More than half of Arkansas residents who used medical marijuana in 2021 used the drug as a painkiller, and a large portion of patients used it to treat post-traumatic stress disorder, according to results of a study presented to state lawmakers on Wednesday.
The study, conducted by the Arkansas Center for Health Improvement, is the first population-based study of medical marijuana funded by a federal health agency, the National Institutes of Health.
As of this month, more than 3% of adults in Arkansas have received permission from their doctors to use the drug to treat one or more of the 18 conditions approved in the state. The state currently has more than 105,000 cardholders, an increase of about 29,000 in three years, according to ACHI’s study.
Lawmakers on the Joint Committee on Public Health, Welfare and Labor asked ACHI CEO Dr. Joe Thompson for more detailed data and raised concerns about some of the information in the study, such as the fact that a third of medical marijuana card certifications in 2021 came from just seven doctors and in many cases there was little evidence of a doctor-patient relationship.
Thompson said ACHI is seeking additional federal funding to further research the use of medical marijuana, including the prevalence of substance-related disorders among users.
“There is very little clinical research because there is no government funding for clinical research. So we don’t know much about marijuana other than anecdotal reports and small studies,” Thompson said.
Arkansas residents voted to legalize cannabis for medical purposes via a constitutional amendment in 2016, but the first products were not sold until 2019. Five years later, medical marijuana has grown into a billion-dollar industry with 37 dispensaries across Arkansas.
Marijuana is illegal at the federal level because it is classified as a Schedule I controlled substance. The Drug Enforcement Administration has recommended that the Department of Justice reclassify it to Schedule III, the category for regulated but legal substances.
Thirty-eight states and the District of Columbia have legalized marijuana to some degree, and Arkansas is one of 14 states where the drug is legal for medical purposes only.
Doctors are not allowed to prescribe specific amounts or dosages because of marijuana’s current federal status compared to other drugs, said committee co-chair Sen. Missy Irvin (R-Mountain View), in response to questions from some lawmakers.
Cardholders visit pharmacies on average every 11 days and the amount of product sold daily “far exceeds existing clinical recommendations” for consumption, the report said.
All dispensaries must have pharmacists on staff who can offer advice on marijuana distribution, but most of these dispensaries operate out of homes, and several facilities employ the same few pharmacists, Thompson says.
Findings and concerns
The study drew on a number of data sources, including the state medical board’s licensing database and the All-Payer Claims Database, which, according to the study’s website, tracks “how and where health care is delivered and how much is spent on it.”
The APCD showed that in 2021, about 92% of medical marijuana card holders had seen a doctor in the previous year and 62% had seen a doctor for a diagnosed condition that they treated with medical marijuana, the report said.
The study examined the clinical effects of medical marijuana on conditions commonly treated with it. The data showed that there was no significant difference in prescription drug use among PTSD patients, regardless of whether they took medical marijuana or not, the report said. However, non-users of medical marijuana were more likely to be hospitalized for PTSD symptoms than those who took the drug for the disease.
Researchers have found no evidence that medical use of marijuana plays a role in the opioid epidemic, Thompson said in response to a question from Senator Fred Love (D-Mabelvale).
Thompson made several policy recommendations to the committee based on the study’s findings, including tightening requirements for doctors to prove their relationship with patients to whom they issue medical marijuana cards, changing purchase limits based on consumption recommendations, and creating stricter enforcement policies to prevent users from giving away or selling unused products.
Republican Rep. Zack Gramlich of Fort Smith expressed concern that the growth of the medical marijuana industry could inadvertently give children access to marijuana products. Medical marijuana card holders must be at least 18 years old.
“Children who would normally never come into contact with such things now have a connection to them,” says Gramlich, referring to his experience as a middle school teacher.
Thompson said he is aware of the “real challenge” parents and educators face in trying to keep their children away from controlled substances, but he was unaware of any existing state ways to identify medical marijuana card holders who have children.
Senator Linda Chesterfield (D-Little Rock) said she would like to see greater government oversight of the medical marijuana industry to ensure that “from seed to sale, we make sure the product is a good product.”
She also said she was more concerned about “the industry itself” and that pharmacies were run by very few people, even though there were dozens of establishments and owners across the state.
A Little Rock law firm was sued last year in Pope and St. Francis counties for fraud and attorney negligence over its efforts to form ownership groups to obtain four of the state’s first 32 dispensary licenses in 2019. The defendants responded with a defamation suit in Pulaski County District Court. Both cases are pending.
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