What we’ve learned since the declaration of the pandemic

The COVID-19 pandemic is impacting almost every aspect of people’s lives, even including how they access and consume cannabis. 

To learn about these changes, the team I lead at the Cannabis Health & Fitness Laboratory at the University of Miami has been gathering survey data from cannabis consumers across the globe since mid-March. To raise awareness of our efforts and to ensure the participation of a broad spectrum of this population, a multisite collaborative of clinical, epidemiological, and behavioral researchers from the University of Texas School of Public Health, SUNY Downstate Medical Center, and the University of North Carolina Lineberger Cancer Center joined with clinicians and public interest groups — including the National Organization for the Reform of Marijuana Laws (NORML). Participant responses are kept anonymous.

The preliminary data from over 2,000 self-identified cannabis consumers in 46 countries are not only informative but also has implications for public policy. Not surprisingly, the rapid spread of COVID-19 has influenced longstanding social mores surrounding the use of cannabis. For instance, a portion of self-identified cannabis consumers report changing their route of use since the pandemic was declared. Among those that changed how they consumed cannabis, there was a reduction of inhaled methods. About 38 percent of respondents who reported using cannabis-inhaled products indicated they have now stopped sharing them with others.

Cannabis consumers who stopped sharing and inhaling cannabis are in accord with World Health Organization recommendations. These recommendations currently call for both physical distancing and for mitigating or eliminating one’s exposure to combustive smoke due to potential adverse effects on both the lungs and the immune system.

Moreover, many of our respondents reported concern about access to medical cannabis, which is understandable. About one-half of respondents have one month or more supply of medical cannabis on hand; however, over one-third of respondents have no more than a two-week supply.

The inability of these patients to stockpile substantial supplies of their medicine is likely influenced by the comparatively high cost of medicinal cannabis products; and, the reality that these products are seldom if ever, covered by conventional insurance plans. In the US, medicinal cannabis dispensaries are predominantly cash-only. Our data shows that over half of respondents were worried about their ability to continue to pay for medical cannabis during this global public health crisis.

Based on what we have learned so far from the study, it is apparent that many cannabis consumers have pre-existing chronic health conditions such as anxiety, depression, and cardiometabolic disease risk. While research is underway to evaluate the impact of COVID-19 on vulnerable populations, there is a lack of collective prevention and intervention programs to reduce the impact of the pandemic, or the virus itself, among medicinal cannabis consumers. 

Since COVID-19 was declared a pandemic, lawmakers and regulators in over 20 states have designated state-licensed cannabis dispensaries as “essential services.” This allows medicinal cannabis dispensaries to remain open during the pandemic. Because many patients who service these retailers must make repeated trips to purchase their medicine in limited quantities to be affordable, this ensures an uninterrupted medicinal supply. It also recognizes that these vulnerable persons should not be abruptly cut off from their established supply chains or inadvertently directed toward the illicit market during this crisis. Products available in the illicit market may potentially be tainted or adulterated and may further compromise patients’ health.

Of course, there remains much more to learn. In the coming weeks, we will be continuing to gather data and analyze responses. It is our hope that this epidemiological data will not only provide important information with respect to both the health and welfare of cannabis consumers during this pandemic, but also assist in guiding lawmakers, regulators, and health officials to craft evidence-based public policies to best address the unique needs of this community. 

Globally, qualifying conditions for medical cannabis, though not uniform, include those with compromised immune systems and other chronic health conditions. This was corroborated by the preliminary results of our study. Therefore, medicinal cannabis consumers comprise a population that we should not marginalize in our global effort to “flatten the curve.” Yes, in some states, medicinal cannabis patients have access via “essential services” designation; but, what about the states and countries that do not.

Dr. Denise C. Vidot is a cannabis epidemiologist and assistant professor at the University of Miami School of Nursing and Health Studies. Paul Armentano is the deputy director of the National Organization for the Reform of Marijuana Laws (NORML). Armentano is not involved with the Cannabis Health & Fitness Laboratory.