本文由小咖机器人翻译整理

期刊来源：Ann Intern Med

原文链接：https://doi.org/10.7326/M23-2811

摘要内容如下：

背景

随着医用大麻供应的增加，医用大麻许可的最新趋势可以为临床政策和护理提供信息。

客观

描述美国医用大麻许可的当前趋势。

设计

重复措施的生态学研究。

设置

2020年至2022年可公开获得的国家注册数据。

参与者

拥有医用大麻执照的人和在美国授权大麻执照的临床医生。

测量

总患者人数和总人口中每10000人的患病率、患者获得许可资格的症状或条件（即患者报告的资格条件）以及授权临床医生的数量。

结果

2022年，在39个允许医用大麻使用的辖区中，有34个报告了患者数量，19个报告了患者报告的合格条件，29个报告了授权临床医生数量。从2020年（3099096）到2022年（4132098），登记患者增加了33.3%，相应的患者人群患病率增加了23.0%（从2020年的每万人175.0增加到2022年的每万人215.2）。然而，从2020年到2022年，15个有非医疗成人使用法律的管辖区中有13个减少了登记人数。患者报告的具有治疗价值的实质性或结论性证据的合格条件的比例从70.4%（2020年）下降到53.8%（2022年）。2022年，慢性疼痛是最常见的患者报告的合格条件（48.4%），其次是焦虑（14.2%）和创伤后应激障碍（13.0%）。2022年，美国有29500名授权临床医生（每1000名患者中有7.7名），其中53.5%是医生。最常见的专业是内科或家庭医学（63.4%），物理医学和康复（9.1%），麻醉或疼痛（7.9%）。

局限性

数据缺失（例如，来自加利福尼亚州）、描述性分析、缺乏个人使用模式的信息以及不断变化的证据基础。

结论

医用大麻项目的注册人数总体上有所增加，但在有非医用成人使用法律的司法管辖区，注册人数普遍减少。用于没有有力证据基础的条件或症状的情况继续增加。鉴于这些趋势，需要进行更多的研究，以更好地了解医用大麻的风险和益处。

主要资金来源

美国国立卫生研究院国家药物滥用研究所。

英文原文如下：

Abstracts

BACKGROUND  As medical cannabis availability increases, up-to-date trends in medical cannabis licensure can inform clinical policy and care.

OBJECTIVE  To describe current trends in medical cannabis licensure in the United States.

DESIGN  Ecological study with repeated measures.

SETTING  Publicly available state registry data from 2020 to 2022.

PARTICIPANTS  People with medical cannabis licenses and clinicians authorizing cannabis licenses in the United States.

MEASUREMENTS  Total patient volume and prevalence per 10 000 persons in the total population, symptoms or conditions qualifying patients for licensure (that is, patient-reported qualifying conditions), and number of authorizing clinicians.

RESULTS  In 2022, of 39 jurisdictions allowing medical cannabis use, 34 reported patient numbers, 19 reported patient-reported qualifying conditions, and 29 reported authorizing clinician numbers. Enrolled patients increased 33.3% from 2020 (3 099 096) to 2022 (4 132 098), with a corresponding 23.0% increase in the population prevalence of patients (175.0 per 10 000 in 2020 to 215.2 per 10 000 in 2022). However, 13 of 15 jurisdictions with nonmedical adult-use laws had decreased enrollment from 2020 to 2022. The proportion of patient-reported qualifying conditions with substantial or conclusive evidence of therapeutic value decreased from 70.4% (2020) to 53.8% (2022). Chronic pain was the most common patient-reported qualifying condition in 2022 (48.4%), followed by anxiety (14.2%) and posttraumatic stress disorder (13.0%). In 2022, the United States had 29 500 authorizing clinicians (7.7 per 1000 patients), 53.5% of whom were physicians. The most common specialties reported were internal or family medicine (63.4%), physical medicine and rehabilitation (9.1%), and anesthesia or pain (7.9%).

LIMITATION  Missing data (for example, from California), descriptive analysis, lack of information on individual use patterns, and changing evidence base.

CONCLUSION  Enrollment in medical cannabis programs increased overall but generally decreased in jurisdictions with nonmedical adult-use laws. Use for conditions or symptoms without a strong evidence basis continues to increase. Given these trends, more research is needed to better understand the risks and benefits of medical cannabis.

PRIMARY FUNDING SOURCE  National Institute on Drug Abuse of the National Institutes of Health.

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