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This study explores the use patterns of people who use cannabis for medicinal-only and combined medicinal and recreational use after implementation of Proposition 64.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A quantitative, population-based online questionnaire included 4,020 current cannabis users, 523 former users, and 635 non-users. This analysis focuses on participants who self-identified as using cannabis for medicinal-only (<jats:italic>n<\/jats:italic>\u2009=\u2009711) or both medicinal and recreational (M\u2009+\u2009R, <jats:italic>n<\/jats:italic>\u2009=\u20091719) purposes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Sixty one percent of current cannabis users report medicinal use. Medicinal-only users were more likely to be female (OR 1.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), have kids in household (OR 1.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and\u00a0began cannabis use later (mean age 34 vs. 23, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Pain relief was the predominant reason for use, followed by sleep, anxiety, and stress relief. While both groups reported positive effects, M\u2009+\u2009R users experienced more negative side effects. Fewer medicinal-only users cited a desire to \u201cfeel the high,\u201d (42% vs. 75% M\u2009+\u2009R, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Medicinal-only users felt less comfortable discussing cannabis with primary care providers than M\u2009+\u2009R users (75% vs 83%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). All users were more likely to seek information online (44\u201357%) or from friends\/family (47\u201352%) than health professionals (26\u201327%). Dispensaries were the main cannabis source for both medicinal groups (72% M vs. 84% M\u2009+\u2009R, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), with licensure being very or extremely important (72% M, 66% M\u2009+\u2009R, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Monthly spending for medicinal-only users was lower ($127 vs. $186 for M\u2009+\u2009R, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and they were more likely than M\u2009+\u2009R users to wait before feeling safe to drive after using cannabis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>People who use medicinal cannabis alone vary in key areas from people who use cannabis for both medicinal and recreational reasons. The need for better patient-provider relationships and clinically informed guidance is evident to support medicinal cannabis users.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s42238-025-00285-9","type":"journal-article","created":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T13:11:05Z","timestamp":1752325865000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medicinal and combined medicinal\/recreational cannabis use in California following the passage of Proposition 64"],"prefix":"10.1186","volume":"7","author":[{"given":"Daniel","family":"Ageze","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee","family":"Dell\u2019Acqua","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas D.","family":"Marcotte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill","family":"Rybar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Baird","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice","family":"Gold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Shaughnessy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilene","family":"Lanin-Kettering","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,12]]},"reference":[{"issue":"1","key":"285_CR1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1093\/FAMPRA\/CMAB108","volume":"39","author":"L Adler","year":"2022","unstructured":"Adler L, Zacay G, Schonmann Y, et al. 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