A quarter of Canadian medicinal cannabis users find it more difficult to secure the marijuana they need after recreational use was legalized in October 2018.

Canadians for Fair Access to Medical Marijuana, the Arthritis Society and the Canadian Pharmacists Association teamed up to survey 996 marijuana patients about the challenges they face. The results have just been published and they show that one in four users cite supply shortages for hampering their ability to access the marijuana they have been prescribed.

Many are turning to the black market or to recreational cannabis dispensaries, according to the survey. 38% of respondents said they typically order direct from a licensed producer within their province, while 37% turn to the illegal market.

A quarter of respondents said they feel that cannabis has become more expensive since adult-use legalization, while 15% said it has become a lot more expensive.

It also found that 61% of medical cannabis users surveyed said they self-medicate, which could be detrimental to their health. The most common conditions cited by users for needing medical cannabis were chronic pain, insomnia, anxiety, stress, and arthritis.

The survey also discovered confusion around mixing medications.

“In order to have an effective medical system for the hundreds of thousands of Canadians using cannabis for medical purposes, it needs to be more accessible,” said Max Monahan-Ellison, vice president at Canadians for Fair Access to Medical Marijuana.

Arthritis Society president and chief executive Janet Yale said cannabis “truly is medicine” for Canadian arthritis sufferers and demanded the health system improve access for patients. She wants to see access become more timely, reliable, and affordable as patients are so reliant on it.

Just over half of respondents said they use marijuana several times per day, while 21% said they use it on a daily basis and 15% said they consume cannabis more than once per week.

Dry cannabis flower was the most popular form of medical cannabis among the patients surveyed, followed by oils, edibles, topicals, and capsules. The average spend per month among medical marijuana patients is $173.25, according to the survey, compared to $115.02 for the general population.

Men spend slightly more than women, while Generation X is the highest spending generation, ahead of Baby Boomers and Millennials.