A Michigan Case Study Explores Donated Cannabis as a Harm-Reduction Tool
A small Michigan program is offering a closely studied example of how donated cannabis might fit into harm-reduction services—but the research does not show that the approach prevents overdoses or causes people to stop using other drugs.
In a 2024 case study published in the Harm Reduction Journal, researchers documented a cannabis donation program operated through a harm-reduction organization in rural Michigan. The program provided cannabis products to 10 clients who had previous experience using cannabis alongside alcohol, methamphetamine, opioids, or other substances.
The study examined the program’s operations from September 2021 through May 2023. Clinical staff assessed clients’ interest and appropriateness for the program, then arranged weekly pickups or deliveries. The organization already offered services including overdose education, naloxone distribution, referrals, peer support, substance-use treatment, and medications for opioid use disorder.
Program staff reported that some participants said cannabis helped them manage pain, anxiety, sleep, withdrawal symptoms, or cravings. Others described using alcohol, methamphetamine, or opioids less frequently. One participant over age 50 reported remaining abstinent from alcohol while recovering from spinal-fusion surgery and credited donated cannabis products—including a topical cream, vape cartridges, and flower—with helping manage pain.
Another participant, who was pregnant, unhoused, and using methamphetamine and opioids at the beginning of the program, reportedly reduced her use and worked with staff to seek medication for opioid use disorder. That account is an observation reported by program staff, not evidence that cannabis is safe or effective during pregnancy. The Centers for Disease Control and Prevention advises against cannabis use during pregnancy because THC can reach the fetus and may affect development.
The researchers also analyzed donation and sales data from a commercial cannabis company. During the 20-month study period, flower accounted for much of the company’s adult-use and medical sales, while donated products were more often edibles, oils, and topicals. The value of donated products represented about 1% of the company’s total gross sales, suggesting that donations could be financially manageable for some businesses.
Michigan’s legal framework made the program possible, although the researchers described the effort as unsanctioned and difficult to administer. Cannabis had been legal for medical use in the state since 2009 and for adult use since 2018. The organization had to coordinate transfers, keep products off-site, follow quantity limits, and arrange transportation for pickups and deliveries. More information about the state’s broader harm-reduction services is available through the Michigan Department of Health and Human Services.
The study’s main contribution is documenting feasibility, not demonstrating effectiveness. It did not use a comparison group, directly interview the recipients, measure overdose rates, or establish that cannabis caused reductions in other substance use. Information about individual outcomes came largely from staff reports, and the experience of 10 clients in one rural program may not apply to other communities or states.
The authors argue that donated cannabis could serve as an optional adjunct to established harm-reduction services for some adults who already use cannabis and find it helpful. They also identify major unanswered questions involving dosing, product safety, legal liability, affordability, transportation, and possible unintended effects. Cannabis itself carries risks, including dependence and impairment, as outlined by the CDC’s overview of cannabis health effects.
For people with opioid use disorder—especially during pregnancy—cannabis should not be treated as a substitute for evidence-based care. SAMHSA identifies buprenorphine and methadone as treatments of choice for opioid use disorder during pregnancy. The Michigan case study instead points to a narrower possibility: when offered within a trusted, nonjudgmental service network, donated cannabis may be one form of client-directed support that warrants more rigorous research.
