Tracking the Number of Registered Medical Patients by State: MAP

As more states allow for adult consumption of cannabis, it’s important to look at how full legalization is affecting medical cannabis markets. Currently, there are 39 states that have legalized medical cannabis, and 19 states that have legalized adult use. Besides South Dakota, every state that has legalized adult use had already legalized medical cannabis at an earlier date.

While the path to legalization—prohibition to medical to recreational—is standard, there are some significant differences and similarities between states that have transitioned from medical to adult use that are worth examining. In particular, we analyzed medical and adult-use sales numbers and looked at average basket size and category preferences in both medical and adult-use markets.

Early on, states were slow to transition from medical to adult legalization. California, which in 1996 was the first state to approve medical use, didn’t approve adult use until 20 years later, in 2016. This transition has moved a lot faster in recent years, in states like Illinois, which  passed medical in 2013 and adult use in 2020. Generally speaking, states with relatively mature recreational markets share some distinctions that differ from newer recreational markets.

But there are a lot of other factors at play that affect adult-use and medical markets.

Data compilation by Andriana Ruscitto. Map design by Katelyn Boyden. Sales in States That Recently Opened Recreational Markets

To begin, we’ll look at Illinois and markets, as they have both made the transition from medical only to medical and adult use within the last two years. When adult-use markets open, they tend to grow at a rapid pace. Sales in Illinois, for example, grew by 226% from $39.2 million, when they first began in January 2020, to $127.8 million in July 2021. Over this same time period, Michigan’s total adult-use sales grew from only $9.8 million to $115.3 million, a whopping 1,077%.

As adult-use sales skyrocketed in both states, medical sales in Illinois have meanwhile remained fairly consistent, with a total increase of 35% from $23.4 million in January 2020 to $31.5 million in July 2021. Medical sales in grew by 75% over this time period—what would be considered a respectable, high growth rate in most industries, but a number that pales in comparison to the state’s colossal growth in adult-use sales.

It is clear that the introduction of adult-use sales leads to a decrease in medical sales proportionally. In July 2021, medical sales in Illinois reached an all-time low, accounting for only 20.9% of all sales (down from a high of 45.5%). medical sales have also steadily declined proportionally, accounting for only 27.7% of all sales in the state by July 2021 (down from a high of 73%). That being said, it’s certainly not the case that adult-use markets are making their medical counterparts irrelevant—remember in both of these markets, adult-use sales still grew respectively.

Perhaps adult-use markets help legitimize cannabis and signal to more people with medical ailments that cannabis can help their condition.

Sales in States with More Mature Recreational Markets

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