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Anxiously Legal: How Pennsylvania’s MedicalCannabis Program Got High on Stress

Updated: 5 days ago

OG article By Stone Slade


July 10, 2025




If you’re wondering what drives a $1.7 billion medical cannabis market in Pennsylvania, the

answer isn’t what you’d expect... unless, of course, you’re also anxious about absolutely

everything these days. Because in the Keystone State, anxiety isn’t just a feeling, it’s a business model.


According to a new study out this week in the Annals of Internal Medicine, researchers from the University of Pittsburgh and Johns Hopkins found that adding “anxiety” to Pennsylvania’s list of qualifying conditions fundamentally changed the state’s medical cannabis program. Before anxiety got the greenlight in July 2019, most patients were signed up for chronic pain or PTSD. But by the very next year, anxiety had skyrocketed past both of them and taken the top spot, and it’s held onto it ever since.



By 2024, more than 68% of Pennsylvania’s 440,000 certified patients had anxiety listed on their card. That’s a lot of nerves.


Now, to be fair, people are anxious. The world’s a mess. But this surge in anxious patients didn’t just affect paperwork, it lit a fire under the whole program. Patient certifications nearly doubled in a single year, and sales jumped from $306 million in 2019 to over $823 million in 2020. That’s not growth. That’s a green explosion.


Today, Pennsylvania has the second-largest medical cannabis program in the country, trailing

only Florida and it’s sixth overall when you stack it up against adult-use markets. Not bad for a

state that still can’t sell you a joint unless you’ve got a doctor’s note.



But let’s be real: this is where the debate starts to bubble. Dr. Coleman Drake, the lead author of the study, says adding anxiety to the list might’ve sent the wrong message, one that implies

cannabis is an effective treatment for it, even though there’s not much hard science to back that up. His concern? People are getting their hopes high... and maybe not much else.


Of course, the lack of research is thanks to the usual suspect: cannabis still being listed as a

Schedule I drug, right up there with heroin. So we can’t legally study it, but we can legally sell it for medical conditions we haven’t studied it for. Makes perfect sense, right?


Drake points out that there’s actually more evidence supporting cannabis for chronic pain, not

anxiety, but thanks to federal restrictions and funding roadblocks, our knowledge is still

frustratingly half-baked. Meanwhile, the number of Americans who support legalization has

soared to 87%, according to a new Pew survey. Yet researchers are still begging for funding

scraps just to figure out what we already kind of know from lived experience.


Let’s be honest: many folks entering medical cannabis programs for anxiety aren’t necessarily

looking for FDA-level clinical outcomes, they’re just looking to feel a little less on edge. And for some people, cannabis does help. But like with everything in this space, the story is complex, the science is behind, and the policies are a weird mix of helpful, hopeful, and half-assed.


Some states are catching on. New Mexico added anxiety in 2023, and now nearly 10% of their patients cite it as a qualifying condition. Others, like Alabama, call it “panic disorder,” while states like New York and Maine let doctors decide what’s appropriate. It’s all a patchwork mess, but hey, at least it’s growing.


In the end, whether you believe cannabis treats anxiety or not, the data from Pennsylvania proves one thing: when you open the door to mental health conditions, the patients come rushing in. Because the truth is, a lot of people are anxious, and even more are fed up with the side effects, high costs, or flat-out failures of traditional pharmaceuticals.


So if cannabis helps someone breathe easier, sleep better, or just get through another day in 2025, who’s really being harmed?


Well... other than Big Pharma’s quarterly report.

 
 
 

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