Health warnings on cannabis dispensary websites

Cannabis users are increasingly turning towards the Internet for information about cannabis, especially medicinal patients, who generally have low to moderate knowledge of important aspects of cannabis like medicinal effectiveness. Potential for misuse of cannabis is much higher when there is a lack of accurate information (Kruger et al., 2020). Overuse of cannabis can be associated with discontinued enrollment in school, trouble dealing with anxiety and stress, and an increased risk of schizotypy (Blavos et al., 2017). Cannabinoid exposure during pregnancy has been shown to have negative effects on the fetal immune system (Dong et al., 2019), is associated with low birth weight, stunted development (Gusstafson & Jacobsson, 2019), and cognitive impairment (Grant et al., 2018). Cannabis dispensary employees have been found to make health suggestions without proper qualifications (Dickson 2018), and advertising on dispensary websites often suggests strains for specific medical conditions, despite the lack of empirical evidence supporting these claims (Kruger et al., 2020; Luc 2020). This increasing medicalization of cannabis by those unqualified to do so is concerning in such a fast-growing field. The present study assesses the presence of health warnings on cannabis dispensary websites, specifically (a) the presence of facts or warnings about potential psychological consequences (e.g., paranoia, increased vulnerability to psychosis), (b) facts or warnings about use in pregnant women, and (c) general dosage warnings. Dispensaries were selected at random in all states that have legal cannabis. 15 dispensaries were selected from each state. If the state had less than 15, all dispensaries in the state were included in coding, for a total of 389 dispensary websites. Dispensaries were identified via informal cannabis websites like leafly.com and potguides.com, as the purpose of the study was to identify dispensary websites that the average person would find when searching the Internet. Previous studies have utilized state agency lists and informal lists (Cavazos-Rehg et al., 2019). Three trained research assistants coded each website for the relevant information. 30% of websites coded had psychological consequence warnings (n = 111), 21.53% had gynecological health warnings, and 45.65% had general use warnings. Three separate logistic regression analyses were performed with the three types of health warnings as the binary outcome variable (the information is either present = 1, or not present = 0) and legality status as the predictor. Legality status had no impact on the presence of psychological consequence information (OR = .737, SE = .174, p = .196) or general dosage information (OR = .786, SE = .479, p = .279), but legality did have a significant influence on the presence of gynecological consequences (OR = .499, SE = .129, p = .007), indicating that when cannabis was recreationally legal, the state was less likely to have information about gynecological health consequences on their dispensary websites. This is troubling, because cannabis is much more easily accessible in states with recreational legalization than medicinal, and the consequences of cannabis use during pregnancy can be severe.