Data from NAP’s LGBTQ+ Cannabis Community

Happy Pride month! Here is a data analysis of NAP’s longitudinal dataset (n = 2,857) that highlights some trends in health status, usage patterns, and system-level access of the LGBTQ+ cannabis community. The LGBTQ+ community has played a huge role in medical cannabis advocacy, continues to have a large presence in the industry, and is often overlooked when it comes to prioritizing research and product-offerings or optimizations.

Over 50% of participants self-identified as part of the LGBTQ+ community! This is a far greater proportion than national estimates and underscores cannabis’s role as a therapeutic modality amongst gender and sexual minority populations. 

From the participants who identified as LGBTQ+, 71% identified as neurodivergent (SubFigure A) with differential proportions of participants who identified as Autistic, ADHD/ADD, or AuDHD (combined Autism and ADHD/ADD). These trends are in line with broader epidemiological findings that link neurodivergence to LGBTQ+ identity and point to potential implications for the development of specific dosing strategies, formulations, and sensory or behavioral profiles.

The LGBTQ+ participants were almost twice less likely to be pain-free (17% versus 9%) and daily reported pain scores were slightly elevated (SubFigure B). There were also similar observed shifts in energy, anxiety, happiness, and sleep quality (data not shown). This differential burden may reflect the compounding effects of discrimination, trauma exposure, and unmet clinical needs and points to an increased subjective therapeutic benefit for the LGBTQ+ cannabis community.

While both groups showed similar patterns for the average daily dose range of cannabis flower, the LGBTQ+ participants showed a higher prevalence of relatively low daily dose of approximately 250 mg/day and a slightly lower incidence of higher-dose usage of greater than 1000 mg/day (SubFigure C). This may indicate sensitivities, economic constraints, or different therapeutic goals and should be investigated further to understand how identity-specific variables can influence both product selection and dosage.

Despite a greater proportion of LGBTQ+ respondents reporting they considered their cannabis consumption medical, they were less likely to possess a medical card both in states with access and in states without access (SubFigure D). This suggests barriers in access to care, trust, and/or institutional navigation - highlighting a need to reform medical cannabis systems to better accommodate the realities of marginalized populations.

This is especially important when considering the 5-10X larger than expected representation of non-binary and gender-diverse individuals in the cannabis industry (Figure E) from two separate industry conferences. Not only are LGBTQ+ individuals a larger proportion of cannabis patients, but they are also playing a critical role in shaping the industry itself. 

This data is just the beginning of our understanding of how identity can affect cannabis consumption, therapeutic benefits, and community. The disproportionately high representation of LGBTQ+ individuals in both patient and professional cannabis spaces combined with the elevated co-occurrences of neurodivergence, higher levels of chronic pain, and medical intent, all point to more specific approaches in both research design and protocol development. Cannabis research must evolve to not only include, but actively address the complex intersectional needs of gender and sexual minority populations.