Sex Differences in Cannabis Use and Effects: A Cross-Sectional Survey of Cannabis Users

Abstract

Introduction: Despite known sex differences in the endocannabinoid system of animals, little attention has been paid to sex differences in human's cannabis use patterns and effects. The purpose of the present study was to examine sex differences in cannabis use patterns and effects in a large sample of recreational and medical cannabis users.Methods: A large sample (n=2374) of cannabis users completed an anonymous, online survey that assessed their cannabis use practices and experiences, including the short-term acute effects of cannabis and withdrawal effects. A subsample of 1418 medical cannabis users further indicated the medical conditions for which they use cannabis and its perceived efficacy.Results: The results indicated that men reported using cannabis more frequently and in higher quantities than did women. Men were more likely to report using joints/blunts, vaporizers, and concentrates, while women were more likely to report using pipes and oral administration. Men were more likely than women to report increased appetite, improved memory, enthusiasm, altered time perception, and increased musicality when high, while women were more likely than men to report loss of appetite and desire to clean when high. Men were more likely than women to report insomnia and vivid dreams during periods of withdrawal, while women were more likely than men to report nausea and anxiety as withdrawal symptoms. Sex differences in the conditions for which medical cannabis is used, and its efficacy, were trivial.Conclusions: These results may be used to focus research on biological and psychosocial mechanisms underlying cannabis-related sex differences, to inform clinicians treating individuals with cannabis use disorders, and to inform cannabis consumers, clinicians, and policymakers about the risks and benefits of cannabis for both sexes.

Mechanisms Underlying Sex Differences in Cannabis Use

“…Female cannabis users have self-reported significantly higher levels of anxiety problems during withdrawal compared to male cannabis users [142]. Females seeking treatment for cannabis dependence, particularly in late adolescence and middle adulthood, have also shown higher rates of anxiety compared to males [143].…”

Cannabis as a substitute for prescription drugs – a cross-sectional study

“…We previously reported on gender differences in cannabis use and effects, highlighting the need for focused research on this topic 27. Importantly, there is evidence of differences in endocannabinoid system function across gender 28–30.…”

Association between cannabis use and methadone maintenance treatment outcomes: an investigation into sex differences

“…As such, these patients may have motivation to use both drugs for purposes of self-medication. Indeed a survey of cannabis users found men were more likely to use cannabis recreationally while women were more likely to use it for purposes of self-medication for conditions such as anxiety and headaches [30]. As we only classified participants based on biological sex, further work should evaluate gender constructs and their influence on treatment response to determine whether the observed sex differences can be explained by biological or social mechanisms, or a combination of the two.…”

“…Although a higher proportion of men use cannabis, women who use cannabis are more likely to experience adverse outcomes such as development of cannabis use disorder, and may also be more likely to show negative outcomes from cannabis in other domains such as more severe cannabis withdrawal symptoms and [28] and worse mental health and social functioning [29]. A large survey of cannabis users, for example, found that a larger proportion of men use cannabis for recreational purposes while more women reported using it for purposes of self-medication [30]. Thus, motivational processes for drug use may differ between men and women.…”