Impact of Anxiety Inclusion on Pennsylvania's Medical Cannabis Program

In recent months, a significant shift has occurred within Pennsylvania's medical cannabis program, following the addition of anxiety disorders as a qualifying condition. This development has led to anxiety becoming the most prevalent diagnosis for cannabis certifications in the state, a finding highlighted in a groundbreaking study co-authored by researchers from the University of Pittsburgh and Johns Hopkins University. The study, published on July 8, 2025, in the *Annals of Internal Medicine*, examined data from the Pennsylvania Department of Health, analyzing 1,730,600 medical cannabis certifications issued from November 2017 to December 2023.

Historically, qualifying conditions for medical cannabis in Pennsylvania have predominantly included chronic pain and post-traumatic stress disorder (PTSD). Prior to the inclusion of anxiety, chronic pain accounted for 67% of certifications, followed by PTSD at 16%. However, once anxiety was added to the list of qualifying conditions, its prevalence surged to 60% of all certifications, with chronic pain and PTSD dropping to 41% and 11%, respectively. Coleman Drake, Ph.D., an associate professor in the Department of Health Policy and Management at the University of Pittsburgh and the study's corresponding author, emphasized that this change fundamentally altered the demographic makeup of the program.

While the rapid increase in anxiety-related certifications signals a broader acceptance of cannabis for various health issues, the implications of this trend raise important questions regarding the efficacy of cannabis as a treatment for anxiety disorders. Drake noted that "evidence supporting cannabis as an effective treatment for anxiety disorders is scant in comparison to other qualifying conditions, notably chronic pain." This lack of robust evidence prompts concern that the inclusion of anxiety as a qualifying condition may mislead patients into believing cannabis is a viable treatment option, despite insufficient clinical backing.

Moreover, the study found that the overall size of the cannabis program, including how many participants switched their diagnoses or enrolled for the first time, remains unclear. The increase in certifications also reflects a growing trend in cannabis use across the United States, where 39 states currently have medical cannabis programs. This broader context indicates a potential shift in public perception regarding the therapeutic benefits of cannabis.

The study's co-authors, Linh Tran and Matthew Eisenberg, Ph.D., from Johns Hopkins University, also highlighted the need for more comprehensive research into the efficacy of cannabis for treating anxiety. They stressed that the existing regulatory barriers and funding limitations have historically hindered more in-depth studies on cannabis use, which is critical given the increasing rates of anxiety and cannabis use in the population.

The findings of this study call for urgent attention to the knowledge gaps surrounding cannabis use for mental health treatment. As cannabis markets continue to evolve and expand, public health officials and policymakers must consider the implications of these changes on treatment modalities and patient education. The urgency of conducting rigorous research in this area is underscored by the increasing number of patients seeking cannabis for anxiety, raising both ethical and health-related concerns.

In conclusion, the inclusion of anxiety disorders in Pennsylvania's medical cannabis program marks a pivotal change in patient demographics and treatment approaches. As the state navigates this new landscape, stakeholders must prioritize evidence-based research to ensure that patients receive accurate information regarding the potential benefits and risks associated with cannabis use for anxiety and other mental health disorders.