New Report: Access to Marijuana by Minors Via Online Dispensaries

Marijuana is a widely used substance derived from theCannabis sativaplant that contains the psychoactive compound Δ⁹-tetrahydrocannabinol. Its growing legalization in the US has expanded the marijuana market, potentially increasing its access by children. According to the National Institute of Health’s 2022 Monitoring the Future survey, 6.3% of 12th graders, 2.1% of 10th graders, and 0.7% of 8th graders reported daily marijuana use over the past 30 days.¹Several studies have shown that underage consumers can buy alcohol, cigarettes, and electronic cigarettes (e-cigarettes) online, highlighting the ineffective age verification procedures of online vendors.^2–5We examined age verification procedures and potential youth access to online marijuana dispensaries.

The Northwell Health Institutional Review Board approved this cross-sectional study. Between July 1, 2022, and June 15, 2023, we used Google search queries, includingbuy marijuana onlineandorder weed online(Table 1), to identify online marijuana dispensaries that sold to US consumers. These data were collected from each website: dispensary information (name, location); shipment regions; product types (edible cannabis products [hereinafter, edibles], e-cigarettes, medical formulations); age restriction and verification precautions; delivery and pickup options; warnings and disclaimers; and payment methods. Descriptive statistics were analyzed from April to June 2023 in R, version 1.2.5033 (R Foundation for Statistical Computing). We followed theSTROBEreporting guideline.

Eighty online marijuana dispensaries based in 32 states were identified (Table 1), and 22 (27.50%) had delivery options for marijuana products across state lines. Of these, 21 dispensaries (95.0%) delivered to states with differing marijuana laws than the dispensary’s home state (Table 2).⁶Products included e-cigarettes (74 dispensaries [92.5%]), edibles (75 [93.8%]), and medical formulations (44 [55.0%]). Of the 75 dispensaries offering edibles, 50 (67.0%) used colorful packaging that could be attractive to minors. Edibles included gummies or candies (72 dispensaries [96.0%]), nonalcoholic drinks (ie, lemonade) (40 [53.3%]), and chocolates (59 [78.7%]).

On entry, 56 (70.0%) of the websites prompted users to click yes to confirm they were of legal age, and 3 (3.8%) asked for a specific birthdate. None required verified age documentation to enter the website. Overall, 53 dispensaries (66.3%) required users to verify age when completing a purchase or on receipt of a marijuana product, and 15 (18.8%) did not require formal age verification during the purchasing process. Age verification methods included government-issued identification (40 dispensaries [50.0%]), a medical marijuana identification number (21 [26.3%]), and self-reported birthdate (8 [10.0%]) (Table 1). Fifty-three dispensaries (66.3%) offered pickup and 54 (67.5%) offered delivery.

Half of the dispensaries provided legal information and 34 (42.5%) offered warnings or disclaimers regarding the safety of purchasing or using marijuana products. Fifty-four dispensaries (67.5%) listed policies regarding sale of marijuana to minors. Of these, 13 (24.0%) did not ask users to verify their age to enter the website and 13 (24.0%) did not ask users to verify their age before purchasing or receiving the product.

Nontraceable payment methods (ie, cash, prepaid cards, cryptocurrency) were accepted by 67 dispensaries (83.8%). Fifteen dispensaries (18.8%) offered first-time buyer discounts, 4 (5.0%) offered student discounts, and 2 (2.5%) offered discounts for using cryptocurrency.

This cross-sectional study found that most online marijuana dispensaries lacked adequate age verification features and most accepted nontraceable payment methods, enabling youth to hide their transactions. Almost 1 in 5 online dispensaries required no formal age verification at any stage of the purchasing process. Limitations of the study included a small sample size and relatively short period of data collection, as researchers used limited search terms and may have been unaware of how to find additional online dispensaries.

Despite regulations, availability of marijuana products remains seemingly high, exacerbated by potential shipment across state lines. It is imperative to require strict age verification procedures prior to cannabis purchases online and to establish stringent surveillance of online marijuana dispensaries to protect youth. Pediatricians and caregivers must be aware of the widespread availability of online dispensaries and potential dissemination of marijuana to minors.

Accepted for Publication:June 18, 2023.

Published Online:September 25, 2023. doi:10.1001/jamapediatrics.2023.3656

Corresponding Author:Ruth L. Milanaik, DO, Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children’s Medical Center of New York, 1983 Marcus Ave, Ste 130, Lake Success, NY 11042 ([email protected]).

Author Contributions:Dr Milanaik had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Mss Terala and Sangiuolo contributed equally.

Concept and design:All authors.

Acquisition, analysis, or interpretation of data:All authors.

Drafting of the manuscript:All authors.

Critical review of the manuscript for important intellectual content:All authors.

Statistical analysis:Terala, Sangiuolo.

Administrative, technical, or material support:Milanaik.

Supervision:Milanaik.

Conflict of Interest Disclosures:None reported.

Data Sharing Statement:See theSupplement.

Additional Contributions:We thank Andrew Adesman, MD, and Charles Schleien, MD, MBA, for their continued support. We also thank Elaine Cheng, BA, Fiona Dubrosa, BS, BA, Mary O’Connor, BA, and Xihang Wang, BA for their contributions to data collection. All contributors are from the Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children’s Medical Center of New York, and none was compensated for their contributions.