More than half of patients stopped medical cannabis within a year, especially older adults. Discontinuation was unrelated to pain type or overall health.
New research shows that more than half of patients prescribed medical cannabis for chronic musculoskeletal pain stop treatment within a year. The findings raise concerns about the drug’s durability as a long-term pain management option, particularly for older adults.
The study, recently published in PLOS One by researchers at the Rothman Institute Foundation for Opioid Research & Education, reported that 57.9 percent of 78 Pennsylvania patients certified for medical cannabis discontinued use within twelve months. Nearly half of these patients—44.7 percent—stopped during the first three months.
Researchers conducted a retrospective review, following patients newly certified through Pennsylvania’s medical marijuana program to determine whether they renewed their certifications or pursued other treatments over a two-year period. Age emerged as the only statistically significant predictor of discontinuation: patients who stopped were, on average, about seven years older than those who continued (71.5 years compared with 64.5 years). Measures of baseline physical and mental health, assessed through PROMIS Global Physical Health and Global Mental Health scores, were similar between the two groups, suggesting that the decision to stop was not linked to overall health status at the outset.
Pain type not a major factor
Contrary to what some pain specialists might assume, the location of a patient’s pain—whether in the lower back, neck, joints, or elsewhere—was not a significant factor in whether they discontinued cannabis treatment. While a slightly larger proportion of those who stopped reported low back pain, the difference was too small to be statistically meaningful. The results instead suggest that a variety of influences, including dissatisfaction with treatment, unwanted side effects, or choosing more definitive procedures such as injections or surgery, may be more important in determining whether patients continue using cannabis.
Co-author Dr. Asif M. Ilyas, President of the Rothman Opioid Foundation in Philadelphia, Professor of Orthopaedic Surgery at Thomas Jefferson University, and Associate Dean of Clinical Research at Drexel University College of Medicine, emphasized that the high rates of discontinuation show that “despite growing enthusiasm and widespread adoption, medical cannabis does not meet expectations for a significant subset of chronic pain patients.”
Lead author Dr. Mohammad Khak added that since pain type and baseline health did not appear to influence continuation, other factors—such as perceived benefit, daily functioning, cost of treatment, or consistency in product quality—are likely to play a more central role in whether patients remain on cannabis therapy.
Study limitations and unanswered questions
The authors caution that their study, while among the first to carefully monitor one-year certification status for medical cannabis in orthopedic pain patients, leaves key questions unanswered. Specific details about cannabis formulation, dosage, and method of delivery were not consistently documented, nor were side effects, functional improvements, or patients’ perceptions of relief. This makes it unclear whether discontinuation was due to a lack of effectiveness, adverse effects, financial burden, or even symptom improvement to the point where cannabis was no longer needed. They also point out that their sample was taken from a single institution’s patient population and may not represent broader trends.
The findings arrive at a time when medical cannabis use is quickly expanding across the United States, highlighting the need for more personalized approaches—especially for older patients, who showed the highest likelihood of stopping use. The research team urges larger, multi-center, prospective studies that collect more detailed data on dosing, delivery methods, side effects, and patient satisfaction, to identify which patients are most likely to benefit from medical cannabis and for how long. Until then, they believe, physicians and patients should approach long-term cannabis therapy with realistic expectations and an openness to adjustments based on early responses.
Reference: “Discontinuation rates and predictors of Medical Cannabis cessation for chronic musculoskeletal pain” by Mohammad Khak, Sina Ramtin, Juliet Chung, Asif M. Ilyas and Ari Greis, 7 August 2025, PLOS ONE.
DOI: 10.1371/journal.pone.0329897
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51 Comments
I would disagree that it’s a failure. As a man with Crohn’s disease, I can tell you first hand that medical marijuana is a success for me.
Disagree. The problem is it grew x10 during covid and niw people cant buy eggs so hard update card…. just simple economics.. I can tell u that in my ring it’s increasing never slowed down.
No socioeconomic controls, no mention if any went recreational to avoid additional cost involved in medical.
This is not a study just a bunch of purely subjective observations by a small group with there own agenda.
Some brands make me more aware of the pain and the pain seems more intense. I prefer the one I’m currently using which is 10 mg CBG and 10 mg of THC and it controls the pain totally and gives me a full 8 hours of sleep for a severe sleep disorder.
It’s not a pain killer, it’s a focus tool and helps sleep .
55 years every day. Sleep focus , pain distractor,….
So people aren’t addicted to it like other pain meds….. hmmmmm…failure for who?
Was this article written by Pfizer?
Is needing medication for life good thing? Imagine if this article was exactly the same, but you swapped marijuana with opiates. OH NO, MOST PEOPLE STOPPED USING IT AFTER A YEAR. Sounds pretty bad huh?
There are so many factors not looked at here, like that most people who get a medical card realize its not worth it when you can still buy weed without it, so why bother renewing? Or that they are no longer in pain and just dont need it any more, ect.
That seems like a rather harsh assessment. They remark, “Furthermore, limited research exists on the reasons for MC discontinuation, which is crucial for optimizing its clinical use.”
This is a retrospective review of the documented results. Inasmuch as the participants were all certified to participate in a formal study, I would be surprised if there were anything but minimal peripheral costs such as transportation. They don’t explicitly say, so you are making an unsupported assumption that economics played a significant role in cessation. The researchers specifically remark that there were no statistical differences in the racial makeup of the two groups and that they all had similar medical insurance.
How would you defend against an accusation that your opinion is similarly “purely subjective?” You might want to ask yourself why you are reacting so strongly to a study where, again without evidence, you assume that the researchers have an “agenda.” Basically, all they said was that the cessation rates were positively correlated with age.
Facts this isn’t a treatment problem it’s a price problem! Why do u think the older people are quitting? There ok social security or a fixed income and want people to pay 300$ for an ounce. I would quit too.
I was thinking the same thing, I will be willing to bet 25% of those who quit just started growing there own or found a non legal supplier.
It the cost… They want u to pay the DHHR for ur registration… Then the product cost itself… Its unaffordable, that’s the issue…
If it wasn’t so expensive I think people wouldn’t stop.. I spend like $400 a month on cannabis. Vape..flower and gummies…
Can you rule out placebo effect? If so, how?
It’s not a pain killer, it’s a focus tool and helps sleep .
So sayeth the opioid industry! Of course they do. They’d prefer we were all on morphine.
This is clearly a tailored study. The test group was only 78 people. That means that the percentage values are larger than the actual number reporting. For instances 50% of 78 is only 39. Completely useless.
Some states have such a hold on the products and accessibility many are pricing out the consumer. Many states do not allow the patient to control their consumption by not allowing the consumer to grow their own. Many states also have a limited amount of growers and variety and choice is an issue. There is a level of monopolies in many states that are controlled by a small group of wealthy or politically connected people. This article misses the mark with not seeing it from the consumer POV.
One would expect that with such a high percentage of people giving it up within a year, I would have met at least a single person who got their med card and quit, instead everyone I know who has gotten their med card still smokes well over a year after getting it
As a former Medical Marijuana Patient, the Medication HELPED immensely, with the pain, with the stress, with increased mobility… my only problem with Medical Marijuana was the freakin’ “COST”.. Retired FIXED INCOME $40, $50, $60, $90 for “ONE” product, get real, Lower those Prices!!! I switched to Online CBD/THC {0.3%} Gummies, etc.. Frequent 15-25% Discounts…
Well, you probably have met people who quit but just didn’t know it since they were not smoking pot anymore.
I do know that I have a neighbor with a med card for pot and she’s tried quitting several times and has always ended up smoking it again. It’s addictive and dangerous. She’s constantly coughing and probably has COPD but still smokes the stuff because she can’t quit it. She’s in her 60s and it’s probably going to kill her.
I knew another woman who had a med card for pot and smoked it a lot. She is in her 50s but exhibited dementia-like or senile thinking. Before I met her and found out her age, we had been emailing and I thought she was in her 80s. Pot ages the brain and makes people stupid. It’s dangerous. She actually believed it was legal for her to drive while smoking the pot because she had the Rx card. I told her it is still a DUI and she didn’t believe me and actually bragged about driving high. Needless to say, I refused to sell her my car. That was partly how we met, she was going to buy my car. No way was I going to let her possibly injure or kill someone with that car. She didn’t have a car at all and lived out of an RV. She desperately needed a car and when I told her the only way I would sell her the car is if she quit the pot, she chose pot. That is how addictive it is.
The people who quit in less than a year of getting the med card are probably the smart ones who recognized the impact it has on their lives and decided it is better to not smoke pot.
Clearly you’ve never used medically or recreational. If you had you would know that the addiction part of it isn’t powerful like how you portrayed your friend and her inability to quit. She goes back to it because of the relief and benefits. The majority of what you said was so far off that I’m really struggling to believe that your not a bot
If you believe that I have some ocean front property in AZ I would like to sell you, beautiful beaches, clear water!
I agree that it’s the price that’s the problem. If my insurance pays for opioids, but not Marijuana, then I’ll choose the former. I learned about how to conduct a reputable study in college and this one failed to apply those set rules. Ignore it.
I have used medical marijuana for 13 years now with great success for management of PTSD and chronic pain.
This study is a complete waste of time… as mentioned above . The scope of the study is very small and it simply does not actually take into account logical reasoning based of the consumer or business providing the product.
I doubt these stats are true. Seems like a funded study to have the facts meet their beliefs.
I just looked at the study. There was no funding.
4 orthopedic surgeons wanted to do a little research to determine whether or not to recommend it to their patients after surgery. The results of that research are in the journal/study.
Also, while I do understand the impulse to immediately question who funded any study and dismiss that study if it was funded by a group or individual who could benefit from a certain result; the simple fact remains that most studies are funded by organizations or individuals who would benefit from a specific outcome.
In other words, by that logic, you would have to dismiss every study that wasn’t crowdfunded or based on research done as part of the on the job responsibilities of doctors and researchers who weren’t provided extra financial incentive (like this study)
You should discount any study based on subjective reporting.
And study not independently reproduced should not even be published.
@Amanda Hugnkiss (I love that joke… classic Bart Simpson calling Moe’s Tavern gag).
This study was based on people not renewing their medical marijuana license… not on subjective reporting.
In fact, the subjective reporting of why they quit would actually make this particular study more valuable.
Subjective reporting is certainly not solid science. But it also cannot be completely dismissed.
When you have a conversation with someone, who tells you about a positive or negative experience they had with any intervention (diet, medication, supplements, exercise, etc), that can be valuable information. That is subjective reporting.
On the same token (but larger scale), if a doctor or researcher has multiple anecdotal reports from patients on an intervention, it’s certainly not as valuable as an RCT where the outcomes are measured in scans or blood values, but it’s still useful information.
The reporting is anything by subjective. They provide a rigorous statistical characterization, unlike anything you have provided.
The whole point of publishing is to inform peers with an interest in what they observed. It is up to those with an interest to attempt to replicate the study. However, somebody has to be first. They remark in the actual study that they got results similar to what others have observed.
The question is did those who quit medical do so in a State that jas recreational? Some don’t believe the cost of a medical card outweighs the cost of added tax to their purchase. I have been on medical for a couple of years and have found that medical use and using to get high aren’t always the same
It definitely depends on the state. In Massachusetts, the cost of the yearly license renewal is 100% worth it, if you’re an every day THC consumer.
But if you’re someone who doesn’t really enjoy getting baked and takes-as-needed for pain, recreational would likely be somewhere between a lot cheaper and the same price (depending on your tolerance and preferred method of ingestion)
I don’t use my real name on news sites. The stats ARE true, they do come from a real study, but this article fails to add needed context.
Go look up how many people cease Opiates which have WAY MORE RISK within a year, and tell me if that 58% number was stupid and dishonest to even mention.
Poor study. I am former medical patient (amputee). The cost of the medical card is too expensive so it doesn’t save me money. If I smoked more marijuana, then I would renew my card because it would save me money. Why must I annually renew my medical card.? My foot did not grow back…
I don’t even see the above reason for not renewing a medical card. I think there are a lot of older folks that may use it some, but their usage may not be enough to justify a medical card.
I think higher quality studies are needed. People who stop renewing their medical marijuana card could be as simple as no longer being able to afford it, or choosing to grow their own.
On the other hand, medical marijuana is like any other natural remedy. There are mixed results.
I know people who claim great results with treatment of glaucoma, pain management and social awkwardness, as well as people who sleep better when they take high CBD and/or CBN edibles or tinctures before bed.
Then again, I also know multiple people who took it for anxiety and said it made them paranoid, which just worsened their anxiety. I personally tried it for gout pain and experienced zero benefit. Even with high dose 1:1 CBD/THC tincture.
In other words, it may be helpful for some, but it is also definitely not helpful for others.
I would like to see this study supplemented with individuals providing their reason for discontinuing medical marijuana. I’d also like to see more studies on the direct effects of THC on inflammatory blood markers.
Side note, for those who prefer smoke to edibles, just exercise caution. All smoke inhalation is bad for your lungs. Holding it in makes it worse..
You will cause less lung damage and get just as baked if you inhale and immediately exhale.
This is the biggest load of baloney I’ve read in my life about medical cannabis.
Just what about it do you think is “baloney?” Do you think that the positive correlation with cessation and age is spurious? If so, why? That is really all that they claim. Just what part of your ox do you think is getting gored?
Young person here weed is still illegal federally so boom with this economy some companies still test for it and it’s not worth being homeless for !
Nearly all of the participants in the study were of retirement age and all were dealing with age-related chronic pain. I would guess that reducing pain was of greater concern than being rejected for a side job as a greeter at Walmart.
Wow I wonder how many were cigarette smokers. You know the legal thing that killed more people than Marijuana and they aren’t only legal they roll em up and push em over the counter without anyone going to jail. Not saying that’s what I would like to see just saying I can smoke 5 packs a day and suffer from it but I can’t smoke Marijuana and relax now that’s punked.
What does your rant have to do with the findings of this study?
As opposed to opiates that they can’t quit
Alot of them just didn’t renew their cards. They didn’t stop using it.
Not surprising, but definitely need more information. I have degenerative disk desease, which causes chronic lower back pain, and I’m going through a pretty bad flair up right now. Someone offered me cannabis gummies a few minutes ago, but I turned them down. They don’t help with this kind of pain (at least for me), and the side effects and how it makes me feel are horrible. I used to smoke a lot when I was young, but this stuff they have these days is just too powerful (turns me into a zombie, lol), and it doesn’t help for the kind of pain I have.
As a medical marijuana user I can tell you one of the reasons why some of us aren’t following through.
The office I went to had confrontational staff. Basically blackmailing you and mistreating you because they think you need them more than they need you. I’ve been treating my problems with medical marijuana for decades but without a license. I don’t want to be on psychotropic medication because it makes me stupid. I got caught with a marijuana card so I managed to get my card so I didn’t go to prison. We’re going to this office with this confrontational staff I decided to go and tell them that if they continue to act like that one of these times are going to do that to the wrong person and it’s not going to end well for them. Well they distorted what I said and I ended up getting locked up in a mental institution for several days. And the mental institutions down here don’t follow the rules. So I racked up about $15,000 in medical bills because I told Karen that if she keeps provoking people she’s going to provoke the wrong one…
And if you look at the reviews on the place that I went and got my medical marijuana card from you would see many other people have similar complaints but I didn’t see these complaints until it was time for me to leave a review about it.
I’m using voice to text but hopefully it gives somebody some insight as to why some of us may not be following up. Even without this confrontational stuff they weren’t very helpful in trying to figure out the online stuff to renew my card….
“As a medical marijuana user I can tell you one of the reasons why some of us aren’t following through.”
None of the things you mention appear to be age-related, which is all the researchers claim.
I think an important point that the researchers didn’t address, nor did any of critical commenters here, is that 34 of the 76 in the initial cohort (~45%) discontinued after the FIRST visit. I find that astounding. If they agreed to participate they must have known what the costs would be before hand and probably decided that IF it gave them pain relief it would be worth it.
I would speculate that those who dropped out did so because their expectations of pain relief were not met and they simply decided that the cost and time did not warrant continuation.
I haven’t tried marijuana in about 50 years. In the 1970s it was common to encounter it at parties. It never had an effect on me. At one party, everyone but me was crashed on the floor. I was bored because I was the only one not sleeping. I was also hungry so I started sampling food at the potluck table. Among other things, I ate about a half-platter of what I innocently assumed were regular brownies. The hostess woke up and and got very concerned when she saw how many ‘magic’ brownies I had consumed because she thought that I might need medical treatment. Even the brownies had no impact. The point of sharing this is that I suspect that the effect of marijuana on people is highly variable, with much of the effect possibly being a placebo effect. That is, people experience what they expect to experience. Apparently 34 people, and possibly as many as 44, chose not to continue in the study because they didn’t get the relief they hoped for. It is unfortunate that the researchers didn’t directly or indirectly address that possibility.
If your article fails to compare figures to OTHER pain control, when your article is about pain control, you’ve kinda failed as a journalist.
You can’t draw negative light to the 58% figure, when opiates are between 70% and 90% for that same metric.
You DEFINITELY can’t draw a negative conclusion when, by the facts and figures, it’s one of the MOST successful options. That just makes you look silly or lazy, or worse, like you’re stroking the industry.
Do better.
They didn’t stop using, they just stopped paying outrageous store prices and pointless renewal fees for med cards