Selective Changes in Medical Cannabis Use Early in the COVID-19 Pandemic: Findings from a Web-Based Sample of Adults in the United States

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

doi:10.1089/can.2021.0115

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…These findings raise the possibility of differing motives underlying increases in cannabis, alcohol, and tobacco use between cannabis use groups. We previously reported a significant increase in daily cannabis use for anxiety after the onset of the pandemic among the medical cannabis subset of this sample (Lake et al, 2022) and similar findings have been reported in other surveys (Vidot et al, 2021). It is possible that these cannabis increases cut into the urge to increase alcohol or tobacco use for similar purposes, whereas nonmedical users may have exhibited a separate nonmedical motive for increasing both cannabis and alcohol or tobacco use during COVID-19 (e.g., more time at home, boredom).…”

Section: Discussionsupporting

confidence: 90%

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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Section: Discussionsupporting

confidence: 90%

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

Self Cite

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“…38,39 In our previous analysis of the US-based sample, the odds of increasing medical cannabis use for anxiety early in the pandemic approximately doubled among women. 32 This current study examined medical cannabis use more broadly; although anxiety was the most common reason cited among those who increased their use (51.3% overall, and 52.3% among women), we cannot attribute the observed increases solely to mental health or stress reasons. More research is needed to further contextualize underlying drivers of sex differences in substance use and mental health changes during the pandemic.…”

Section: Discussionmentioning

confidence: 84%

“…The magnitude of this change is similar to what we recently documented in a web-based sample of people who use cannabis for medical purposes in the United States, in which daily cannabis use increased from 16.2% pre-pandemic to 20.7% in the first few months of the pandemic. 32 Our previous study's sample comprised people who self-reported using cannabis for therapeutic purposes. 32 We suspect that the current study recorded a substantially higher prevalence of daily medical cannabis use because the sample consisted solely of people authorized to use cannabis for medical purposes.…”

Section: Discussionmentioning

confidence: 99%

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Shifts in medical cannabis use in Canada during the COVID-19 pandemic

Lake

Cooper

Ong³

et al. 2023

Health Promot Chronic Dis Prev Can

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Introduction The COVID-19 pandemic has had widespread secondary negative health impacts including loss of material security and exacerbation of mental illness in at-risk populations. While increases in the nonmedical use of certain substances, including cannabis, have been observed in samples of the Canadian population, no research has documented COVID-concurrent shifts in medical cannabis use in Canada. Methods Data were derived from the 2021 Canadian Cannabis Patient Survey, an online survey administered in May 2021 to people authorized to use medical cannabis recruited from one of two Canadian licensed medical cannabis producers. McNemar tests assessed for changes in past 3-month medical cannabis frequency from before to during the pandemic. We explored correlates of increasing frequency of cannabis use since before the pandemic in bivariable and multivariable logistic models. Results In total, 2697 respondents (49.1% women) completed the survey. Daily medical cannabis use increased slightly but significantly from before the pandemic (83.2%) to during the pandemic (90.3% at time of survey; p < 0.001). Factors significantly associated with increasing frequency of medical cannabis use included female gender, younger age, pandemic-related job loss, primary cannabis use to manage mental health, prescription drug use and nonmedical cannabis use (p < 0.05). Conclusion There were slight shifts towards higher frequency of medical cannabis use after the onset of the COVID-19 pandemic. While short- and long-term impacts of cannabis use on pandemic-related mental distress are unknown, clinicians working with patients who use medical cannabis should be aware of possible changes in use patterns during the pandemic.

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“…For example, in samples of people who use cannabis for therapeutic purposes, women more often report using cannabis for relief of anxiety 8,9 and were more likely to increase their use of cannabis to manage anxiety after the onset of the COVID-19 pandemic. 10 From a public health standpoint, understanding sex and gender differences in cannabis' subjective and reinforcing effects is critical.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in the subjective and reinforcing effects of smoked cannabis

2023

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Preclinical studies have shown sex-based differences in the reinforcing effects of cannabinoid 1 receptor agonists such as delta-9-tetrahydrocannabinol (THC). This study sought to test whether these sex differences translate to humans by assessing the subjective and reinforcing effects of smoked cannabis in male and female volunteers. We pooled data (n = 68; 55M, 13F) from two within-subject randomized controlled trials of healthy, ≥weekly cannabis users comparing the subjective and reinforcing effects of smoked active ($25 mg THC) versus placebo cannabis (0-mg THC). Subjective ratings of drug effects and mood were measured using visual analogue scales, and reinforcing effects were measured with a cannabis selfadministration task. Sex-dependent outcomes were explored using generalized linear mixed models. Under active cannabis conditions, female participants reported greater reductions from baseline in cannabis craving and significantly higher cannabisspecific ratings of strength, liking, willingness to take again and good effect, compared with males (interaction p < 0.05). Placebo and active cannabis were selfadministered by 22% and 36% of male participants, respectively, and by 15% and 54% of female participants, respectively. Receipt of active cannabis significantly increased likelihood of self-administration (p = 0.011), but a sex difference was not detected (p = 0.176). Although females were more sensitive to certain positive subjective effects of active cannabis, they were not more likely than males to selfadminister it. These findings highlight the need to test sex differences as a primary objective in experimental studies and may shed light on accelerated trajectories from initiation to cannabis use disorder observed among women.

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Selective Changes in Medical Cannabis Use Early in the COVID-19 Pandemic: Findings from a Web-Based Sample of Adults in the United States

Cited by 7 publications

References 34 publications

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.

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.

Shifts in medical cannabis use in Canada during the COVID-19 pandemic

Sex differences in the subjective and reinforcing effects of smoked cannabis

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