Marijuana as a substitute for alcohol and other drugs among medical marijuana users from a cluster-based sample of dispensaries in los angeles county (LAC)

Introduction: The use of marijuana for medicinal purposes is growing, yet little research exists on how and why individuals use medical marijuana (MM). This study examines overall health profiles, behaviors, and the practice of substitution (of another drug) among medical marijuana users in LAC.

Methods: MM dispensaries were randomly sampled in proportion to their distribution throughout the county, with varying survey recruitment days/times to maximize sampling variability. 182 clients from 13 dispensaries completed the survey. The majority (74%) were male; ages ranged from 17 to 63 (Mean=28.4). Racial/ethnic breakdown: 44% white, 26% Hispanic, 13% African American, 6% Asian/Pacific Islander, 7% multi-ethnic, and 4% other. 55% had some college education, and 45% worked full time. Results: Mean age of first marijuana use was 17.2 (SD=5.3), and average duration of MM use was 2.5 years. MM was used equally for physical health and mental health conditions. Nearly all (91%) believed that use of MM has helped them “very much”. 21% reported misuse of illicit drugs; 46% reported risky alcohol use; and 44% smoked cigarettes. Over half (58.4%) used MM as a substitute for prescription drugs, 41.2% for alcohol, and 30% for other illicit drugs. Clients preferred MM because it is “natural,” has less adverse side effects, and is more effective. Conclusions: Medical marijuana is often used as a substitute to reduce the negative outcomes associated with prescription drugs, alcohol, or other illicit drugs. Therefore, health interventions targeted at MM users should address this substitution practice within the framework of harm reduction.