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Recommendations From Cannabis Dispensaries About First-Trimester Cannabis Use

posted 01/05/2018

publication (Obstet Gynecol 2018;131:1031–8) DOI: 10.1097/AOG.0000000000002619

Betsy Dickson, MD, Chanel Mansfield, MPH, Maryam Guiahi, MD, MSc, Amanda A. Allshouse, MS, Laura M. Borgelt, PharmD, Jeanelle Sheeder, PhD, Robert M. Silver, MD, and Torri D. Metz, MD, MS


To characterize recommendations given to pregnant women by Colorado cannabis dispensaries regarding use of cannabis products for nausea during the first trimester of pregnancy. METHODS: This was a statewide cross-sectional study in which advice about cannabis product use was requested using a mystery caller approach. The caller stated she was 8 weeks pregnant and experiencing morning sickness. Dispensaries were randomly selected from the Colorado Department of Revenue Enforcement Division website. The primary outcome was the proportion of marijuana dispensaries that recommended a cannabis product for use during pregnancy.We hypothesized that 50% of dispensaries would recommend use. A sample size of 400 was targeted to yield a two-sided 95% CI width of 10%. Secondary outcomes included the proportion endorsing cannabis use as safe during pregnancy, specific product recommendations, and encouraging discussion with a health care provider. Recommendations were compared by licensure type (medical, retail, or both) and location (rural vs urban). RESULTS: Of the 400 dispensaries contacted, 37% were licensed for medical sale (n5148), 28% for retail (n5111), and 35% for both (n5141). The majority, 69% (277/400), recommended treatment of morning sickness with cannabis products (95% CI 64–74%). Frequency of recommendations differed by license type (medical 83.1%, retail 60.4%, both 61.7%, P,.001). Recommendations for use were similar for dispensary location (urban 71% vs nonurban 63%, P5.18). The majority (65%) based their recommendation for use in pregnancy on personal opinion and 36% stated cannabis use is safe in pregnancy. Ultimately, 81.5% of dispensaries recommended discussion with a health care provider; however, only 31.8% made this recommendation without prompting.


Nearly 70% of Colorado cannabis dispensaries contacted recommended cannabis products to treat nausea in the first trimester. Few dispensaries encouraged discussion with a health care provider without prompting. As cannabis legalization expands, policy and education efforts should involve dispensaries. (Obstet Gynecol 2018;131:1031–8) DOI: 10.1097/AOG.0000000000002619

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