O

nly a tiny fraction of people enrolled in medical marijuana programs in the United States are getting any real medical oversight.

Why it matters:

Nearly half of all states have some sort of medical marijuana program. But a study published Monday in Health Affairs finds that the most heavily used programs — which collectively enroll 99.4 percent of all medical marijuana patients in the US — don’t have the kind of regulations you’d expect of a medical practice. For instance, they might not test or label the pot. Or they might not require state licensing of manufacturers or dispensaries.

Study coauthor Dr. Silvia Martins says that’s a problem: “When you’re allowing someone to have access to a certain product as a medication, it needs to be overseen by good medical practices and medical rules,” said Martins, an associate professor at the Columbia University Mailman School of Public Health.

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Researchers, who used data from the fall of 2014, write that there’s a connection between less regulation and more participation in these programs.

But keep in mind:

Eric Sevigny, a professor of criminal justice at Georgia State University, pointed out that some of this relationship could be explained by the fact that many less-regulated programs are simply older, and have had more time to enroll participants.

What’s next?

Future research will look at how the degree to which a medical marijuana program is regulated impacts public safety and public health.

The bottom line:

Medical marijuana programs differ widely from state to state, and patient access varies widely, too.

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