Greg Rhee and Robert Rosenheck built the analysis on data from the National Survey on Drug Use and Health (NSDUH), a federally administered annual survey running since 1971. In 2013, NSDUH added a direct question: had a doctor recommended cannabis in the prior 12 months? That year, 1.2% of respondents said yes. By 2020, that figure climbed to 2.5% — a more than 100% increase, at an average growth rate of 12.9% per year.
Rhee and Rosenheck hold affiliations with the Yale School of Medicine’s Department of Psychiatry and the VA New England Mental Illness, Research, Education and Clinical Center. By the study’s conclusion, 39 states and Washington, D.C. had enacted legal medical programs. Living in one of those states was a statistically significant predictor of physician-recommended cannabis use.
“This study documents a continued nationwide increase in use of cannabis for diverse medical purposes between 2013 and 2020,” the researchers wrote. “Living in a state that legalized medical cannabis remained significantly associated with greater odds of medical cannabis use.”
Who Shows the Highest Rates of Use?
identified several demographic variables linked to elevated rates of physician-recommended cannabis use. Adults aged 18 to 25, men, people who had never been married, college graduates, and the uninsured all showed significant associations. The researchers noted these associations do not mean those groups necessarily saw greater increases in prevalence over time — only that they appeared more frequently among users in the survey data.The study did not examine how the shift from medical-only to adult-use recreational legalization affected prevalence. The team acknowledged this directly.
“Unfortunately, it’s outside the scope of analysis because we were not able to distinguish states by legalization status,” lead author Rhee explained in an email to Marijuana Moment.
Health Conditions Associated With Cannabis Use
When researchers examined respondents who reported specific conditions, clear clinical patterns emerged. People with poorer self-rated health, a past-year major depressive episode, cocaine use disorder, or non-prescription pain reliever use all showed significantly greater odds of physician-recommended cannabis use.
“The association of medical cannabis use with depression, cocaine use disorder, and non-medical use of pain relievers suggests it may have either been prescribed for those conditions or used on patient initiative,” the authors wrote. They acknowledged the NSDUH data does not provide enough detail to confirm causality.
A Critical Safety Contrast With Opioids
Cannabis does not generally cause fatal overdoses — a stark contrast with opioids that the researchers highlighted directly. Documented risks do exist. Elevated risk of psychosis and motor vehicle accidents rank as the most cited concerns in the literature.
Despite rapid growth in physician-recommended cannabis use, the long-term evidence base remains incomplete. “Medical cannabis is increasingly used,” Rhee said. “But long-term medical benefits and harms are not clearly known for multiple medical conditions. Future studies are needed to weigh effectiveness against safety.”
What the Data Means for Legalization Policy
State-level legalization remains the clearest predictor of physician-recommended cannabis use. Thirty-nine states and Washington, D.C. had already enacted programs within the study period. Legalization has continued expanding since 2020. This growth trend has very likely continued beyond the data cutoff.
The full paper — “Increasing Use of Cannabis for Medical Purposes among US Residents, 2013–2020” — is available in the American Journal of Preventive Medicine. It stands as one of the most comprehensive analyses of physician-recommended cannabis use trends using nationally representative U.S. survey data.
Frequently Asked Questions About Medical Cannabis Use
Has physician-recommended cannabis use actually doubled in the United States?
Yes. A peer-reviewed VA and Yale study found the share of NSDUH respondents reporting physician-recommended use rose from 1.2% in 2013 to 2.5% in 2020 — more than doubling in seven years at an average rate of 12.9% per year.
What is the biggest factor behind this growth?
State-level legalization. Living in a state with a legal cannabis program was a statistically significant predictor of use throughout the study period. As legalization has continued expanding since 2020, this trend has likely continued.
Which groups show the highest rates of use?
The study found significant associations among adults aged 18–25, men, people who have never been married, college graduates, and those without health insurance. Among clinical populations, people with depression, poor self-rated health, cocaine use disorder, or non-prescription pain reliever use also showed higher odds.
What conditions is cannabis most often recommended for?
The NSDUH data does not capture specific diagnoses in granular detail. The findings suggest physician-recommended and patient-initiated use for conditions including depression, pain, and substance use disorders, among others.
Is cannabis safer than opioids?
Unlike opioids, cannabis does not typically cause fatal overdoses. Documented risks include elevated risk of psychosis and impaired driving. The study’s authors stressed that long-term safety and efficacy data across conditions remains limited and called for more research.