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. 2022 May 4;48(3):321-327.
doi: 10.1080/00952990.2021.2007257. Epub 2022 Feb 7.

Changes in medical and non-medical cannabis use among United States adults before and during the COVID-19 pandemic

Ryan D Assaf  1   2 , Pamina M Gorbach  1   2   3 , Ziva D Cooper  1   4   5
Affiliations

Changes in medical and non-medical cannabis use among United States adults before and during the COVID-19 pandemic

Ryan D Assaf et al. Am J Drug Alcohol Abuse. .

Abstract

Background: During the SARS-CoV-2 pandemic, cannabis dispensaries in the United States (US) reported increased sales.Objectives: This study assessed changes in cannabis use before to during the pandemic; it was hypothesized that cannabis use increased during the pandemic.Methods: A US-based survey of adults assessed patterns of use before and during the pandemic. Participants recruited via social media from 8/2020 to 9/2020 self-reported medical and non-medical cannabis use. Use was categorized as ≤ monthly, weekly, and daily/almost daily; adjusted logistic regressions determined associations between cannabis use before the pandemic with change in frequency during the pandemic.Results: Of 1,886 respondents (63% male),1,113 reported non-medical and 603 medical use of cannabis. Those reporting ≤monthly non-medical use before the pandemic had higher odds of increasing use during the pandemic than those using weekly before the pandemic (AOR 3.2 [95% CI 2.2-4.5]). Those reporting ≤ monthly and daily medical cannabis use before the pandemic had higher odds of increasing use during the pandemic than those using weekly before the pandemic (AOR 2.3 [95% 1.3, 3.9]; AOR 2.4 [95% CI 1.2, 5.1] respectively).Conclusions: The most notable increases in cannabis use during the pandemic were among those who reported using cannabis least frequently before the pandemic (two to three times odds of increased use among ≤ monthly use compared to weekly). These findings have important implications for potential health consequences related to increased cannabis use both during and after the pandemic, even in populations thought to be protected by minimal use prior to the pandemic.

Keywords: COVID-19; Cannabis; SARS-CoV-2; cannabinoids.

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Figures

Figure 1.
Figure 1.
Adjusted logistic regression of non-medical and medical cannabis frequency of use before to during the pandemic among a cannabis using population, August-September 2020. Data were collected on those whoreported cannabis and/or cannabidiol use in the United States in a single web-based survey to assess cannabis behaviors before and during the COVID-19 pandemic. Multivariable logistic regressions were conducted to assess the association of cannabis behaviors before the pandemic to changes in behaviors during the pandemic. Figure 1 shows cannabis use before the COVID-19 pandemic on change in cannabis use during the COVID-19 pandemic. Change in cannabis use during the COVID-19 pandemic was dichotomized as increased or stayed the same (reference). Models for non-medical and medical cannabis use were conducted separately (denoted with a * in Figure 1). Adjusted odds ratio and 95% confidence intervals (denoted as 95% CI in Figure 1) are presented and displayed in a forest plot. State’s cannabis regulatory status, participant’s age, and participant’s sex were adjusted for in the models. Age was recentered at mean age and rescaled per 10-unit increase (denoted as Age** in Figure 1). Sample sizes for the models were: non-medical cannabis (n = 848); medical cannabis (n = 474).
Figure 2.
Figure 2.
Adjusted logistic regression of non-medical and medical cannabis frequency of use before the pandemic on change in mode of cannabis use during the pandemic among a cannabis using population, August-September 2020. Data were collected on those who reported cannabis and/or cannabidiol use in the United States in a single web-based survey to assess cannabis behaviors before and during the COVID-19 pandemic. Multivariable logistic regressions were conducted to assess the association of cannabis behaviors before the pandemic to changes in behaviors during the pandemic. Figure 2 shows cannabis use before the COVID-19 pandemic on change in mode of use during the COVID-19 pandemic. Change in mode of use was dichotomized as change from inhalation to oral or did not change from inhalation to oral (reference). Models for non-medical and medical cannabis use were conducted separately (denoted with a * in Figure 2). Adjusted odds ratio and 95% confidence intervals (denoted as 95% CI in Figure 2) are presented and displayed in a forest plot. State’s cannabis regulatory status, participant’s age, and participant’s sex were adjusted for in the models. Age was recentered at mean age and rescaled per 10-unit increase (denoted as Age** in Figure 2). Sample sizes for the models were: non-medical cannabis (n = 894); medical cannabis (n = 406).
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