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Cannabis Consumption Rose in Medical-Only States During the Pandemic, Study Finds

By Alexander Beadle

Published: Nov 10, 2022   
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Cannabis use became more prevalent during the Covid-19 pandemic in medical-use states and in states with total cannabis prohibition, according to a study published this week in JAMA Network Open.

No significant differences in prevalence were seen in states with legal recreational cannabis use. Generally, higher cannabis use was tied to a desire to relax or to reduce pain.

Based on these findings, the researchers theorize that more restrictive frameworks for cannabis use may not be effective at preventing use during times of great stress.

More adults used cannabis to relax during the pandemic

For this study, the researchers – from the Denver Health and Hospital Authority and the University of Colorado School of Medicine – analyzed responses to the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS) system from 2019 to 2021. The RADARS system is designed to collect information relating to the abuse, misuse, and diversion of prescription drugs, and includes several measures relating to cannabis use.

Using the RADARS system Drug Abuse Screening Test score, reports of cannabis use in the past 12 months, reason for use, and a range of other demographic factors, the researchers assessed whether there were any significant changes in cannabis use prevalence during the Covid-19 pandemic. The legality and accessibility of cannabis in the state of each respondent was recorded as either allowing recreational cannabis use (recreational states), allowing medical use only (medical states), or where cannabis was completely prohibited (nonlegal states).

The researchers found that cannabis use prevalence was significantly higher during the pandemic in medical states and nonlegal states, compared to pre-pandemic figures. This higher prevalence was mainly driven by increases among adults aged between 18 and 29 and aged between 30 and 54.

The most commonly reported motivations for using cannabis overall were to relax or improve sleep, followed by a desire to get high and a desire to reduce pain. During the pandemic, higher percentages of users reported using cannabis to relax and reduce pain in medical cannabis states. Percentages were also noticeably lower among those using cannabis to get high and individuals who reported non-medical prescription drug use in the past 12 months.

Similar changes were also observed within the nonlegal states. However, these changes were not deemed to be statistically significant.

Prevalence high in legal states, but pandemic caused few changes

In terms of raw numbers, the prevalence of past 12-months cannabis use was twice as high in recreational states compared to nonlegal states. But the researchers did not find any significant differences in cannabis use prevalence in recreational states when comparing RADARS data from before and during the pandemic.

Additionally, while cannabis use prevalence was higher in medical states among 18- to 54-year-olds, prevalence actually fell slightly among those aged between 18 and 29 in recreational states. The percentage of people using cannabis to get high and for past 12-month non-medical prescription drug use also declined in recreational states during the pandemic.

“We observed higher cannabis use to relax and reduce pain, concurrent with decreasing nonmedical use of prescription drugs and use to get high, suggesting that cannabis may have been used to cope with stressors or compensate for disrupted access to prescription opioids,” the researchers wrote, referring to their overall findings.

The researchers do note several limits on this study, including that the RADARS data do not capture information on factors preceding cannabis use, individual perceptions of cannabis legality, or on substance use severity. Further research is still needed to take these factors into account. However, the researchers say that the current findings would suggest that more restrictive legal frameworks may not be effective at preventing substance use during times of great stress.

Cannabis and the Covid-19 pandemic

The Covid-19 pandemic caused significant disruption within most industries, including education, healthcare, and manufacturing. It’s no surprise, then, that US dispensaries reported record sales in early March 2020 as consumers looked to stock up on their favorite products before coronavirus restrictions could be fully implemented.

By late March, the stockpiling boom was over. Sales plummeted in April as shelter-in-place orders began to take effect, before rebounding again in May as restrictions began to relax. It would take until June for the market to return to near-normal levels of sales.

Outside of consumer behavior and commercial interests, the Covid-19 pandemic also presented many challenges for cannabis testing facilities. In a talk at the Analytical Cannabis Expo West Online 2021, Dr. Julie Martellini, who was science operations manager at MCR Labs at the time, explained how the lab swiftly implemented new staff training protocols to help cope with surges when other staff had to isolate.

“If we have people staying at home quarantining due to covid symptoms or exposure, we need to maintain the lab,” Martellini said. “So, we have had people from other departments volunteer to train as weighers – that’s our biggest rate limiting step in the lab, taking the time to weigh those samples – so everyone is fully trained.”

The lab also formed an internal Covid-19 committee that became responsible for creating and implementing protocols such as decontamination logs, contact investigations, return-to-work permissions, and additional training on various healthcare regulations.


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