rate than younger age groups\u003csup\u003e43\u003c/sup\u003e yet remain at greater risk of falls\u003csup\u003e44\u003c/sup\u003e and cannabis-drug interactions, given their higher rates of multimorbidity and multiple medication use.\u003csup\u003e45\u003c/sup\u003e Women are more likely to have cannabis-related medical problems,\u003csup\u003e46\u0026ndash;47\u003c/sup\u003e experience a faster onset of cannabis use disorder\u003csup\u003e48\u0026ndash;50\u003c/sup\u003e and suffer more severe adverse medical, psychological and functional consequences from addictive disorders than men, including more severe withdrawal symptoms.\u003csup\u003e51\u003c/sup\u003e These findings thus suggest a significant gap in the medical monitoring of two vulnerable populations for whom MC use may pose an especially high risk.\u003c/p\u003e \u003cp\u003eIn contrast, Black patients were found to be four times as likely to receive provider guidance as other racial/ethnic groups, a finding consistent with at least one other study in which Black oncology patients reported greater comfort than White patients in discussing MC with their providers.\u003csup\u003e52\u003c/sup\u003e Rates of cannabis use have been rising faster among Black Americans than Whites, with increases also noted among Black patients with conditions commonly treated by MC, such as epilepsy, irritable bowel syndrome and chronic pain.\u003csup\u003e53\u0026ndash;54\u003c/sup\u003e Additionally, studies suggest that Black Americans experience lower pain thresholds than Whites yet are more likely to encounter providers who either underestimate their pain or have insufficient resources to adequately diagnose and treat it.\u003csup\u003e54\u003c/sup\u003e These factors may not only increase Black patients\u0026rsquo; desire to use cannabis for pain management, but their higher pain levels may prompt greater assertiveness in seeking information from MC providers.\u003c/p\u003e \u003cp\u003ePatients with PTSD were notably less likely to receive provider advice than those with other qualifying conditions. While the reasons for this gap are unclear, studies show that PTSD patients who use cannabis are more likely than PTSD patients with no cannabis use to have mental health comorbidities, lower cognitive functioning, reliance on avoidance coping strategies and, despite greater psychiatric problems, no corresponding increase in mental health treatment engagement.\u003csup\u003e55\u003c/sup\u003e This tendency toward avoidance and reduced care-seeking may partially explain the lower levels of patient-provider communication among cannabis-using PTSD patients.\u003c/p\u003e \u003cp\u003eOur multivariate analysis also showed a preference for indica and hybrid strains over sativa strains among patients who received provider advice. Although there is some evidence that sativa and indica strains as popularly defined produce different subjective and physiological effects,\u003csup\u003e56\u0026ndash;58\u003c/sup\u003e the validity of the popular strain distinction has been questioned due, in part, to the extensive hybridization of modern products.\u003csup\u003e59\u0026ndash;60\u003c/sup\u003e Presumed differences in the physiological effects of sativa and indica, however, appear on numerous cannabis-related websites,\u003csup\u003e61\u003c/sup\u003e and dispensary staff often recommend indica and/or hybrid strains over sativa strains for chronic pain, anxiety and insomnia.\u003csup\u003e32, 62\u003c/sup\u003e Given our incomplete understanding of the effects of phytocannabinoids on human physiology,\u003csup\u003e63\u003c/sup\u003e it is possible that certifying providers\u0026rsquo; recommendations are influenced by popularized ideas about strains. Sajdeya et al. (2021) for example, found that 93% of MC providers in Florida obtained information about cannabis from online sources and 90%, from cannabis dispensary staff.\u003c/p\u003e \u003cp\u003eAlthough lack of communication between patients and their certifying providers was pervasive, our analysis showed that patients who received advice rated their cannabis treatment as more effective than patients who received no advice. This finding is consistent with that of Clobes et al. (2025), who found higher treatment efficacy ratings among patients who collaborated with a cannabis clinician or whose PCP knew of their cannabis use. Communication and guidance from healthcare providers may thus positively influence patients\u0026rsquo; satisfaction and, ultimately, their treatment outcomes, potentially through clearer expectations, better usage instructions, and/or increased confidence in the treatment plan.\u003c/p\u003e \u003cp\u003eWhile a limited research base and lack of standard clinical protocols reduce the ability of MC-prescribing clinicians to provide clear clinical recommendations, consensus-based MC practice guidelines have emerged in recent years, including protocols for treating specific medical conditions, guidelines for low-risk use, and recommendations for core clinician competencies for MC prescribing and management.\u003csup\u003e65\u0026ndash;67\u003c/sup\u003e However, wide variations in state regulations governing MC may contribute to patient-provider communication gaps by reducing provider incentives to participate in evidence-based learning opportunities and/or to conduct office-based certification and assessment visits. Many states, including New Jersey, require no CME or other training for MC-authorized providers,\u003csup\u003e68\u003c/sup\u003e thus reducing the level of medical expertise in those areas in which standards and evidence do exist. Similarly, while some states, such as Florida, require patients and providers to be physically present in the same room during patient certification visits and annual assessments,\u003csup\u003e29\u003c/sup\u003e many states, including New Jersey, permit all patient-provider communications to be conducted online,\u003csup\u003e69\u003c/sup\u003e a practice this study found significantly reduces patient-provider communication in all areas of cannabis prescribing and monitoring. The current study results thus suggest that more stringent state requirements surrounding MCP provider training, patient certification and care management may enhance medical oversight while insuring safer MC use and more effective treatment outcomes.\u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eOur sample included only 228 participants and thus may not represent all patients enrolled in New Jersey\u0026rsquo;s MCP.\u003csup\u003e70\u003c/sup\u003e However, the sample was derived from a population-based, representative sample of New Jersey cannabis users\u003csup\u003e22\u003c/sup\u003e and includes respondents from all 21 New Jersey counties whose distribution of qualifying medical conditions closely matches those of MCP enrollees statewide. Demographically, however, study respondents were somewhat more likely than all enrollees to be female (63% vs. 47%) and under age 50 (68% vs. 56%), possibly reflecting a tendency for lower participation of males and older adults in online surveys generally.\u003csup\u003e71\u003c/sup\u003e (See Additional File 1 for demographic characteristics and qualifying medical conditions). Further, the experiences of current survey respondents are unlikely to reflect those of MC patients nationally, given the wide divergence in state MCP regulations and practices. Because this was a cross-sectional survey, associations between patient characteristics and receipt of medical advice do not imply causality. Also, recall bias may have affected reporting of past cannabis use practices as well as MC-related communications with health providers.\u003c/p\u003e \u003cp\u003eDespite these limitations, this is one of the few quantitative surveys to measure patient-provider communications in MC programs from the perspective of patients. Further, it is one of the first to document the negative effects of MCP telehealth certifications and assessments on information-sharing between patients and their providers, with the findings arguing for changes in state regulatory requirements involving provider education and oversight of MC patients.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cu\u003eEthics approval and consent to participate\u003c/u\u003e: The current study was approved by the Rutgers Institutional Review Board (IRB). All participants completed an informed consent prior to participating in any study activities.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eConsent for publication:\u003c/u\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAvailability of data and materials:\u0026nbsp;\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eCompeting interests\u003c/u\u003e: The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eFunding\u003c/u\u003e: Funding for this study was provided by the Division of Mental Health and Addiction Services, New Jersey Department of Human Services (DMHAS). Suzanne Borys, Assistant Division Director of DMHAS, assisted in editing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAuthors\u0026apos; contributions\u003c/u\u003e: OK contributed to conceptualization of the paper, literature reviews, writing and editing the manuscript and developing policy implications. DG contributed to the data analysis, literature reviews, manuscript editing and preparation of the manuscript for publication. SB contributed to manuscript editing. AK contributed to conceptualization of the paper, data analysis, writing, editing, preparing the manuscript for publication and developing policy implications.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAcknowledgements\u003c/u\u003e: We would like to acknowledge the survey research firm, SSRS, for assistance with the data collection for this paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSubstance Abuse and Mental Health Services Administration. 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JAMA Netw Open. 2021;4(9):e2125262. https://doi.org/10.1001/jamanetworkopen.2021.25262.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraun IM, Nayak MM, Roberts JE, Chai PR, Tulsky JA, Abrams DI,. Pirl W. Backgrounds and trainings in cannabis therapeutics of dispensary personnel. JCO OP. 2022;18(11): e1787-95. https://doi.org/10.1200/OP.22.00129.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMerlin JS, Althouse A, Feldman R. Analysis of state cannabis laws and dispensary staff recommendations to adults purchasing medical cannabis. JAMA Netw Open. 2021;4(9):e2124511. https://doi.org/10.1001/jamanetworkopen.2021.24511.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCompassionate Clinics of America. Find a Doctor \u0026amp; Get a Medical Cannabis Card in New Jersey [Internet]. 2026 [cited 2026 Jan 27]. Available from: https://mycompassionateclinic.com/locations/state/new-jersey/\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuzikevits M, Gordon-Hecker T, Rekhtman D, et al. Sex bias in pain management decisions. Proc Natl Acad Sci U S A. 2024;121(33):e2401331121. https://doi.org/10.1073/pnas.2401331121.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSamulowitz A, Gremyr I, Eriksson E, Hensing G. \u0026ldquo;Brave men\u0026rdquo; and \u0026ldquo;emotional women\u0026rdquo;: a theory-guided literature review on gender bias in health care and gendered norms towards patients with chronic pain. Pain Res Manag. 2018;2018:6358624. https://doi.org/10.1155/2018/6358624.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaile VT. Gender as a factor in the physician and patient interaction: from service quality perspective. J Mark Consum Behav Emerg Mark. 2018;2:21\u0026ndash;32. https://doi.org/10.7172/2449-6634.jmcbem.2018.2.2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlibhai SM, Krahn MD, Cohen MM, Fleshner NE, Tomlinson GA, Naglie G. Is there age bias in the treatment of localized prostate carcinoma? Cancer. 2004. https://doi.org/10.1002/cncr.11884.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNeal D, Morgan JL, Kenny R, Ormerod T, Reed MWR. Is there evidence of age bias in breast cancer health care professionals\u0026rsquo; treatment of older patients? Eur J Surg Oncol. 2022;48(12):2401\u0026ndash;2407. https://doi.org/10.1016/j.ejso.2022.07.003.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHillerbrand E, Shaw D. Age bias in a general hospital: is there ageism in psychiatric consultation? Clin Gerontol. 1990;9(2):3\u0026ndash;13. https://doi.org/10.1300/J018v09n02_02.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSomes J. 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Exp Clin Psychopharmacol. 2015;23(6):415\u0026ndash;421. https://doi.org/10.1037/pha0000053.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSherman BJ, McRae-Clark AL, Baker NL, Sonne SC, Killeen TK, Cloud K, Gray KM. Gender differences among treatment-seeking adults with cannabis use disorder: clinical profiles of women and men enrolled in the achieving cannabis cessation\u0026ndash;evaluating N-acetylcysteine treatment (ACCENT) study. Am J Addict. 2017;26(2):136\u0026ndash;144. https://doi.org/10.1111/ajad.12503.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCuttler C, Mischley LK, Sexton M. Sex differences in cannabis use and effects: a cross-sectional survey of cannabis users. Cannabis Cannabinoid Res. 2016;1(1):166\u0026ndash;175. https://doi.org/10.1089/can.2016.0010.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFairman BJ. Trends in registered medical marijuana participation across 13 U.S. states and the District of Columbia. Drug Alcohol Depend. 2016;159:72\u0026ndash;79. https://doi.org/10.1016/j.drugalcdep.2015.11.015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKerridge BT, Pickering R, Chou P, Saha TD, Hasin DS. DSM-5 cannabis use disorder in the national epidemiologic survey on alcohol and related conditions-III: gender-specific profiles. Addict Behav. 2018;76:52\u0026ndash;60. https://doi.org/10.1016/j.addbeh.2017.07.012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev. 2018;66:12\u0026ndash;23. https://doi.org/10.1016/j.cpr.2017.10.012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWendel AV, Walters KJ, Tomko RL, Rojewski AM, McClure EA. Evaluating racial disparities in cancer patient\u0026ndash;provider communication about cannabis in a state without a legal cannabis marketplace. Support Care Cancer. 2025;33(2):78. https://doi.org/10.1007/s00520-024-09131-9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMontgomery L, Dixon S, Mantey DS. Racial and ethnic differences in cannabis use and cannabis use disorder: implications for researchers. Curr Addict Rep. 2022;9(1):14\u0026ndash;22. https://doi.org/10.1007/s40429-021-00404-5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKnoebel RW, Starck JV, Miller P. Treatment disparities among the Black population and their influence on the equitable management of chronic pain. Health Equity. 2021;5(1):596\u0026ndash;605. https://doi.org/10.1089/heq.2020.0062.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHill ML, Loflin M, Nichter B, Na PJ, Herzog S, Norman SB, Pietrzak RH. Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms. J Trauma Stress. 2022;35(4):1154\u0026ndash;1166. https://doi.org/10.1002/jts.22823.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkey SA, Waddell JT, Shah RV, Kennedy GM, Frangos MP, Corbin WR. An ecological examination of indica versus sativa and primary terpenes on the subjective effects of smoked cannabis: a preliminary investigation. Cannabis Cannabinoid Res. 2023;8(5):857\u0026ndash;866. https://doi.org/10.1089/can.2022.0213.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuro A, Cladellas R, Castella J. Cannabis and its different strains. Exp Psychol. 2021;68(2):57\u0026ndash;66. https://doi.org/10.1027/1618-3169/a000510.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrodie HG, Hathaway BA, Li A, Baglot SL, Kaur S, Hill MN, Winstanley CA. Divergent effects of oral cannabis oil extracts marketed as C. indica or C. sativa on exertion of cognitive effort in rats. Behav. Neurosci. 2023;137(1):41. https://doi.org/10.1037/bne0000535.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcPartland JM, Small E. A classification of endangered high-THC cannabis (Cannabis sativa subsp. indica) domesticates and their wild relatives. PhytoKeys. 2020;144:81\u0026thinsp;\u0026minus;\u0026thinsp;12. https://doi.org/10.3897/phytokeys.144.46700.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLapierre \u0026Eacute;, Monthony AS, Torkamaneh D. Genomics-based taxonomy to clarify cannabis classification. Genome. 2023;66(8):202\u0026ndash;211. https://doi.org/10.1139/gen-2023-0005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePearce DD, Mitsouras K, Irizarry KJ. Discriminating the effects of Cannabis sativa and Cannabis indica: a web survey of medical cannabis users. J Altern Complement Med. 2014;20(10):787\u0026ndash;791. https://doi.org/10.1089/acm.2013.0190.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoang C, Holmes LM, Ling PM. Dispensing medical advice: San Francisco Bay Area budtender recommendations for pain and sleep relief. Cannabis. 2025;8(3):1\u0026ndash;8. https://doi.org/10.26828/cannabis/2025/000328.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLigresti A, De Petrocellis L, Di Marzo V. From phytocannabinoids to cannabinoid receptors and endocannabinoids: pleiotropic physiological and pathological roles through complex pharmacology. Physiol Rev. 2016;96(4):1593\u0026ndash;1659. https://doi.org/10.1152/physrev.00002.2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eClobes TA, Mee MM, Jimenez JM, Maldonado J, Song JR. Impact of healthcare provider awareness and guidance on the medical cannabis experience. Med Cannabis Cannabinoids. 2025;8(1):47\u0026ndash;57. https://doi.org/10.1159/000544125.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhaskar A, Bell A, Boivin M, Briques W, Brown M, Clarke H, et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res. 2021;3(22). https://doi.org/10.1186/s42238-021-00073-1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZolotov Y, Temple LM, Isralowitz R, Gorelick DA, Abraham R, Abrams DI, Barich K, Boehnke KF, Dahmer S, Friedman J, Frye P, Haramati A, Issac J, Mathre ML, McNabb ME, Ring M, Russo EB, Slawek DE, Temple BR, Kogan M. Developing medical cannabis competencies: a consensus statement. JAMA Netw Open. 2025;8(10):e2535049. https://doi.org/10.1001/jamanetworkopen.2025.35049.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFisher B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, et al. Lower-risk cannabis use guidelines: a comprehensive update of evidence and recommendations. Am J Public Health. 2017;107(8):e1\u0026ndash;12. https://doi.org/10.2105/AJPH.2017.303818.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFederation of State Medical Boards. CME requirements for medical marijuana: state-by-state overview. Washington (DC): Federation of State Medical Boards; 2024. Available from: https://www.fsmb.org/siteassets/advocacy/key-issues/medical-marijuana-cme-requirements.pdf.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNew Jersey Cannabis Regulatory Commission. A guide to the medical cannabis program for healthcare practitioners. 2026 [cited 2026 Jan 5]. Available from: https://www.nj.gov/cannabis/medicinalcannabis/health-care-providers/.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNew Jersey Cannabis Regulatory Commission. 2023 annual report on the medical cannabis program. Trenton (NJ): NJ State Library; 2024 Sep 19. [cited 2026 Jan 5]. Available from: https://dspace.njstatelib.org/server/api/core/bitstreams/098c6b3f-6be2-49bf-96cd-9c9853ce9ce1/content.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu M, Zhao K, Fils-Aime F. Response rates of online surveys in published research: a meta-analysis. Comput Hum Behav Rep. 2022;7:100206. https://doi.org/10.1016/j.chbr.2022.100206.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Demographic Characteristics and Characteristics of Medical Cannabis Program Enrollment and Medical Cannabis Use\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMCP Patients\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;228)\u003c/p\u003e \u003cp\u003e% or Mean (SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMean Age\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.19 (14.43)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender Minority\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cem\u003eRace/Ethnicity\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfrican American\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eMarital Status\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried or Living As\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced/Separated/Widowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eEducation\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess Than High School or High School Grad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSome College\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege Grad+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cem\u003eEmployment\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eStatus\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFull-Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePart-Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed, Looking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed, Other (Retired, disabled, student, etc.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMCP Enrollment Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eYear of MCP Enrollment\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2017 or before\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2018\u0026ndash;2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2021\u0026ndash;2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cem\u003eWho First Suggested MC as Treatment\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe Patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFriends/Family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary Care Provider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther Specialist/Clinician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eWho Certified Patient for MC\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary Care Provider\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther Specialist/Clinician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNew Provider for MCP Certification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eMedical Enrollment Visit Type\u003c/em\u003e\u003csup\u003e\u003cem\u003e1\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSaw the Provider in Person\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSaw the Provider Online Only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"7\" rowspan=\"8\"\u003e \u003cp\u003e\u003cem\u003ePatient Qualifying Conditions for MC Card\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChronic Pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost Traumatic Stress Disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMigraines\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInflammatory Bowel Disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultiple Sclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMedical Cannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eFrequency of MC Use in the Last Three Months\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnce a Month or Less\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGreater Than Monthly, but Not Daily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eFrequency of MC Use on Days Used\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnce a Day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;3 Times a Day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026thinsp;+\u0026thinsp;Times a Day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cem\u003eMost Frequent Mode of MC Administration in Last 12 Months\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSmoking (Joint Pipe, Bong)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEdibles and Beverages\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVaping (Cartridge or Bud)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther (Tinctures, Pills, Syringe)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eCannabis Strains Preferred for Treating Primary Qualifying Condition Overall\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSativa Dominant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndica Dominant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHybrid Strains or Used Sativa and Indica Equally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cem\u003ePerceived Effectiveness of Cannabis in Treating Primary Qualifying Condition\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 50% Effective\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50%-75% Effective\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76%-89% Effective\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90%+ Effective\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"9\" rowspan=\"10\"\u003e \u003cp\u003e\u003cem\u003eAcute Adverse Side Effects of MC Experienced in the Last 12 Months\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperienced Any Adverse Side Effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePanic Reactions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFeeling Faint/Dizzy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisassociation/Depersonalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParanoia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNausea/Vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFlashbacks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHallucinations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDeveloped a Tolerance to Medical Cannabis\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eUses Cannabis Recreationally AND Medicinally\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cem\u003eMarijuana Problem Scale Responses\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo problems on all items\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne or more minor problems but no major problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne or more major problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003csup\u003e1\u003c/sup\u003e\u003cem\u003eMCP patients who saw a new provider for MCP Certification only (n\u0026thinsp;=\u0026thinsp;145)\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003csup\u003e2\u003c/sup\u003e\u003cem\u003eOpioid Use Disorder, Dysmenorrhea, Seizure Disorder, Glaucoma, HIV or AIDs, Intractable Skeletal Spasticity, Muscular Dystrophy\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBivariate Associations Between MCP Patient Characteristics and Receipt of Health Provider Advice about Medical Cannabis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReceived Health Provider Advice about Medical Cannabis\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;127)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDid NOT Receive Health Provider Advice about Medical Cannabis\u003c/p\u003e \u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;101)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDemographic Characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean or % (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean or % (SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eX\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e or F\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.109\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e18\u0026ndash;35\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e36\u0026ndash;49\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e50+\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.238\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMale\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFemale/Other\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace/Ethnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.036\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eWhite\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eBlack\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eHispanic\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOther\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMarried or Living as Married\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNever Married\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDivorced/Widowed/Separated\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.189\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eLess Than High School or High School Grad\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSome College\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eCollege +\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.858\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFull-Time\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePart-Time\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eUnemployed\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMCP Enrollment Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCertifying Health Provider\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePrimary Care Provider\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMedical Specialist or Other Established Provider\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMC Specialist Seen in Person\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMC Specialist Seen Online Only\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary Qualifying Medical Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eAnxiety\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePain\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePTSD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOther\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eYear Enrolled in MCP\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e2013\u0026ndash;2020\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003e2021 or later\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCannabis Use Characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePreferred Strain for Primary Qualifying Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSativa\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eIndica\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eHybrid or Equal Use of Both\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMost Frequent Mode of Delivery\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSmoke\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eVape\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eEat or Drink\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOther\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFrequency of Medical Cannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.647\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMonthly or Less\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMore than Monthly but Less Than Daily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDaily\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRecreational Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.922\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eUses Recreationally AND Medicinally\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eUses Medicinally Only\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDeveloped Tolerance to Cannabis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.143\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eYes\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eNo\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMean Number of Adverse Effects from Cannabis Use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.39 (0.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.58 (0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceived Effectiveness of Cannabis in Treating Primary Qualifying Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74.08 (20.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.05 (25.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMean Score on Marijuana Problem Scale (MPS) Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.53 (3.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.82 (3.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.501\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-cannabis-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jcan","sideBox":"Learn more about [Journal of Cannabis Research](https://jcannabisresearch.biomedcentral.com/)","snPcode":"42238","submissionUrl":"https://submission.springernature.com/new-submission/42238/3","title":"Journal of Cannabis Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8758519/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8758519/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: To ensure medical oversight in an environment of rapidly expanding medicinal cannabis use, states have established a framework of state-sponsored medicinal cannabis programs (MCPs), with regulatory standards governing qualifying medical conditions and care-monitoring by authorized health providers. Whether MCP regulations strengthen medical oversight, however, is unclear, given the notable lack of research into health communications and provider practices within MCPs. This paper addresses this gap by providing information from the patient’s perspective about medical information-seeking and advice within New Jersey’s MCP, including the types of cannabis-related medical advice patients desired, sources of information and the factors affecting the receipt or non-receipt of medical guidance from MCP-authorized providers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Adult (18+) registered medicinal cannabis users (n = 228) were recruited for this online study as part of a larger, population-based, statewide survey of New Jersey cannabis users conducted in 2022–2023. Respondents were questioned about medical advice sought and received with respect to dosage, side effects, tolerance, withdrawal symptoms and strains. Descriptive statistics, chi-square analysis, ANOVA and multivariable logistic regression were used as appropriate to describe patients’ information-seeking behaviors and identify factors associated with receiving advice from MCP-authorized health providers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Findings revealed a sizeable communication gap between patients and their MCP-affiliated providers. Only 52% received advice from their provider in any of the five topic areas studied while dispensary staff provided information to 85% of patients. The primary driver of patient-provider non-communication was online certification with a medicinal cannabis specialty provider. Patients certified by a cannabis specialist \u003cem\u003ein person\u003c/em\u003e or by an established provider, such as their primary care provider, were three-four times more likely to have received information than patients certified online. Primary care providers, however, were significantly underrepresented among MCP-authorized providers. Women, patients over age 50 and patients with PTSD were also less likely than others to receive provider advice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: While some states require in-person only certification and monitoring, New Jersey and other states permit all medical monitoring to be conducted virtually. More stringent state requirements surrounding MCP provider training, patient certification and care management may enhance medical oversight while ensuring safer cannabis use and more effective outcomes.\u003c/p\u003e","manuscriptTitle":"Is There a Doctor in the House? Patient Experiences Regarding Information-Seeking and Provider Advice in New Jersey’s Medicinal Cannabis Program","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-10 00:39:39","doi":"10.21203/rs.3.rs-8758519/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-30T10:34:33+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-29T08:47:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-26T20:46:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"201998333043489971536370066282477243172","date":"2026-02-11T23:26:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"253504657869903405782197828703169062295","date":"2026-02-11T18:40:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317955977995238127571262282797143640341","date":"2026-02-09T23:53:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-09T16:01:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"11718167941336104633385294117989529740","date":"2026-02-09T14:47:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"278467809435796199411223733147650316133","date":"2026-02-05T22:55:50+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-05T10:08:34+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-05T01:22:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-04T09:26:19+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Cannabis Research","date":"2026-02-01T19:33:48+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-cannabis-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jcan","sideBox":"Learn more about [Journal of Cannabis Research](https://jcannabisresearch.biomedcentral.com/)","snPcode":"42238","submissionUrl":"https://submission.springernature.com/new-submission/42238/3","title":"Journal of Cannabis Research","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f574548b-6dcd-4824-89fc-29d21cbfb5a7","owner":[],"postedDate":"February 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-14T13:38:21+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-10 00:39:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8758519","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8758519","identity":"rs-8758519","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}