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Record W4411885468 · doi:10.1111/add.70117

Understanding medical cannabis use internationally: Why definitions and context matter

2025· article· en· W4411885468 on OpenAlexafffundabout
Myfanwy Graham, Rosalie Liccardo Pacula, Seema Choksy Pessar, Yimin Ge, Alexandra F. Kritikos, Wayne Hall, David Hammond

Bibliographic record

VenueAddiction · 2025
Typearticle
Languageen
FieldMedicine
TopicCannabis and Cannabinoid Research
Canadian institutionsUniversity of Waterloo
FundersInstitute of Population and Public HealthNational Health and Medical Research CouncilCanadian Institutes of Health Research
KeywordsCannabisContext (archaeology)MedicineMedical cannabisMedical prescriptionMental healthEnvironmental healthPsychiatryFamily medicineGeographyNursing

Abstract

fetched live from OpenAlex

AIMS: To identify variation in identification of medical consumers using alternative self-reported measures and assess whether differences in these rates exist across jurisdictions with different medical policy approaches using evidence from an international study on cannabis use. DESIGN: Secondary analysis of wave 4 (2021) of the International Cannabis Policy Study (ICPS) cross-sectional survey. SETTING: United States, Canada and Australia. PARTICIPANTS: 16 951 (USA 10 472; CAN 5935; AUS 544) respondents who completed the survey and reported past year cannabis use across the three jurisdictions. MEASUREMENTS: Four different medical cannabis use measures were available, and rates of each were estimated using logistic regression methods that adjusted for age, gender, education and ethnicity. Medical cannabis use measures included potentially authorized use (i.e. involving a licensed health professional recommendation, authorization or prescription), pharmaceutical use (i.e. involving a pharmaceutical-grade product), therapeutic use (i.e. to manage physical or mental health conditions) and self-identified medical cannabis use. Country-specific differences were compared and discussed in light of measure and differing cannabis policies. FINDINGS: In wave 4 of the ICPS, 34.0% reported any past year cannabis use, but rates of medical use differed significantly according to the specific question. Far more individuals reported therapeutic use in the past year across all countries [77.3%; 95% confidence interval (CI) = 76.4%-78.2%] than any other measure of medical use. While just over one quarter (28.2%; 95% CI = 27.3%-29.2%) self-identified as a medical user, fewer reported being potentially authorized (22.8%; 95% CI = 22.0%-23.7%) or having a pharmaceutical prescription from a medical professional (12.3%; 95% CI = 11.6%-13.0%). Australians (27.2%; 95% CI = 23.0%-31.4%) and Americans (25.9%; 95% CI = 24.6%-27.2%) were more likely to report potentially authorized use than Canadians (17.3%; 95% CI = 16.1%-18.4%), but only Australians (27.4%; 95% CI = 23.6%-31.2%) reported high levels of prior use of a pharmaceutical-grade cannabinoid. CONCLUSIONS: In the International Cannabis Policy Study, the proportion of respondents (adjusted for demographic factors) who reported medical use varied depending on the measures used within and between countries.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.636
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.076
GPT teacher head0.314
Teacher spread0.238 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations3
Published2025
Admission routes3
Has abstractyes

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