Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

Abstract

IntroductionQuantitative studies indicate that the COVID-19 pandemic has contributed to increased rates of prenatal cannabis use. However, little is known about how the pandemic has impacted cannabis use from the perspective of pregnant individuals themselves. Our objective was to characterize COVID-19-related changes in cannabis use among pregnant individuals who used cannabis during the pandemic.MethodsWe conducted 18 focus groups (from 11/17/2021 to 12/17/2021) with Black and White pregnant individuals aged 18+ who self-reported prenatal cannabis use during universal screening at entrance to prenatal care (at ~8 weeks gestation) in Kaiser Permanente Northern California. Virtual focus groups were transcribed and analyzed using thematic analysis.ResultsThe sample of 53 pregnant individuals (23 Black, 30 White) was 30.3 years old (SD = 5.2) on average, and most (70%) self-reported daily versus weekly or monthly prenatal cannabis use. Major themes regarding the impact of the pandemic on cannabis use included increases in use (resulting from depression, anxiety, stress, boredom), and changes in social use (less sharing of smoked cannabis products), modes of use (from smoking to other modes due to respiratory concerns) and source (from storefront retailers to delivery).ConclusionCoping with mental health symptoms and stress were identified drivers of perceived pandemic-related increases in prenatal cannabis use in 2021. Pregnant individuals adapted their use in ways consistent with public health recommendations to decrease social contact and reduce or quit smoking to mitigate COVID-19 transmission and harms. Proactive, mental health outreach for pregnant individuals during future pandemic waves may reduce prenatal cannabis use.

Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians

“…The study was approved by the Kaiser Permanente Northern California IRB; additional details on the study design have been published elsewhere. 13,21 This study followed the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines to ensure that data collection and analysis were systematic and verifiable. 22 Using electronic health record data, we identified a potentially eligible sample of pregnant non-Hispanic White and non-Hispanic Black English-speaking adults who self-reported any prenatal cannabis use since pregnancy on the universal screening questionnaire at entrance to prenatal care (at about 8 weeks of gestation).…”

“…The study was approved by the Kaiser Permanente Northern California IRB; additional details on the study design have been published elsewhere. 13,21 This study followed the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines to ensure that data collection and analysis were systematic and verifiable. 22…”

Maternal cannabis use alters excitatory inputs to corticostriatal efferent neurons in rat offspring

“…Pregnant people are increasing their cannabis use following medical and recreational legalization (Young-Wolff et al, 2017) and these trends are expected to remain strong as the social stigma and perceived harms of cannabis use continue to decrease (Wen et al, 2018). A growing number of pregnant people believe that the use of cannabis during pregnancy is safer than the use of prescription medications (Foti et al, 2023), while during the COVID-19 pandemic, cannabis use among pregnant people significantly increased (Young-Wolff et al, 2021), predominantly to cope with mental health and stress-related issues (Young-Wolff et al, 2023). Furthermore, this is not solely a concern for the United States.…”