In 2022, an estimated 17.7 million people reported using marijuana daily or near-daily compared to 14.7 million daily or near-daily drinkers, according an analysis of national survey data. In 1992, when daily pot use hit a low point, less than 1 million people said they used marijuana nearly every day.

Alcohol is still more widely used, but 2022 was the first time this intensive level of marijuana use overtook daily and near-daily drinking, said the study’s author, Jonathan Caulkins, a cannabis policy researcher at Carnegie Mellon University.

“A good 40% of current cannabis users are using it daily or near daily, a pattern that is more associated with tobacco use than typical alcohol use,” Caulkins said.

The research, based on data from the National Survey on Drug Use and Health, was published Wednesday in the journal Addiction. The survey is a highly regarded source of self-reported estimates of tobacco, alcohol and drug use in the United States.

From 1992 to 2022, the per capita rate of reporting daily or near-daily marijuana use increased 15-fold. Caulkins acknowledged in the study that people may be more willing to report marijuana use as public acceptance grows, which could boost the increase.

Most states now allow medical or recreational marijuana, though it remains illegal at the federal level. In November, Florida voters will decide on a constitutional amendment allowing recreational cannabis, and the federal government is moving to reclassify marijuana as a less dangerous drug.

Research shows that high-frequency users are more likely to become addicted to marijuana, said Dr. David A. Gorelick, a psychiatry professor at the University of Maryland School of Medicine, who was not involved in the study.

The number of daily users suggests that more people are at risk for developing problematic cannabis use or addiction, Gorelick said.

“High frequency use also increases the risk of developing cannabis-associated psychosis,” a severe condition where a person loses touch with reality, he said.

Previously, the task force had said women could choose to start breast cancer screening as young as 40, with a stronger recommendation that they get the exams every two years from age 50 through 74.

The announcement Tuesday from the U.S. Preventive Services Task Force makes official a draft recommendation announced last year. The recommendations were published in the Journal of the American Medical Association.

“It’s a win that they are now recognizing the benefits of screening women in their 40s,” said Dr. Therese Bevers of MD Anderson Cancer Center in Houston. She was not involved in the guidance.

Other medical groups, including the American College of Radiology and the American Cancer Society, suggest mammograms every year — instead of every other year — starting at age 40 or 45, which may cause confusion, Bevers said, but “now the starting age will align with what many other organizations are saying.”

Breast cancer death rates have fallen as treatment continues to improve. But breast cancer is still the second-most common cause of cancer death for U.S. women. About 240,000 cases are diagnosed annually and nearly 43,000 women die from breast cancer.

The nudge toward earlier screening is meant to address two vexing issues: the increasing incidence of breast cancer among women in their 40s — it’s risen 2% annually since 2015 — and the higher breast cancer death rate among Black women compared to white women, said task force vice chair Dr. John Wong of Tufts Medical Center in Boston.

“Sadly, we know all too well that Black women are 40% more likely to die from breast cancer than white women,” Wong said. Modeling studies predict that earlier screening may help all women, and have “even more benefit for women who are Black,” he said.

Here are more details on what’s changed, why it’s important and who should pay attention.

WHEN SHOULD I GET MY FIRST MAMMOGRAM?

Age 40 is when mammograms should start for women, transgender men and nonbinary people at average risk. They should have the X-ray exam every other year, according to the new guidance. Other groups recommend annual mammograms, starting at 40 or 45.

The advice does not apply to women who’ve had breast cancer or those at very high risk of breast cancer because of genetic markers. It also does not apply to women who had high-dose radiation therapy to the chest when they were young, or to women who’ve had a lesion on previous biopsies.

WHAT ABOUT WOMEN 75 AND OLDER?

It’s not clear whether older women should continue getting regular mammograms. Studies rarely include women 75 and older, so the task force is calling for more research.

Bevers suggests that older women talk with their doctors about the benefits of screening, as well as harms like false alarms and unnecessary biopsies.

WHAT ABOUT WOMEN WITH DENSE BREASTS?

Mammograms don’t work as well for women with dense breasts, but they should still get the exams.

The task force would like to see more evidence about additional tests such as ultrasounds or MRIs for women with dense breasts. It’s not yet clear whether those types of tests would help detect cancer at an earlier, more treatable stage, Wong said.

DOES THIS AFFECT INSURANCE COVERAGE?

Congress already passed legislation requiring insurers to pay for mammograms for women 40 and older without copays or deductibles. In addition, the Affordable Care Act requires insurers to cover task force recommendations with an “A” or “B” letter grade. The mammography recommendation has a “B” grade, meaning it has moderate net benefit.

Cada noche sin falta, Paul Blumstein se coloca una máscara para evitar despertarse constantemente por tener dificultades para respirar.

Desde que se le diagnosticó un trastorno del sueño llamado apnea, es su rutina y, aunque le ayuda, no le gusta traer la máscara.

“Es como si un pulpo estuviera aferrado a mi cara”, dice Blumstein, de 70 años, quien vive en Annandale, Virginia. “Quisiera dormir una vez sin esa sensación”.

Han pasado dos décadas desde que los médicos reconocieron por completo que la respiración que se para y reanuda durante el sueño está relacionada con una serie de problemas de salud, incluso con muerte prematura, pero todavía no hay un remedio que resulte fácil para la mayoría.

Las máscaras de presión en la vía aérea, el remedio más común, han mejorado su diseño y ahora son más pequeñas y silenciosas, pero los pacientes se siguen quejando de que provoca resequedad en nariz y boca, además de claustrofobia.

Ahora, nuevas formas de dominar la apnea, y el explosivo ronquido que la acompaña, compiten por un lugar en las recámaras de millones de personas que desean pasar una buena noche. Los productos van desde un artilugio de 350 dólares para evitar dormir de espalda, hasta un implante quirúrgico de 24,000 dólares que presiona la lengua hacia el frente con cada respiración.

La guarda bucal para apnea, proporcionada por dentistas, funciona en algunos, pero tiene sus propios problemas, incluido el dolor de mandíbula. Algunos pacientes han probado la cirugía, pero con frecuencia no funciona. Los médicos recomiendan perder peso, pero la dieta y el ejercicio pueden ser un reto para quienes no duermen bien.

Hasta ahora, no hay píldoras para la apnea, pero los investigadores trabajan en ellas. En un estudio de este año, un medicamento con THC, el ingrediente activo de la marihuana, resultó prometedor.

¿Qué es la apnea del sueño? En las personas que tienen el trastorno, los músculos de su tráquea y lengua se relajan, y bloquean el paso del aire durante el sueño, como consecuencia de la obesidad, el envejecimiento y la estructura facial. Dejan de respirar, a veces hasta un minuto y cientos de veces cada noche, luego despiertan roncando y jadeando. Eso les impide tener un sueño profundo y restaurador.

Tienen más probabilidades de tener derrames cerebrales, ataques cardiacos y problemas de ritmo cardiaco, y es más probable que mueran antes. Pero es difícil definir si esos problemas son ocasionados por la apnea del sueño, por el exceso de peso, la falta de ejercicio o algo totalmente diferente.

Para los especialistas, el principal y más estudiado remedio sigue siendo la presión positiva continua en la vía aérea, o CPAP. Se aplica con un dispositivo motorizado que bombea aire a través de una máscara para abrir la vía aérea del paciente. Unos 5 millones de estadounidenses lo han probado, pero una tercera parte lo dejó en los primeros años por la incomodidad y la inconveniencia.

Martin Braun, de 76 años, de la Ciudad de Nueva York, dejó de usar su ruidosa máquina y extraña máscara, pero dice que la probará otra vez luego de un choque automovilístico cuando se quedó dormido al volante. “Ahí fue cuando caí en la cuenta de que esto ya es algo serio”, dijo Braun.

Aunque los científicos no han demostrado que la CPAP ayude a vivir más, la evidencia muestra que reduce la presión arterial, la somnolencia durante el día, los ronquidos y el número de veces que un paciente deja de respirar. También mejora la calidad de vida, el humor y la productividad.

A Blumstein lo diagnosticaron hace como 15 años luego de quedarse dormido al volante en un semáforo. Compartió sus frustraciones con el uso de la máscara en una reciente reunión organizada por pacientes con la Administración de Alimentos y Medicamentos de EEUU, como lo hizo Joelle Dobrow de Los Ángeles, quien dijo que se tardó siete años en encontrar una que le gustara.

“Pasé por 26 estilos diferentes de máscara”, dijo. “Llenaba una hoja de cálculo para no duplicarlas”.

Atinarle desde el principio es importante por las políticas de las aseguradoras. Medicare y otras aseguradoras dejaron de pagar máquinas rentadas de CPAP si un paciente nuevo no la usa suficiente. Pero con frecuencia, los pacientes han tenido problemas con los ajustes y las máscaras, y obtienen poca ayuda de los proveedores de equipo, según la doctora Susan Redline, el Hospital Bringham and Women’s, en Boston.

Mientras continúe la búsqueda de mejores remedios, escuchar a los pacientes será la clave, dijo Redline. “En realidad sólo atendemos de forma efectiva a un porcentaje muy pequeño de gente”, agregó.

Smartphone apps that monitor pill-taking are now available, and researchers are testing how well they work when medication matters. Experts praise the efficiency, but some say the technology raises privacy and data security concerns.

Selfie medicine works like this: Open an app on your phone, show your pills, put them in your mouth and swallow. Don’t forget to show your empty mouth to the camera to prove today’s dose is on its way. Then upload the video proof to the clinic.

Fans say the technology addresses a big problem: About half of drugs for chronic conditions aren’t taken as prescribed because of cost, side effects or patient forgetfulness.

With treatment for opioid addiction, a skipped dose can mean a dangerous relapse. The National Institute on Drug Abuse is funding research to tailor a smartphone app for those patients and see if they’ll use it.

“If we can keep patients engaged, we can keep them in treatment longer,” said lead researcher Dr. Judith Tsui of the University of Washington School of Medicine in Seattle.

The next phase of her research will compare a group of patients who use the monitoring app called emocha (ee-MOH-kuh) with those who don’t to see if there’s a difference.

At one Tennessee treatment center, some patients with opioid addiction are already using the app to upload selfies of their daily dose and answer questions about how they’re doing.

“Every time they sign on, it allows us to capture data. Are they having cravings? Suicidal tendencies?” said Scott Olson, CEO of Dallas-based Pathway Healthcare, which is trying the app at its Jackson, Tennessee, site. “Maybe a phone call from a counselor might make the difference between staying clean and a relapse.”

Olson thinks insurers will pay for the service with more evidence. For monitoring tuberculosis patients, health departments pay roughly $35 to $50 per patient each month for systems that include encrypted data storage. A small health department might pay as little as $500 a month.

The idea of watching someone take their medicine — called directly observed therapy or DOT — has roots in tuberculosis where one person’s forgetfulness can be serious for everyone. If patients don’t take all their antibiotics, their infectious TB germs can get stronger, developing drug resistance and endangering the broader community.

But taking a handful of pills daily for up to a year is difficult, so public health departments traditionally sent workers to people’s homes and workplaces to watch them take their doses. Today, many TB patients prefer remote monitoring. Nurses like it too.

Nurse Peggy Cooley has used Skype for years to chat live with patients taking TB medicine.

“We can accomplish in a two-minute phone call something that might have taken an hour to do and most of that hour was in the car,” said Cooley, who works for the Tacoma-Pierce County Health Department in Washington state.

The new uploaded selfies don’t need an appointment. They are a daily routine for many tuberculosis patients in Seattle, San Francisco, Los Angeles and Houston, where savings on mileage and worker time amounted to $100,000 in a recent year.

In Boston, Albuquerque and five other cities, researchers are studying whether the technology works for hepatitis C, a blood-borne virus that’s surging among a new generation of injection drug users. New drugs for hepatitis C can cure, but they’re expensive — $75,000 for a 12-week course of treatment — so insurers want to make sure patients take them.

“I think it holds a lot of promise,” said researcher Dr. Alain Litwin of University of South Carolina School of Medicine, who’s testing whether patients do better when someone watches them take their pills.

What’s next? An insurer in Maryland plans to use the technology in diabetes and high blood pressure to make sure Medicare and Medicaid patients take their medicine. Startups selling the apps say they could be used by faraway adult children monitoring an elderly parent’s daily pill-taking.

Experts worry about privacy, data security and penalties for poor pill-taking.

“That’s the biggest ick factor,” said Carolyn Neuhaus, a medical ethicist at the Hastings Center in New York. “You can imagine a program where benefits are tied to compliance and the insurer says, ‘We won’t pay for medication anymore unless you’re taking it correctly.'”

Globally, the rapid spread of smartphones creates an opportunity to eradicate TB, say the app developers.

But eliminating TB may take simpler, cheaper technologies that can be scaled for millions of cases, said Dr. Daniel Chin, who leads TB efforts for the Bill and Melinda Gates Foundation.

The group supports research in China and India on two homegrown technologies. China’s tool, about the size of a child’s shoebox, reminds patients to take their pills and saves data for review. In India, the government favors a blister pill pack printed with phone numbers; a patient punches out a daily pill, then calls the revealed number.

Worldwide, TB kills more than 1.6 million people annually, even though most deaths are preventable with treatment.

“If we are going to eliminate the disease, we need technology,” said Dr. Richard Garfein of the University of California, San Diego School of Medicine, who helped develop one of the smartphone apps, SureAdhere.

Researchers found a similar breast cancer risk with the progestin-only intrauterine device, and they couldn’t rule out a risk for other hormonal contraceptives like the patch and the implant.

But the overall increased risk was small, amounting to one extra case of breast cancer among 7,700 women using such contraceptives per year. Experts who reviewed the research say women should balance the news against known benefits of the pill — including lowering the risk of other cancers.

“Hormonal contraception should still be perceived as a safe and effective option for family planning,” said Dr. JoAnn Manson, chief of preventive medicine at Harvard’s Brigham and Women’s Hospital, who was not involved in the research.

Women in their 40s may want to consider non-hormonal IUDs, getting their tubes tied or talking with their partners about vasectomy, Manson said.

Studies of older birth control pills have shown “a net cancer benefit” because of lowered risk of cancer of the colon, uterus and ovaries despite a raised breast cancer risk, said Mia Gaudet, a breast cancer epidemiologist at the American Cancer Society.

There was optimism that newer, low-dose contraceptives would lower the breast cancer risk, but these results have dashed those hopes, said Gaudet, who wasn’t involved in the research.

About 140 million women use some type of hormonal contraception, including about 16 million in the United States.

Researchers analyzed health records of 1.8 million women, ages 15 to 49, in Denmark where a national health care system allows linking up large databases of prescription histories, cancer diagnoses and other information.

Results were published Wednesday in the New England Journal of Medicine. Novo Nordisk Foundation funded the research, but played no role in designing the study. The foundation has ties to the Danish pharmaceutical company Novo Nordisk, which primarily makes diabetes drugs and does not make contraceptives.

Current and recent use of hormonal contraceptives was associated with a 20 percent increased risk of breast cancer. Risk increased with longer use, from a 9 percent increase in risk with less than a year of contraceptive use to a 38 percent increase after more than 10 years of use.

Digging further, the researchers found no differences among types of birth control pills. Because of fewer users, the results for the patch, vaginal ring, implant and progestin shot were less clear, but the analysis didn’t rule out an increased breast cancer risk for those methods.

“No type of hormone contraceptive is risk-free unfortunately,” said lead author Lina Morch of Copenhagen University Hospital.

Researchers accounted for education, childbirth and family history of breast cancer, but they weren’t able to adjust for several other known cancer risk factors such as alcohol use and limited physical activity, or protective factors such as breast-feeding.

Women with a family history of breast cancer may want to ask their doctors about other contraceptives, said Dr. Roshni Rao, a breast surgeon at New York-Presbyterian/Columbia University Medical Center.

“Oral contraceptives are like any other medication,” Rao said. “There are risks and there are benefits. If you have a reason to be taking them, it’s perfectly reasonable to do so.”

Follow AP Medical Writer Carla K. Johnson on Twitter: @CarlaKJohnson

Doctors’ groups oppose the bills because of flawed science and ethical concerns. There is no evidence the procedure works and little information about its safety.

The procedure involves shots of the hormone progesterone given if a woman changes her mind after the first step of a medical abortion.

Since 2015, Arkansas and South Dakota have enacted laws requiring doctors to tell women about it. An Arizona law was challenged in court and later repealed. Bills are under consideration in Indiana, North Carolina and Utah. A Colorado proposal was killed in a committee in the Democratic-led House earlier this month.

“It’s really concerning that legislatures are passing laws interfering in the doctor-patient relationship and forcing them to tell women about an experimental therapy that is unproven,” said Dr. Daniel Grossman, a professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at University of California, San Francisco.

What is medical abortion?

About a third of women who seek abortions in early pregnancy choose medical abortions because they want a less invasive procedure than a surgical abortion.

In the United States, medical abortion involves taking two drugs. The first — mifepristone — thins the lining of the uterus and loosens the connection between the embryo and the uterine lining. The second — misoprostol — softens and opens the cervix and causes contractions to push out the pregnancy.

The second drug is taken at home hours to days after the first drug.

Women rarely change their minds before completing the treatment. Doctors are required to report such information to the manufacturer of mifepristone. Between 2000 and 2012, less than 0.004 percent of women taking mifepristone changed their minds, Grossman said.

“Women are very sure of their decision by the time they go to the abortion clinic,” Grossman said.

What are the claims for “reversal”?

Progesterone is legitimately used to prevent preterm birth in women who are at risk of early delivery. Some claim it can counteract the effects of an unfinished medical abortion.

Dr. George Delgado in San Diego, California, is the chief advocate. He is medical director of Culture of Life Family Services, described as “the ‘flip-side’ to Planned Parenthood” on its website. The clinic “offers true reproductive health care and abortion alternatives to women,” the website says.

Delgado published a paper in 2012 about six women who had taken mifepristone, the first medication in the two-part medical abortion, then had a series of progesterone shots. Four of the six women had healthy babies. The other two aborted.

Delgado says he has given progesterone to several hundred other women who also changed their minds after starting a medical abortion. He says he has a 60 to 70 percent success rate and hopes to publish the results in a peer-reviewed journal.

“If there’s a way to give them a second chance at choice, it will be a wonderful thing,” Delgado said.

What is the evidence?

Delgado’s study is not considered high-quality research because it is small and there was no comparison group. Researchers have questioned whether the women were given adequate information about the experimental nature of the procedure.

For women who change their minds after taking mifepristone, doing nothing and waiting to see what happens may be just as effective as progesterone shots.

That’s because mifepristone alone doesn’t work very well without the second drug. Thirty percent to 50 percent of women who take mifepristone alone will have continued pregnancies, according to the American Congress of Obstetricians and Gynecologists. (Delgado disputes this and says the survival rate of embryos after mifepristone is much smaller.)

Progesterone shots are generally safe but can cause swelling, irritation and other side effects. The cost of pushing an experimental procedure into widespread use also raises ethical questions, Grossman said. The injections and doctor visits involved can cost up to $1,000.

She doesn’t mind. It’s the fragrance of money and jobs.

“My family says I smell,” said Thompson, who quit the classroom to work for Ataraxia, one of a handful of cultivation centers in Illinois, which is one of 23 states with medical marijuana. “I can’t tell though.”

The Associated Press recently gained an exclusive look at Illinois’ first legal marijuana crop, and the new farmland ritual beginning amid surrounding cornfields in the historic town of Albion: the harvest of medical marijuana that will soon be sold in dispensaries around the state.

Ataraxia is the first center to make it to the finish line after running a gantlet of state requirements. For the company to find a home in Albion — where grain trucks rumble past the sleepy central square, cicadas drone in the trees shading a century-old courthouse and a breeze touches an empty bandstand — is paradoxical. Stores can’t sell package liquor, but marijuana has been welcomed as a badly needed source of employment.

A comical T-shirt for sale says the town is “High and Dry.”

Cheryl Taylor, who sells the shirts at her shop on the square, said the marijuana facility has everyone curious: “It’s brought our little town to life.”

Down a country road, tucked behind the New Holland tractor dealer and the Pioneer seed plant, the history-making cannabis crop is being cut and dried behind the locked doors of a giant warehouse. By mid-October, strains with names like Blue Dream, OG Kush, Death Star and White Poison will be turned into medicine in many forms: oils, creams, buds for smoking, edible chocolates and gummies.

It’s been a twisting path to harvest, marked by delays and a secretive, highly restrictive program meant to avoid the creation of easy-access pot shops seen in other states. Until Illinois gave approval in late September for the AP’s tour, only company workers and government inspectors had been inside the warehouse.

Thousands of cannabis plants — some in full bud, coated with cannabinoid-rich fibers — filled two large rooms at the facility on the day of the AP’s tour. Mother plants and young plants started from cuttings had their own, smaller rooms.

The 1,900-person community of Albion, which is closer to Louisville, Kentucky, than Chicago, has embraced all this, sight unseen.

“It’s a good thing for the local economy,” said Doug Raber, who sells insurance. “This is a pretty conservative area. Any kind of revenue we can have here is good.”

Local developers sold a cornfield to Ataraxia for $5,000 an acre, which real estate agent Randy Hallam said is a 50 percent discount. The city also paid to build a road and extend water and sewer lines. The company hired locals to build and outfit the warehouse.

But only seven people, aside from managers, have been hired permanently. With only 3,000 approved medical marijuana patients, the company can’t expand yet. CEO George Archos said he wants to hire 50 to 60, and meeting that goal will go a long way to keeping the community’s support.

“Albion needs to diversify its employment,” said Duane Crays, editor of The Navigator, Albion’s newspaper. Chief employers regionally are agriculture, oil and gas production, and an auto filter plant.

Albion might seem an unlikely place for pioneering a marijuana crop, but it is no stranger to controversies, large and small. A few years ago, residents were at odds over whether to restore the historic brick streets or pave them over. The current debate is whether to sell alcohol in stores or keep the city dry, as it has been for decades, except for clubs.

A love triangle was the city’s first rift. Albion was founded in 1818 by an Englishman, George Flower; a former rival for the affections of Flower’s wife founded his own settlement 2 miles away. The two men did agree on abolition, and the rival, Morris Birkbeck, penned essays credited with keeping Illinois free of slavery.

Traces of that settler spirit remain today, Ald. Arrol Stewart said. “As the sign says when you come into town: ‘Progressively Independent since 1818,'” Stewart said.

Residents’ excitement over the health benefits of marijuana — from stimulating appetite in cancer patients to easing stiffness for people with multiple sclerosis — may also have historic roots. The bandstand marks the spot where a mineral spring once drew patients with a host of ailments; it was said the water could cure.

“My wife has MS,” Hallam said. She doesn’t have her patient card yet, he said, “but she has a doctor’s appointment coming up.”

More than 230,000 state residents could have lost the tax credits that help them pay for coverage if the court had ruled the other way. In Illinois, the average monthly subsidy is $211.

Without tax credits, consumers would have seen their premiums increase on average by 169 percent, according to the nonpartisan Kaiser Family Foundation.

The ruling came as a relief to Shawn Turner, 55, of Cisco in central Illinois. She finished chemotherapy for uterine cancer last summer and now sees her doctor for regular follow-up scans to make sure the cancer is gone.

“I’m just so relieved and happy, not just for me but for everyone who’s being helped by this,” Turner said Thursday after being informed of the ruling.

She and her husband pay $236 a month for a mid-level “silver” health plan, and the government pays the insurance company $830 a month. Blue Cross Blue Shield has covered more than $265,000 in medical bills for Turner.

The fear of cancer returning would have kept them from dropping the coverage, even if the subsidies were struck down.

“We would have to go into savings and retirement or start selling stuff,” she said before the high court’s decision.

Groups representing Illinois doctors and hospitals applauded the ruling.

Illinois State Medical Society President Scott Cooper said the decision “provides important peace of mind for thousands of Illinois patients” who buy insurance through HealthCare.gov. And Illinois Hospital Association President Maryjane Wurth said the subsidies make insurance affordable to thousands of low- and moderate-income residents.

Reaction also came from Land of Lincoln Health, a not-for-profit health plan that covers more than 50,000 Illinoisans. Company President Jason Montrie said “all Americans have the right to access affordable, high-quality health insurance,” and the subsidy helps many Illinois citizens meet their essential health care needs.

The federal health care law has survived repeated repeal attempts by Republican opponents in Congress.

U.S. Rep. Bob Dold, R-10th, was among a few Republicans in the House to vote against a repeal earlier this year. Dold reiterated his stance that it’s time to stop talking about the law’s flaws and start talking about fixing them.

“The Supreme Court’s ruling today in no way ends Washington’s responsibility to implement the serious, bipartisan reforms to the law that are needed to drive down costs, restore access to care and make healthcare work for everyone,” Dold said in a statement Thursday.

Many consumers had been unaware of the case before the Supreme Court. Forty-four percent of Americans said they’d heard nothing at all about it, and another 28 percent said they’d heard only a little, according to the Kaiser Family Foundation tracking poll in early June.

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“The governor believes there is a lot of time left to evaluate a pilot program, and we should not extend the program until it has been fully evaluated,” Rauner spokeswoman Catherine Kelly said in a statement.

Rauner was reacting to a bill backed by Rep. Lou Lang, a Skokie Democrat who sponsored the original medical marijuana legislation. Lang’s bill would extend the program four years from when the first dispensary begins officially operating.

The pilot program is scheduled for automatic repeal on Jan. 1, 2018. Because of unexpected delays, businesses aren’t yet selling the drug and aren’t expected to begin sales until later this year.

Lang said sticking with the original end date for the program would drive up costs for patients and create unnecessary hardship for businesses. “It’s important that we put a little more time on the clock,” he said.

Meanwhile, 2,000 approved medical cannabis patients have paid to register for the program. Lang’s bill would allow those patients to use their registry cards for a year after the first dispensary starts operating without paying a $100 renewal fee.

That part of the bill may not be necessary. Illinois Department of Public Health spokeswoman Melaney Arnold said the department intends to issue the cards once dispensaries are open and patients won’t have to renew their registration until 12 months from the date the registry card is issued.

Officials in Rauner’s administration asked Lang to hold off on filing his bill, but Lang said he pushed ahead. He added that the governor “should do his job and I’ll do mine.”

The bill is HB3299.

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Circuit Court Judge Kathleen Kennedy also ordered Cresco Labs to post a bond of $200,000 to compensate for any harm caused if delays are later found to be improperly granted.

Cresco Labs was the top-scoring company and the winner in the licensing competition for a center in Kankakee that would serve Ford, Iroquois and Kankakee counties. The company also has obtained a state license for a growing center in Joliet.

A company called PM Rx, claims the Illinois Department of Agriculture broke its rules when awarding permits, and it should have received the state license for the downstate center.

The case, one of at least four legal proceedings entangling Illinois’ marijuana pilot program, involves questions about a secret selection process and whether unsuccessful businesses will ever know why their applications failed to win permits.

The Illinois medical marijuana law shields the applications from public disclosure, which has kept PM Rx unable to directly cite problems with the government’s evaluation of applications. But Gov. Bruce Rauner’s office has said problems in the process under his predecessor had created a “risk of substantial and costly litigation” to the state when licenses were issued Feb. 2 for growing centers and dispensaries.

Citing the governor’s concerns, PM Rx persuaded the judge to pause the process. PM Rx also noted the state’s troubles completing FBI background checks of applicants and called into question the background of Cresco’s lead grower.

PM Rx also raised doubts about whether Cresco, which won three state licenses for growing centers, had enough money to get its business off the ground.

Attorneys for the Agriculture Department and Cresco refuted the claims, saying Cresco has met all of its financial obligations and passed background checks.

“They argue we’re searching for financing. So what? We’re allowed to,” Cresco Labs’ attorney Steve Levy said in court Wednesday.

Levy had argued that his client wasn’t properly notified about the lawsuit. He said Cresco Labs wasn’t able to argue its case against the temporary restraining order granted two weeks ago. Kennedy’s order halted the Illinois Department of Agriculture from issuing a permit to Cresco for its Kankakee operation.

In allowing the order to stand Thursday, the judge noted that Cresco will be able to make its arguments as the case progresses.

Separately Thursday, the Illinois Appellate Court denied the Agriculture Department’s appeal of the same temporary restraining order.