Changes in medical and non-medical cannabis use among United States adults before and during the COVID-19 pandemic

Assaf, Ryan D; Gorbach, Pamina M.; Cooper, Ziva D.

doi:10.1080/00952990.2021.2007257

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…This cross-sectional study used data from an anonymous, USA-based web survey on cannabis-related behaviors from August to September 2020. Detailed methods of the survey have been described elsewhere [ 19 ]. Briefly, respondents were eligible to complete the survey if they were (1) 18 years of age or older, (2) reported any cannabis or cannabidiol (CBD) use in the last 12 months and (3) lived in the USA ( N = 1883).…”

Section: Methodsmentioning

confidence: 99%

“…One study in Spain found that individuals reported decreases in the average joints (a rolled cannabis cigarette) smoked per week during the pandemic compared to before [ 17 ]. On the other hand, two scoping reviews on cannabis use during the pandemic and other studies in the USA reported comparable frequencies of cannabis use before and during the pandemic among adults who used cannabis in the last year [ 15 , 16 , 18 , 19 ]. It was also reported that mode of cannabis use stayed the same between the time periods with most respondents reporting a method for cannabis inhalation (smoking [joint/blunt/bong/pipe], vaporizing plant, wax/dab, and/or vaping oil/concentrates) [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Puff, Puff, Don’t Pass: harm reduction for cannabis use during a viral respiratory pandemic

et al. 2023

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Background Prior to the COVID-19 pandemic, cannabis use social practices often involved sharing prepared cannabis (joints/blunts/cigarettes) and cannabis-related paraphernalia. Previous studies have demonstrated that sharing paraphernalia for cannabis, tobacco, and crack cocaine is a risk factor for respiratory viral and bacterial infections. Although COVID-19 is a respiratory viral infection that spreads through droplets and airborne transmission, it is unclear if many individuals adopted harm reduction practices around sharing cannabis. This study: quantifies the prevalence of sharing prepared non-medical cannabis and cannabis-related paraphernalia reported before and during the pandemic; assesses changes in sharing of non-medical cannabis from before to during the pandemic; assess the association between frequency of non-medical cannabis use and sharing of cannabis during the pandemic; and describes how respondents obtained their cannabis and the reasons for changing their cannabis use during the pandemic to explain differences in sharing patterns. Methods This cross-sectional study used data collected from an anonymous, US-based web survey on cannabis-related behaviors from August to September 2020 (n = 1833). Participants were included if they reported using a mode of inhalation for non-medical cannabis consumption. We calculated proportional changes in sharing cannabis before/during the COVID-19 pandemic. Associations between frequency of cannabis use and cannabis sharing during the COVID-19 pandemic were assessed using logistic regression analysis. Results Overall, 1,112 participants reported non-medical cannabis use; 925 (83.2%) reported a mode of cannabis inhalation. More respondents reported no sharing during (24.9%) than before the pandemic (12.4%; p < 0.01); less respondents shared most of the time (19.5% before; 11.2% during; p < 0.01) and always during the pandemic (5.2% before; 3.1% during; p < 0.01). After adjusting for covariates, the odds of any sharing during the pandemic for those who reported ≥ weekly cannabis use was 0.53 (95% CI 0.38, 0.75) compared to those who reported ≤ monthly. Conclusions Sharing of prepared cannabis and cannabis-related paraphernalia decreased during the COVID-19 pandemic compared to before the pandemic. This finding suggests potential risk mitigation strategies taken by participants for COVID-19 prevention either directly through behavior change or indirectly through adherence to COVID-19 prevention recommendations. Harm reduction messaging around sharing of cannabis during surges of COVID-19 or other respiratory infections may provide benefit in reducing infection among those who use cannabis, especially as cannabis use in the USA continues to increase.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Puff, Puff, Don’t Pass: harm reduction for cannabis use during a viral respiratory pandemic

et al. 2023

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“…Data for this study were derived from an online anonymous cross-sectional study of adults who use cannabis for medical and/or nonmedical purposes (Assaf et al, 2022). Respondents were considered eligible for the survey if they were aged ≥18 years, lived in the United States, reported any past-year use of cannabis or cannabis-based products (including delta-9-tetrahydrocannabinol [THC]- and cannabidiol [CBD]-based products), and provided informed consent.…”

Section: Methodsmentioning

confidence: 99%

Changes in secondary substance use after the onset of the COVID-19 pandemic among people who use cannabis: Findings from a web-based sample of adults in the United States.

Lake¹,

Assaf²,

Gorbach³

et al. 2023

Experimental and Clinical Psychopharmacology

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The coronavirus disease 2019 (COVID-19) pandemic has had widespread impacts on mental health and substance use. Increases in cannabis use have been documented in the United States, but little is known about how other substance use has changed among people who use cannabis. We sought to examine changes in alcohol, tobacco, opioid, and stimulant use during COVID-19 and explore how these changes relate to patterns of cannabis use. Data were obtained from a web-based survey of adults in the United States who use cannabis (n = 1,471) administered in September 2020. Using data reported in retrospective (prepandemic) and time-of-survey assessment periods, we explored changes in the prevalence of regular (≥ weekly) alcohol, tobacco, opioid, and stimulant use during COVID-19 among respondents who used medical and nonmedical cannabis. We used modified Poisson regression to examine cannabis-related correlates of increasing or decreasing secondary substance use during the pandemic. There was a slight but significant increase in ≥weekly alcohol use in the medical use group only (41.4%-47.0%, p = .034). ≥Weekly tobacco, opioid, and stimulant use did not change significantly. Pandemic-concurrent shifts in secondary substance use depended on interacting cannabis-related factors including medical cannabis use, prepandemic cannabis frequency, and pandemic-concurrent frequency changes. For example, ≥weekly prepandemic cannabis use was significantly and positively associated with decreasing opioid use frequency among the medical cannabis use group only. Assessments of the pandemic's effects on substance use should consider relationships between cannabis and other substances, which may differ according to cannabis-specific behaviors, motives, and contexts of use. Public Health SignificanceThis study suggests that, overall, ≥weekly use of tobacco, opioids, and stimulants did not change substantially early after the onset of the coronavirus disease 2019 (COVID-19) pandemic in a sample of people who use cannabis. Modest group-level changes in alcohol use were detected among people who use medical cannabis. On an individual level, interaction between purpose, frequency, and COVIDconcurrent changes in cannabis use influenced the likelihood of increasing or decreasing alcohol, tobacco, opioid, or stimulant use, highlighting cannabis-specific indicators of heightened vulnerability to the pandemic's effects on mental health and substance use.

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“…We detected numerous epidemiologic cross-sectional and retrospective questionnaire studies from various countries and different populations showing mixed results for cannabis consumption trends during the pandemic, with some of them showing an (occasionally marginally) increased cannabis use (e.g., Vanderbruggen et al 2020;Manthey et al 2021;Assaf et al 2022) and others which reported either a decreased cannabis use or no change (e.g., Nguyen et al 2021;Scherbaum et al 2021;Manthey et al 2021). Participants who experienced two lockdowns reported more frequent consumption of alcohol and cannabis in the past 30 days than those who experienced only one lockdown.…”

Section: Changes In Various Populationsmentioning

confidence: 99%

Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review

et al. 2022

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The interaction between cannabis use or addiction and SARS-COV-2 infection rates and COVID-19 outcomes is obscure. As of 08/01/2022 among 57 evaluated epidemiological/clinical studies found in Pubmed-database, most evidence for how cannabis use patterns were influenced by the pandemic was given by two systematic reviews and 17 prospective studies, mostly involving adolescents. In this age group, cannabis use patterns have not changed markedly. For adults, several cross-sectional studies reported mixed results with cannabis use having increased, decreased or remained unchanged. Two cross-sectional studies demonstrated that the severity of adults´ cannabis dependence was either increased as a consequence of increasing cannabis use during the pandemic or not changed. Regarding the effect of cannabis use on COVID-19 outcomes, we found only five retrospective/cross-sectional studies. Accordingly, (i) cannabis use did not impact mild COVID-19 symptoms; (ii) cannabis using individuals experienced more COVID-19-related hospitalizations; (iii) cannabis using veterans were associated with reduced SARS-COV-2 infection rates; (iv) frequent cannabis use was significantly associated with COVID-19 mortality, and (v) cannabis dependents were at higher risk of COVID-19 breakthrough after vaccination. It should be outlined that the validity of these retrospective/cross-sectional studies (all self-reports or register/e-health-records) is rather low. Future prospective studies on the effects of cannabis use on SARS-COV-2 infection rates and COVID-19 outcomes are clearly required for conclusive risk–benefit assessments of the role of cannabis on users’ health during the pandemic. Moreover, substance dependence (including cannabis) is associated with (often untreated) somatic comorbidity, which severity is a proven key risk factor for worse COVID-19 outcomes.

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Changes in medical and non-medical cannabis use among United States adults before and during the COVID-19 pandemic

Cited by 12 publications

References 11 publications

Puff, Puff, Don’t Pass: harm reduction for cannabis use during a viral respiratory pandemic

Puff, Puff, Don’t Pass: harm reduction for cannabis use during a viral respiratory pandemic

Changes in secondary substance use after the onset of the COVID-19 pandemic among people who use cannabis: Findings from a web-based sample of adults in the United States.

Cannabis use, abuse and dependence during the COVID-19 pandemic: a scoping review

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