More Doctors Than Ever Are Approving Patients for Medical Cannabis

October 25, 2026

Photo via Unsplash.

Nearly 36,000 physicians, nurse practitioners, and other licensed clinicians across the country are now authorizing patients to use medical cannabis, up from around 29,500 just four years earlier. That's the headline finding from a peer-reviewed study published September 29, 2026 in Annals of Internal Medicine, and it lands at a moment when the whole legal architecture around medical cannabis is shifting underneath it. Those nearly 36,000 authorizing clinicians now serve roughly 3.9 million patients nationwide, with chronic pain topping the list of conditions cited for approval. The timing isn't incidental: this data arrives five months after the federal government moved cannabis from Schedule I to Schedule III, and at a point where medical cannabis is now legal in 41 states plus Washington, DC.

But here's the wrinkle that state program administrators already know and that the national numbers tend to obscure: more authorizing doctors doesn't automatically mean more enrolled patients. In some states, medical cannabis rolls are actually shrinking even as the physician pool authorizing it grows. Understanding why requires pulling apart what this new study actually measured, what's changed legally since April, and why state-level policy choices are pulling medical cannabis programs in opposite directions at the same time.

What the New Study Actually Found

Photo by erwinbosman via Pixabay.

The study, led by University of Michigan researcher K.F. Boehnke and titled U.S. Authorizing Clinicians and Medical Cannabis Caregivers: 2020-2024, pulled its numbers directly from publicly available state medical cannabis program records rather than surveys or self-reported data. That matters for credibility: these are administrative counts, not estimates based on who said they'd be willing to recommend cannabis if asked.

The topline figure is a jump from about 29,500 authorizing clinicians in 2020 to more than 35,000 in 2024. A companion paper pegs that growth at roughly 19%, while the headline figure cited elsewhere in the research puts overall growth since 2020 at approximately 16% -- the discrepancy likely reflects slightly different cutoff dates and methodology between the two analyses, but both point in the same direction. Just under 36,000 practitioners were actively issuing recommendations to about 3.9 million patients as of the most recent data pull.

Chronic pain remained, by a wide margin, the condition clinicians most often cited when authorizing a patient. That tracks with what state program data has shown for years -- chronic pain consistently outpaces other qualifying diagnoses as the condition behind most authorizations.

One detail in the study is easy to overlook but worth flagging: researchers also counted nearly 110,000 registered medical marijuana caregivers in 2024 -- the people, often family members, legally permitted to purchase, possess, or administer cannabis on behalf of a registered patient. That's roughly three caregivers for every authorizing clinician, a ratio that hints at how much of the medical cannabis system still depends on informal support networks rather than clinical infrastructure alone.

Rescheduling and the Legal Landscape Behind the Numbers

Photo via Unsplash.

Context matters here, and the biggest piece of context is April 2026's federal rescheduling. Medical cannabis products moved from Schedule I -- the category reserved for substances deemed to have no accepted medical use -- to Schedule III, which acknowledges accepted medical use alongside moderate potential for abuse. As of June 2026, medical cannabis is legal in 41 states and DC, with 24 states plus DC having gone further and legalized recreational use for adults.

Rescheduling changed plenty on the research and banking side, but it didn't change the one thing patients and clinicians care about most directly: physicians still cannot write a prescription for cannabis. No cannabis product carries FDA approval, so what clinicians issue under state law is an authorization or recommendation -- not a prescription in the pharmaceutical sense. That distinction is the quiet engine behind why medical cannabis programs look so different depending on which state you're in. Prescriptions are standardized by federal drug approval processes; authorizations are governed entirely by whatever rules a given state legislature or health department has written, which is why requirements for physician certification, patient registration, qualifying conditions, and renewal timelines vary so widely from Michigan to Florida to Oklahoma.

Paul Armentano, deputy director of NORML, pointed to this study as evidence that medical cannabis use and its perceived efficacy are becoming broadly accepted within the healthcare profession and among patients themselves -- not a fringe practice tolerated at the margins of medicine, but something increasingly folded into mainstream clinical conversations about pain management and chronic disease. Given the authorization-versus-prescription gap isn't closing anytime soon, patients should always verify their own state's current rules rather than assume federal rescheduling simplified anything on the ground.

Doctors Are Coming Around, Survey Data Shows

In the 2026 survey, nearly all physicians (95%) support legal medical access to cannabis, and most acknowledge its therapeutic value (85%), yet notably fewer (74%) would personally recommend it to patients.

Separate survey research backs up the idea that this is a genuine attitude shift among physicians, not just patients pushing harder for access. A July 2026 survey in the Journal of Cannabis Research polled 879 healthcare professionals and found that more than 85% believe cannabis has legitimate therapeutic applications and already have patients who use it, whether or not those clinicians personally authorized it.

The numbers get more striking from there. Ninety-five percent of surveyed professionals said they support legal medical access to cannabis, and 74% said they would personally recommend cannabis therapy to a patient if circumstances called for it. That's not a slim majority tolerating a political reality -- it's something closer to professional consensus.

What's notably missing, according to many of the same respondents, is formal training. A recurring theme in the survey was clinicians asking for more structured education on cannabis pharmacology, dosing, and drug interactions, which suggests medical schools and continuing education programs haven't caught up to where clinical interest already sits. That gap matters practically: a physician who believes in cannabis's therapeutic value but never received real training on it is more likely to under-dose, over-dose, or simply decline to engage with a patient's questions.

CDC-compiled data adds another data point from a different angle, finding that 69% of US clinicians believe cannabis has medical utility and that more than a quarter have already recommended it to a patient at some point. Put all three data sets side by side and a consistent picture emerges: the growth in authorizing clinicians documented in the Annals of Internal Medicine study isn't simply a function of more patients showing up and asking. Physicians themselves have moved.

More Authorizing Doctors Doesn't Always Mean More Patients

Here's where the national growth story gets complicated. The 2026 MJBiz Factbook estimates total US registered medical marijuana patients at roughly 3.7 million -- a number broadly consistent with the 3.9 million figure in the Annals of Internal Medicine study, but one that masks significant movement underneath. MJBizDaily's own analysis cautions against assuming that more authorizing clinicians translates directly into more registered, paying patients.

New Jersey is the clearest illustration of this. The state's medical cannabis program had 129,369 registered patients in May 2022. By mid-May 2026, that number had fallen to 46,881 -- a drop of nearly two-thirds in four years. The timing lines up almost exactly with the launch of New Jersey's recreational adult-use sales, and that's not a coincidence.

This pattern shows up repeatedly in states that transition from medical-only to medical-plus-recreational markets. Once adults can walk into a dispensary and buy cannabis without a physician's authorization, annual registration fee, or renewal visit, many patients simply stop bothering with the medical program, even if cannabis is still managing a real health condition for them. The hassle and cost of staying medically registered loses its appeal when the recreational counter next door sells the same product with none of the paperwork.

That doesn't mean medical registration becomes pointless once recreational sales start. Medical patients in most adult-use states still get meaningfully higher possession limits, tax exemptions or reduced rates unavailable to recreational buyers, and -- critically -- legal access for minors and through registered caregivers, neither of which recreational markets typically allow at all.

Not Every State Is Making It Easier

Photo by PublicDomainPictures via Pixabay.

While the national trend points toward more physicians authorizing cannabis, that trend is anything but uniform, and Oklahoma is the clearest counterexample right now. The state's SB 1066 took effect January 1, 2026, and it raised the bar for physicians who want to issue medical marijuana recommendations: they must now complete additional, specific medical marijuana education and formally register with the Oklahoma Medical Marijuana Authority before authorizing a single patient.

That's a meaningful friction point layered onto a process that, in many states, remains relatively lightweight. It also signals something worth watching: as medical cannabis becomes more normalized nationally, some state legislatures are responding not by loosening the rules but by tightening them, adding continuing-education mandates or physician registries that didn't exist a few years ago. Oklahoma isn't alone in floating this kind of approach -- other states have discussed similar credentialing or registry requirements for the physicians who authorize patients, even as federal rescheduling moves in the opposite direction.

None of this is abstract for anyone actually trying to use a state's medical cannabis program, whether as a patient or a physician. Qualifying conditions, physician registration mandates, renewal timelines, and even what counts as a valid authorization differ enough state to state that reading a national trend piece and assuming it applies to your specific situation is a mistake. Always check your own state's current medical cannabis statute and your state health department's physician certification rules -- NORML's state-by-state guide and your state's official cannabis regulatory agency page are good starting points -- before assuming anything about access, cost, or eligibility.

The upshot is that federal rescheduling and this new clinician data tell a story of growth and acceptance at the national level, but the actual experience of getting authorized or registered as a patient still depends enormously on which state line you happen to live behind.

Put the pieces together and what emerges isn't just a bureaucratic uptick in authorization counts -- it's a real normalization of cannabis within mainstream medical practice. The survey data showing 85%+ of clinicians believe in cannabis's therapeutic value, paired with tens of thousands more physicians actually acting on that belief by authorizing patients, suggests this shift is being driven from the physician side as much as from patient demand. That's a notable change from a decade ago, when most doctors treated cannabis authorization as something to be handled cautiously, if at all.

Still, it's worth resisting the temptation to read rescheduling as having solved anything definitively. Schedule III status hasn't closed the gap between authorization and prescription, and until an FDA-approved cannabis product exists for a given condition, that gap isn't going anywhere. Every authorizing clinician in this study is working within a state-law framework that federal law still doesn't fully mirror -- and that mismatch is exactly what keeps producing divergent state policies like New Jersey's shrinking patient rolls alongside Oklahoma's new physician registration hurdles.

Expect that divergence to keep widening rather than resolve. Some states will keep easing physician certification requirements as cannabis becomes more clinically routine; others will add friction in the name of oversight, the way Oklahoma just did. The national growth figures in this new study are real and meaningful, but they're an average sitting on top of a genuinely uneven map -- and anyone relying on medical cannabis, or considering authorizing it, still needs to know their own state's rules rather than the national headline.