Patterns of past month cannabis consumption and cannabis use disorder – Insights from a nationally representative survey

Abstract

Background

As cannabis usage continues to surge in the United States, understanding the nuances between medical and recreational use, as well as the frequency of past-month consumption, is critical for public health. The need to differentiate these patterns and assess their implications for Cannabis Use Disorder (CUD) is important for both clinical care and health policy in the United States.

Methods

This study utilized data from the AmeriSpeak® web-based panel, a nationally representative sample of U.S. households. Participants (n = 1719) were adults aged 18 and older who completed a self-report survey in December 2023 or January 2024 and reported past-month cannabis use. The Cannabis Use Disorder Identification Test (CUDIT) was employed to measure usage frequency and identify CUD risk, with scores of 8 or more indicating hazardous use and scores of 12 or more indicating possible CUD. Multinomial logistic regressions were conducted to explore associations between sociodemographic characteristics and cannabis dependence, further segmented by past-month frequency of medical and recreational use.

Results

Approximately 10 % of adults reported past-month medical cannabis use and 17 % reported recreational use. Any past-month medical cannabis use was associated with a 26 % CUD rate (95 % CI: 19.8–30.4) and hazardous use rate of 25 % (95 % CI: 18.5–31.2). When broken down by frequency, CUD rates ranged from 16 % to 34 % for people who use cannabis for medical purposes : occasional use (19 %, 95 % CI: 13.7–24.3), moderate use (24 %, 95 % CI: 17.5–30.5), and daily or near-daily use (31 %, 95 % CI: 24.1–38.3). People who use cannabis for non-medical (recreational) reasons showed a 21 % overall CUD rate (95 % CI: 17.7–25.2), with segmented rates by frequency indicating 10 % for occasional use (95 % CI: 6.2–13.8), 24 % for moderate use (95 % CI: 18.1–29.9), and 32 % for daily or near-daily use (95 % CI: 25.3–38.7). Younger adults (18−29) and males were identified as the most at-risk groups, exhibiting the highest CUD scores across both medical and recreational categories.

Discussion

Over a quarter of people who use cannabis meet the criteria for CUD, underscoring the importance of more precise assessments of cannabis use patterns. While no significant differences between medical and recreational cannabis use were observed, the nuances in usage patterns become obscured when grouping all individuals who use cannabis in the past-month together, potentially masking important differences in risk levels. Integrating frequency and quantity metrics into clinical assessments, similar to practices in alcohol consumption research, is imperative. This approach allows healthcare providers to gain a comprehensive understanding of cannabis use behaviors and associated CUD risks, providing crucial insights for developing targeted interventions, support services, and strategies to address cannabis-related health risks effectively.