Smart Cannabis: A Prescription Digital Therapeutic Framework for Enhancing Medical Cannabis Care.

Despite expanding legalization and therapeutic interest, medical cannabis remains contested, characterized by self-directed use, inconsistent product labeling, and minimal clinical oversight. Patients are often left to navigate strain selection, dosing, and administration without meaningful support from the healthcare system. This open-loop model poses significant risks, particularly for vulnerable populations, and fails to meet the safety, efficacy, and accountability standards expected of medical treatments. This commentary introduces a Smart Cannabis model that would integrate medical cannabis with smartphone-delivered prescription digital therapeutics (PDTs) to improve precision, safety, and therapeutic effectiveness. PDTs could offer real-time monitoring, personalized guidance, and data-driven feedback that could enhance cannabis efficacy by optimizing formulation, dosing, and timing based on individual response patterns. Further, PDTs have been leveraged to treat migraine, depression, insomnia, and PTSD, which offer synergies with cannabis treatment. When combined, cannabis and PDTs could form a closed-loop care system capable of fine-tuning treatment to maximize intended outcomes while minimizing risks. If implemented, this fusion may also generate real-world evidence to inform clinical guidelines, policy decisions, and product development. Massachusetts's Medical Use of Marijuana Program, administered by the Cannabis Control Commission, offers a unique opportunity to pilot this approach, given its robust regulatory infrastructure, centralized patient registries, and history of innovation. Policy recommendations include launching Smart Cannabis pilot programs, improving product labeling standards, establishing bundled reimbursement models, and expanding clinician education. Smart Cannabis is not simply a technological upgrade; it is a necessary evolution in cannabinoid care, one that aligns with the principles of precision medicine and modern therapeutic governance.