Regulations are increasing cannabis access, but comparisons of medical/recreational use are limited.
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Most medical users (89.0%) report cannabis manages symptoms/disease and two-thirds report less use of other medicines.
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Medical users show more psychopathology, substance use and problematic cannabis use; 80.1% also use recreationally (MED + REC).
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Compared to medical only, MED + REC report more substance use. Despite similar severity, more use cannabis for psychiatric conditions.
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MED + REC users may be at-risk subpopulation requiring attention in a post-legalization landscape.
Abstract
Background
Regulatory changes are increasing access to both medical cannabis and cannabis in general. As such, understanding patterns of recreational and medical cannabis use is a high public health priority.
Objectives
Patterns of cannabis use (recreational and medical), other substance use, and psychiatric symptoms were characterized in a large sample of community adult cannabis users in Canada, prior to federal cannabis legalization.
Methods
This was a self-report assessment of 709 cannabis users (Mean age = 30.19 (11.82) years; 55.01% female). Patterns of overall substance use and psychiatric symptomatology were compared based on recreational/medical cannabis status.
Results
Overall, 61.4% of participants endorsed exclusively recreational use, while 38.6% reported some level of medical use. Of all medical users, only 23.4% reported authorization from a health professional. Recreational cannabis users typically reported infrequent use (less than weekly), whereas medical users modally reported daily use. Compared to recreational users, medical users reported more problematic cannabis use in addition to greater psychiatric symptomatology (anxiety, depression and trauma). Interestingly, a large majority of medical users also reported using recreationally (80.6%), while exclusive medical use was less common (19.3%). This dual motives group reported more daily cannabis use and more alcohol and tobacco use. Compared to medical-only users, individuals using cannabis for both medical and recreational purposes more often used cannabis to treat psychiatric conditions.
Conclusions
These findings reveal the differences in cannabis use patterns and preferences between recreational and medical users, and even within medical users. In particular, dual motives individuals, who use cannabis for both positively and negatively reinforcing purposes, may warrant special attention as a subpopulation.
