Characterization of medical and recreational cannabis use among U.S. adults: Results from a nationally representative...

This study estimates the prevalence and correlates of medical cannabis use (MCU), recreational cannabis use (RCU) and combined medical + recreational cannabis use (MRCU) among U.S. adults. We analyzed data from the sub-sample of adults aged 18 or older who had used cannabis in the past year (N = 12,706), drawn from the 2022 National Survey on Drug Use and Health (NSDUH). Descriptive and bivariate analyses were conducted to identify the correlates of MCU, RCU and MRCU. A total of 11.14% reported MCU, 83.02% RCU, and 5.83% MRCU. Past-year cannabis use disorder (CUD) prevalence was higher for MRCU (43.61%) compared to MCU (34.43%) and RCU (28.85%), and for MCU compared to RCU (ps<0.001). Individuals reporting MRCU were more likely to report past year serious psychological distress and any past year illegal drug use in comparison to those reporting strictly recreational or medical use (ps<0.05), and were also more likely to report past year major depressive episode (p<.05), receiving treatment for mental health in the past year (p<.05), and more days of cannabis use in the past month than people who only used cannabis recreationally (p<.001). In summary, adults who reported MRCU have a higher prevalence of CUD and endorsed worse mental health relative to people reported RCU and MCU, especially in comparison with RCU. This underscores the importance of physicians accurately selecting patients who will be good candidates for medical cannabis, regularly conducting assessments for CUD and other mental disorders, and, when necessary, referring patients to appropriate services.