Lena Yannella

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The Problem: The legalization of cannabis for both medical and recreational use has become more widespread, and public opinion regarding it has become more liberal. But there is a limited amount of research that compares cannabis usage among adults with medical conditions, as opposed to without medical conditions.

 

Why do this study?  Cannabis has gained acceptance in large part because of its medical uses, but it is not known what proportion of people use cannabis for medical reasons. A past study found that cannabis users over the age of fifty were almost equally split between medicinal and recreational users, but this new study included people as young as eighteen.

 

The study: This study used a probability sample of about 170,000 adults in the United states between 2016-17, taken from the Behavior Risk Factor Surveillance System. It analyzes the prevalence and patterns of cannabis usage, sorting people by age, medical condition and sociodemographic status. Those with medical conditions were more likely to use cannabis, especially if they suffered from asthma, chronic obstructive pulmonary disease, arthritis, cancer, or depression. But older people with medical conditions were less likely than young people with medical conditions to report regular cannabis usage. Specifically, among those with medical conditions, 25.2% of people aged 18-24 and only 2.4% of people aged 65+ used cannabis. Adults with medical conditions were also more likely than adults without medical conditions to report using cannabis for medicinal reasons, and less likely to report using cannabis for recreational purposes. Specifically, 45.5% of users with medical conditions said their cannabis use was for medical reasons, but only 21% of those without medical conditions said their cannabis use was for medical reasons. Only 23.7% of people with medical conditions reported using cannabis for recreational purposes, but 57.7% of people without medical conditions reported using cannabis for recreational purposes. Across the board, the most popular method of using cannabis was smoking.

 

Conclusions: Cannabis usage is more common among adults with medical conditions. The study suggests that clinicians should understand the prevalence and purposes of cannabis usage among their patients and work on a case-by-case basis to maximize benefits and reduce risks.

 

Funder: None

 

Author conflicts: None

 

Commentary (David Casarett MD): This study is important mostly because of its size and scope.  Most studies of cannabis use have been small, and focused on a single population or clinic.  But this study is nationwide in the US, and offers a representative picture of cannabis use patterns.  One of the most interesting results was the finding that although medical use was more common among people with medical conditions, approximately one in 5 people without medical conditions reported they were using medically.  This raises interesting questions about what the medical indications for that use were.  Another interesting finding was an approximately 10x decrease in medical use prevalence from young adults to those over 65.  Further research is needed to understand whether use is inappropriately high among young adults or inappropriately low among older adults.