{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:01:39Z","timestamp":1792530099600,"version":"4.5.0"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP2030765"],"award-info":[{"award-number":["APP2030765"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000036","name":"Institute of Population and Public Health","doi-asserted-by":"publisher","award":["PJT\u2010153342"],"award-info":[{"award-number":["PJT\u2010153342"]}],"id":[{"id":"10.13039\/501100000036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To identify variation in identification of medical consumers using alternative self\u2010reported 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of wave 4 (2021) of the International Cannabis Policy Study (ICPS) cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>United States, Canada and Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>16\u2009951 (USA 10\u2009472; CAN 5935; AUS 544) respondents who completed the survey and reported past year cannabis use across the three jurisdictions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>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\u2010grade product), therapeutic use (i.e. to manage physical or mental health conditions) and self\u2010identified medical cannabis use. Country\u2010specific differences were compared and discussed in light of measure and differing cannabis policies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>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)\u2009=\u200976.4%\u201378.2%] than any other measure of medical use. While just over one quarter (28.2%; 95%\u00a0CI\u2009=\u200927.3%\u201329.2%) self\u2010identified as a medical user, fewer reported being potentially authorized (22.8%; 95%\u00a0CI\u2009=\u200922.0%\u201323.7%) or having a pharmaceutical prescription from a medical professional (12.3%; 95%\u00a0CI\u2009=\u200911.6%\u201313.0%). Australians (27.2%; 95%\u00a0CI\u2009=\u200923.0%\u201331.4%) and Americans (25.9%; 95%\u00a0CI\u2009=\u200924.6%\u201327.2%) were more likely to report potentially authorized use than Canadians (17.3%; 95%\u00a0CI\u2009=\u200916.1%\u201318.4%), but only Australians (27.4%; 95%\u00a0CI\u2009=\u200923.6%\u201331.2%) reported high levels of prior use of a pharmaceutical\u2010grade cannabinoid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70117","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:16:46Z","timestamp":1751357806000},"page":"2141-2146","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Understanding medical cannabis use internationally: Why definitions and context matter"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0618-7497","authenticated-orcid":false,"given":"Myfanwy","family":"Graham","sequence":"first","affiliation":[{"name":"Monash Addiction Research Centre Monash University  Melbourne VIC Australia"},{"name":"Centre for Drug Repurposing and Medicines Research Hunter Medical Research Institute  Newcastle NSW Australia"},{"name":"Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6145-9865","authenticated-orcid":false,"given":"Rosalie Liccardo","family":"Pacula","sequence":"additional","affiliation":[{"name":"Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2942-3974","authenticated-orcid":false,"given":"Seema Choksy","family":"Pessar","sequence":"additional","affiliation":[{"name":"Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yimin","family":"Ge","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Bloomberg School of Public Health  Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra F.","family":"Kritikos","sequence":"additional","affiliation":[{"name":"Schaeffer Center for Health Policy &amp; Economics University of Southern California  Los Angeles CA USA"},{"name":"NORC University of Chicago  Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1984-0096","authenticated-orcid":false,"given":"Wayne","family":"Hall","sequence":"additional","affiliation":[{"name":"Centre for Youth Substance Abuse Research University of Queensland  Brisbane QLD Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8197-6010","authenticated-orcid":false,"given":"David","family":"Hammond","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences University of Waterloo  Waterloo ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13910"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.27735"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6613"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-22755-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2023.03.007"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.05266"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2016.1160932"},{"key":"e_1_2_10_9_1","volume-title":"International cannabis policy study technical report \u2013 Wave 4","author":"Corsetti D","year":"2021"},{"key":"e_1_2_10_10_1","volume-title":"Cannabis report","author":"National Conference of State Legislatures (NCSL)","year":"2024"},{"key":"e_1_2_10_11_1","volume-title":"Legislative review of the Cannabis Act: Final report of the Expert Panel","author":"Health Canada","year":"2024"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.104210"},{"key":"e_1_2_10_13_1","volume-title":"International cannabis policy study survey","author":"Hammond D","year":"2021"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.18356\/9789210028233c024"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2024.307721"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T05:18:17Z","timestamp":1757654297000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":14,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/add.70117"],"URL":"https:\/\/doi.org\/10.1111\/add.70117","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"assertion":[{"value":"2025-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}