title: From 32 ounces to zero: a medical geographic study of dispensing a cultivated batch of "plum" cannabis flowers to medical marijuana patients in Washington State.
abstract: The medicinal use of cannabis is a growing phenomenon in the U.S. predicated on the success of overcoming specific spatial challenges and establishing particular human-environment relationships. This article takes a medical geographic "snapshot" of an urban site in Washington State where qualifying chronically ill and debilitated patients are delivered locally produced botanical cannabis for medical use. Using interview, survey, and observation, this medical geographic research project collected information on the social space of the particular delivery site and tracked the production cost, reach, and health value of a 32-ounce batch of strain-specific medical cannabis named "Plum" dispensed over a four-day period. A convenience sample of 37 qualifying patients delivered this batch of cannabis botanical medicine was recruited and prospectively studied with survey instruments. Results provide insight into patients' self-rated health, human-plant relationships, and travel-to-clinic distances. An overall systematic geographic understanding of the medical cannabis delivery system gives a grounded understanding of the lengths that patients and care providers go, despite multiple hurdles, to receive and deliver treatment with botanical cannabis that relieves diverse symptoms and improves health-related quality-of-life.
authors.affiliation: Department of Physical Medicine and Rehabilitation, New York University, Rusk Institute of Rehabilitation Medicine, New York, NY 10016, USA. aggars03@nyu.edu
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Aggarwal
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Carter
authors.forename: Craig
authors.initials: C
authors.lastname: Zumbrunnen
authors.forename: Richard
authors.initials: R
authors.lastname: Morrill
authors.forename: Mark
authors.initials: M
authors.lastname: Sullivan
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Mayer
mesh_terms: D002188:Cannabis; D002908:Chronic Disease; D016527:Drug Costs; D035264:Flowers; D062306:Geography, Medical; D019538:Health Care Surveys; D006801:Humans; D010342:Patient Acceptance of Health Care; D008517:Phytotherapy / Q000191:economics; D028321:Plant Preparations / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D010946:Plants, Medicinal; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use*; D011788:Quality of Life; D012111:Residence Characteristics; D013997:Time Factors; D014187:Transportation of Patients; D016896:Treatment Outcome; D019037:Urban Health Services / Q000191:economics; D014861:Washington
chemical_list: D028321:Plant Preparations; D011619:Psychotropic Drugs