Cannabis use and beliefs among people in recovery from substance use disorders

Cannabis use has increased dramatically in the past decade and is currently among the most commonly used drugs in the world. Among people in recovery from substance use disorders (SUDs), cannabis is sometimes put forward as a less harmful substitute for other drugs, conflicting with abstinence-based recovery approaches. We aimed to describe cannabis use among people in recovery, explore relations among cannabis use (CU) status (Current-CU, Former-CU, Never-CU) and beliefs about social acceptability, safety, benefits, risks, and addictiveness of cannabis, and compare beliefs about the addictiveness of cannabis with that of other substances.

This study was a cross-sectional, online survey of people in recovery (n = 507) from SUDs. Cannabis use and beliefs about acceptability, benefits, risks, safety, and addictiveness were assessed, and diagnostic criteria for SUDs, including cannabis use disorder (CUD).

Participants were, on average, 47.2 (SD = 12.2) years old, 67.3% female, 81.1% White, and 93.7% non-Hispanic/Latino; 35.9% and 51.3% indicated Current- or Former-CU, respectively. Current-CU was associated with use for therapeutic purposes, and more positive beliefs about the acceptability (ps ≤ .010), safety (ps < .001), and benefits of cannabis, and risks compared to Former- or Never-CU. Those who never used cannabis rated cannabis as the least socially acceptable (ps ≤ .015), least safe (ps ≤ .036), and were least likely to endorse potential benefits. Individuals who formerly used cannabis generally showed intermediate beliefs. All participants believed cannabis was less addictive than alcohol (ps < .001), cigarettes (ps < .001), and cocaine (ps < .001), but Current-CU believed cannabis was significantly less addictive (ps < .001) than Former- and Never-CU. Participants with mild CUD believed cannabis was less addictive than those with severe CUD. Among participants with other SUDs, beliefs about the addictiveness of the respective substance did not differ by SUD severity (ps ≥ .298).

These findings underscore the importance of recognizing heterogeneity in cannabis use among people in recovery. Those with mild CUD believed cannabis was the least addictive while those with severe CUD believed cannabis was most addictive. In contrast, beliefs about the addictiveness of other substances were independent of SUD severity. This pattern of beliefs about addictiveness appears to be specific to cannabis. Understanding beliefs about cannabis use among people in recovery may clarify its impact on recovery.