Centering Patient Health Over Legal Status: A Student-Driven Cannabis Risk Stratification Framework for Undergraduate Medical Education.

Liu J.; Moore S.; Zhai X.; Mather R.; Oles W.; Cerda I.; McGuire P.; Connery H. · Substance use & addiction journal · 2026

**Background & Methods** This is a curriculum development review article where a student-faculty working group in addiction psychiatry, addiction medicine, and pain medicine created an evidence-informed cannabis education framework for undergraduate medical students. The authors reviewed peer-reviewed literature on cannabis-related risks, usage patterns, and patient counseling approaches, then identified integration points within existing medical school curricula without requiring major restructuring. **Key Findings** • A Cannabis Use Risk Stratification Framework was developed that organizes cannabis-related health benefits and risks into teachable categories based on use-related factors (frequency, potency, route) and patient-related factors (age, comorbidities, functional impact), enabling students to move beyond legal status-based discussions toward patient-centered harm reduction counseling. • The framework is delivered through two 1-hour sessions: a preclinical lecture introducing the conceptual framework and a preclerkship session using case-based learning and simulations for practical application, providing students with specific clinical skills including cannabis history-taking, benefit/risk identification, and brief educational counseling. • This educational approach addresses a significant gap in undergraduate medical education by providing an adaptable, jurisdiction-agnostic framework that prepares physicians to counsel patients on cannabis use despite incongruence between state and federal laws and the growing prevalence of cannabis use for both evidence-supported and limited-evidence indications (anxiety, depression, chronic pain). **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. The abstract references cannabis-related risks as a subject of instruction but does not specify particular adverse effects or safety concerns identified within the framework. **Evidence Quality** This is a curriculum development and review article rather than a clinical trial or empirical study, representing a lower level of evidence (educational innovation). Limitations include lack of reported student learning outcomes, no assessment of framework effectiveness on clinical practice patterns, and absence of comparative data with traditional curricula. The framework is grounded in peer-reviewed literature but the paper itself does not present original empirical data on cannabis risks or patient outcomes. Generalizability may be limited by the single-institution development process, though authors note the framework is designed to be adaptable across diverse institutional and jurisdictional contexts.

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