The American Medical Association published a new study that found while marijuana usage among Canadian adults increased in the year following legalization of the drug, the problematic use of the drug actually decreased.
The JAMA Network Open report published Wednesday looked at data collected from 1428 adults aged between 18 and 65 who were assessed roughly every six-months during the period September 2018 through October 2023.
The study’s primary objective, partially funded by Canada’s Institutes of Health Research (CIHR), was to determine how the consumption pattern changed after the legalization of marijuana for adult use in the country, with sales beginning October 2018. Researchers wanted to determine if consumption patterns had changed in relation to how often people used marijuana prior to the legalization, as well as if users’ preferences for products changed.
Overall, the frequency of marijuana consumption increased over a five-year span. Over the course of the five-year period, cannabis use increased in all participants by an average 0.35 per cent each year.
Cannabis use dropped the most among those who consumed it daily before its legalization. Before legalization, people who smoked marijuana daily decreased their frequency of use more than those that smoked marijuana weekly.
Before legalization of marijuana, those who only used it once or twice a month reported a slight increase in their use.
Cannabis use has increased in the United States, but misuse of cannabis is down.
As for misuse, analysis using the so-called Cannabis Use Disorder Identification Test – Revised (CUDIT-R) showed a significant decrease in cannabis misuse overall, authors wrote, especially during the early months of the COVID-19 pandemic, from April to October 2020.
People who used marijuana monthly or less than monthly before legalization saw their CUDIT-R scores drop significantly, while those who’d never used marijuana saw a slight increase—suggesting that at least some people did start using after legalization and then develop problematic habits.
The study notes that people who used marijuana on a weekly basis prior to legalization had their CUDIT scores drop “below the CUDIT cutoff of 6, which indicates problem cannabis abuse.” This suggests that marijuana use amongst occasional users has improved since legalization.
This trend may be explained by the age of users. The report states that “the apparent discrepancy” between increased cannabis consumption and decreased cannabis misuse could have been caused by younger users, who typically switch from problematic to not-problematic cannabis use with age.
The authors noted that, in terms of changes to use patterns based on the frequency of usage prior to legalization: “Regression to the mean may explain some of the interactions findings.”
They said that “fundamentally however, the results did not indicate an increased risk of adverse outcomes in adults who actively used cannabis prior to legalization.”
In terms of product preference, there were statistically significant declines across the board in flower, concentrates, oils, tinctures, and topicals. In contrast, edibles, drinks and vapes cartridges were used more.
Report: “The use of cannabis cartridges and disposable vape pens has increased the most, with an annual rise in prevalence from 18.4% before legalization to 33.0% five years later.”
The authors wrote that, while further research is needed, the results indicate both positive and adverse consequences of legalization. The observed rise in usage is a negative. The positives are the lower scores on marijuana misuse and an apparent transition from combustible cannabis to noncombustible, both of which carry lower risks.
This report states, “From the public health perspective, these results can be mixed, as increased usage might be considered detrimental, while decreased abuse is a good outcome.”
Additionally, while the results were statistically significant, the research team noted that “for both outcomes…it is debatable whether these changes were clinically significant.”
The study states that this is especially true for CUDIT R scores misused, which “have decreased only by 0.4 points over a period of 5 years on a scale from 32 to 32”, according to the report.
In the United States, as marijuana laws change more frequently, government officials and public health professionals have tracked consumer behavior. Recently, a Centers for Disease Control and Prevention report broke down federal statistics on cannabis usage among U.S. adults. It found that although smoking remains the preferred method of consumption, eating, vaporizing and dabbing methods are gaining in popularity.
In 2022, 15,3 percent of adult users reported using marijuana currently, and 7.9 percent said they used it daily. Most (79.4%) reported that they were smokers, followed by those who ate (41.6%), vaped (30.3%), or dabbed (14.6%).
About half of all adults who used marijuana (46.7 percent) reported multiple methods of use—most typically smoking and eating or smoking and vaping.
Rates of both vaping and dabbing—as well as cannabis use in general—were higher in young adults than the general adult population.
An earlier analysis from CDC found that rates of current and lifetime cannabis use among high school students have continued to drop amid the legalization movement.
Another recent federal report, published by the Substance Abuse and Mental Health Services Administration (SAMHSA), found that consumption among minors—defined as people 12 to 20 years of age—had fallen slightly in the past year. Despite methodological changes that make comparisons over time difficult, it also suggests that youth use has fallen significantly in the past decade.
A separate poll recently found that that more Americans smoke marijuana on a daily basis than drink alcohol every day—and that alcohol drinkers are more likely to say they would benefit from limiting their use than cannabis consumers are.
The survey showed that U.S. adult drinkers are three times more likely than marijuana users to think they would be better off using less of their favorite substance. The survey also found that lifetime alcohol consumption among adult was more prevalent than marijuana use. However, the daily cannabis usage was more popular.
An earlier report published in the Journal of Studies on Alcohol and Drugs that found that secondhand harm caused by marijuana use is far less prevalent than that of alcohol, with respondents reporting secondhand harm from drinking at nearly six times the rate they did for cannabis.
Yet another 2022 study from Michigan State University researchers, published in the journal PLOS One, found that “cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults” in legal states, “but not for underage persons who cannot buy cannabis products in a retail outlet.”
The trends were observed despite adult use of marijuana and certain psychedelics reaching “historic highs” in 2022, according to separate data.
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