The natural history of marijuana use among young adult medical marijuana patients in Los Angeles

Background: The legalization of medical marijuana in California in 1996 was a step towards providing more medical alternatives to individuals with chronic health conditions. Since then, studies have focused primarily on the medicinal benefits of marijuana and/or patient characteristics among adults, but focused less on young adults who might be most vulnerable to the effects of marijuana use and are among the most impacted by legislative changes regarding access to marijuana. Specifically, limited data exist on health histories of young adult medical marijuana patients, their motives and patterns of marijuana use before and after getting a doctor's recommendation and the role of medical marijuana dispensaries on their motives and use behaviors. Methods: A total of 40 young adults (aged 18 to 26), who had a valid doctor's recommendation for medical marijuana use, were recruited in Los Angeles to complete a quantitative survey as well as a semi-structured qualitative interview in 2014-15. Study participants were asked about health histories, their motivations for marijuana use before and after obtaining recommendation, how their health condition was linked to marijuana use, and their perception on medical marijuana dispensaries. Simple descriptive analysis was utilized to present frequency results from the quantitative survey. A qualitative thematic analysis was used to analyze transcripts and results present the main themes extracted from the interviews. In addition, geospatial analysis was applied to assess the accessibility of dispensaries. Results: Initial reasons to use marijuana were not linked up to participants' health histories even though all experienced one or more medical conditions in their teenage and/or young adulthood period. The majority of the participants discovered the medicinal benefits of marijuana either before or after becoming a medical marijuana patient and a minority of them continued using marijuana largely for recreational purposes. For a majority of participants, early health histories and motivations for use linked up the reason reported to the doctor for getting the recommendation. Participants' marijuana use increased during the early phase after obtaining a medical marijuana recommendation. After a while, a majority found a balance between their marijuana use and life responsibilities. Medical marijuana dispensaries reported by the participants can be roughly categorized into two types: professional and transactional. Professional dispensaries offered quality customer service. Dispensaries were spread across almost all parts of Los Angeles but participants were generally willing to travel a long distance to reach their primary dispensary of choice. Conclusions: Young adult medical marijuana patients experienced various health conditions in their teenage and/or young adulthood period. For a majority, their health condition served as a strong motivating factor to continue to use marijuana and ultimately, to seek a doctor's recommendation for medical marijuana. Legal access to marijuana resulted in more marijuana use. After a while, marijuana use stabilized in accordance with their life responsibilities. Results also suggest the importance of professional medical marijuana dispensaries in educating patients.