Using prospective mixed methods to investigate the effect of the COVID-19 pandemic on cannabis demand

Following the COVID-19 pandemic, it is vital to understand how major global stressors influence substance use, including cannabis-related outcomes. The Marijuana Purchase Task assesses hypothetical cannabis demand (i.e., relative reinforcing value) and can detect contextual alterations. This study paired prospective cannabis demand assessment with qualitative inquiry to explore how COVID-19 impacted cannabis use behavior. Individuals previously enrolled in a laboratory cannabis administration study opted in to a remote follow-up survey (n = 41, 46% female). Participants were categorized as those who did or did not increase use based on self-reported changes in cannabis flower use and provided contextual explanations regarding pandemic-related influences on cannabis outcomes. General linear models with repeated measures examined mean differences in demand by occasion (i.e., before/during COVID-19), group (i.e., those who did/did not increase use), and their interaction. Those who increased use exhibited significantly higher demand during the pandemic; those who did not increase use exhibited similar demand across time revealing a Group × Time interaction. Thematic analysis contextualized quantitative findings, explaining external influences that affect use and demand (e.g., changes in cost, access, environment). COVID-19 differentially impacted cannabis use and demand, with prepandemic use affecting trajectories. Contextual influences (i.e., availability, free time, income) facilitate the escalation of use under conditions of extreme global stress.