Last year, I wrote about a medical cannabis market stuck between promise and perception. The promise was clear: Patients across the country were using cannabis to manage conditions where traditional therapies fell short. The perception lagged behind. Policy uncertainty, limited clinical translation, and product strategies borrowed from adult-use markets kept medical cannabis from being taken seriously as a therapeutic category.
Less than a year later, the gap I wrote about is beginning to close.
Not all at once. Not evenly. And not without friction. But taken together, shifts across federal policy, state medical programs, clinical research, and product development are indicating the medical cannabis market is no longer waiting for permission to mature. What is emerging is a marketplace increasingly defined by physician engagement, data-driven personalization, and products developed for consistent, predictable clinical use.
The Clinical Landscape Is Rapidly Evolving
The most consequential shift now underway is not regulatory or commercial, but clinical.
For cannabinoid-based treatments to move from symptom management to improved therapeutic impact, three elements must work together: physicians diagnosing patients, data that can guide personalized treatment decisions, and products designed to reliably deliver those recommendations. That bridge is now beginning to form.
Health care systems and industry partners are starting to generate the kind of real-world clinical data that has long been missing from medical cannabis. At Northwell Health, New York’s largest health care provider, a proof-of-concept observational study is underway in conjunction with Cannabis Doctors of New York’s Dr. Kenneth Weinberg and Cannformatics, where I serve as co-founder and chief commercial officer. The study examines how cannabinoid-based treatments may impact behavioral and psychological symptoms of dementia in patients who are already successfully using cannabis as part of their care.
In parallel, Cannformatics is working with Dr. Laszlo Mechtler, president of the DENT Neurologic Institute and an internationally recognized authority in neurology, neuro-oncology, headache medicine, and cannabinoid medicine. This collaboration supports a joint venture focused on developing more personalized, data-informed cannabinoid-based approaches for patients with migraines (headache disorders are the second most prevalent disease globally).
Supporting this work is Cannformatics’ Cannabis-Responsive (C-Res) biomarker technology, which measures how an individual’s biology responds to cannabinoids. The approach is grounded in clinically validated protocols widely accepted in the medical community, providing an evidence base for biomarker-guided treatment decisions beyond trial and error.
DENT’s cannabis clinic has treated more than 15,000 patients and routinely captures outcomes data, offering rare insight into how different cannabinoid formulations perform across real-world patient populations.
These initiatives matter not because results have already been published, but because they represent a structural shift toward data that can support clinical claims, guide product development, and inform standards of care. This type of infrastructure simply did not exist in cannabis a few years ago.
New York State Is Accelerating Clinical Cannabis Care
One of the most encouraging signs of progress last year came not from policy changes alone, but from how New York State is pairing legislative reform with investment in clinical cannabis care.
In November, Gov. Kathy Hochul signed legislation expanding and modernizing New York’s medical cannabis program, reducing barriers to access and reinforcing the state’s commitment to medical use, as Cannabis Business Times reported.
That policy momentum has been matched by visible clinical engagement. At the second annual New York State Medical Cannabis Symposium, Cannabinoids in Clinical Practice, hosted by the Office of Cannabis Management and led by Dr. June Chin, physicians, researchers, and health systems presented cannabis research with the rigor applied to other therapeutic areas. The symposium highlighted research and implementation challenges across pain, post-traumatic stress disorder (PTSD), and neuropsychiatric conditions. The sessions underscored a shift toward evidence-based evaluation rather than anecdotal use.
New York is leaning into that momentum. In January, Hochul directed her administration to establish the nation’s first Center of Excellence for Medical Cannabis and Health Equity, with the goal of integrating clinical research, physician training, patient access, and public health outcomes.
Product Innovation Is Catching Up to Clinical Expectations
As clinical research and application scale, product innovation for medical patients has also advanced, particularly in how cannabinoids are formulated, delivered, and dosed.
One clear trend is the acceleration of formulations designed for faster onset, more predictable effects, and durations. Examples include Organigram’s launch of happly, a U.S. hemp-derived THC brand built around FAST nanoemulsion technology and functional ingredients, as well as Percise, a hemp-based brand that utilizes Capsoil’s patented, clinically validated Liposoll platform.
In Percise’s case, clinical input from Mechtler informed the development of formulations designed to alleviate migraines, manage pain and anxiety, and improve sleep quality.
Transdermal delivery formats also gained visibility. New THC:CBD patch SKUs are appearing on more medical menus, marketed for sustained, steady relief rather than acute intoxication. Their market penetration reflects growing demand for non-oral, non-inhaled options that support consistent dosing over time.
Controlled- and pulse-delivery technologies continue to mature. Brands such as Curio Wellness are applying pharmaceutical-style controlled-release logic to cannabinoid delivery, using multiphase formats designed to avoid sharp peaks and rapid drop-offs – approaches borrowed directly from established drug-delivery models in sleep, pain, and behavioral health.
Policy Momentum Is Opening the Door to Clinical Integration
In November, President Donald Trump signed an executive order directing the federal government to move cannabis from Schedule I to Schedule III under the Controlled Substances Act. The announcement coincided with confirmation that, beginning this spring, certain CBD products will qualify for reimbursement under Medicare Advantage plans for the first time.
While the action did not resolve federal regulatory barriers, it achieved something equally important: It reduced stigma. It created space for clinicians, researchers, payers, and policymakers to reconsider cannabinoid-based treatments as legitimate therapeutic tools rather than political flashpoints.
That shift is reinforced at the state level. Over the past year, legislation advanced or was introduced in Indiana, Iowa, South Carolina, Tennessee, and Texas to create or expand comprehensive medical cannabis programs. Wisconsin considered a medical-only framework with clearly defined qualifying conditions, including cancer and PTSD. Together, these efforts reflect a broader pattern: States that remain cautious about adult-use cannabis are increasingly willing to acknowledge medical need.
This distinction matters. It reinforces that medical cannabis is not simply a subset of recreational use, but a category with its own clinical logic, patient populations, and standards of care, creating a policy environment more compatible with physician-led, evidence-driven treatment.
An Inflection Point, Not a Reset
The medical cannabis market is at an inflection point.
The future of cannabinoid-based treatments will not be defined by THC percentages or strain names. It will be defined by physician-led diagnosis, biomarker-informed personalization, and patient-ready products designed to deliver consistent, predictable experiences.
The policy door is open. The science is advancing. The clinical infrastructure is forming.
Brands and health care partners now face a choice help define this next phase of cannabis-based treatments or react to it as it takes shape around them. Those who step up will not just survive the transition. They will help establish a new, clinically grounded cannabis market focused on patients and outcomes first.
Kenneth Epstein is the co-founder and chief commercial officer of Cannformatics, a biotechnology start-up developing and applying Cannabis-Responsive™ biomarker technology to guide health care providers and patients to evidence-based personalized medical cannabis treatment.
