Cannabis is an open access peer-reviewed journal dedicated to the scientific study of marijuana/cannabis from a multidisciplinary perspective. Consistent with the mission of the Research Society on Marijuana (RSMj), the journal publishes empirical research of the determinants, correlates, consequences, contexts, and assessment of marijuana use as well as the treatment of problematic marijuana use, including cannabis use disorder. The journal covers research across the human spectrum (note that we currently do not accept animal model research).
Subjective Stress and Diurnal Salivary Cortisol in Adults with Frequent Cannabis Use
Objective: The hypothalamic-pituitary-adrenal (HPA) axis, the major neuroendocrine system that responds to stress, may be dysregulated by substance use. The rise of cortisol in the morning, known as the cortisol awakening response (CAR), is believed to be a reliable marker for individual differences in HPA axis activity. The purpose of this study was to investigate differences in the CAR between individuals with frequent cannabis use (CU) and healthy controls (HC) and determine whether cannabis use status moderates the relationship between subjective stress and cortisol levels. Method: 39 CU and 43 HC reported subjective stress levels and collected daily saliva samples at awakening, 30 minutes later, and in the evening, on two consecutive weekdays. We examined group differences in the CAR (30 min post awakening – awakening cortisol), and the association between stress and cortisol levels at each collection time with group entered as a moderator in regression analyses. Results: There were no significant group differences in the CAR (p = .23). At awakening, subjective stress was positively related to cortisol levels (p = .001) and CU had higher cortisol than HC (p = .047), which was significantly related to consequences of cannabis use (p = .007). Conclusions: While the rise of the CAR did not differ between groups, individuals with frequent cannabis use exhibited significantly higher basal cortisol levels at awakening. This elevation was positively correlated with cannabis-related consequences, suggesting that awakening cortisol may serve as a neurobiological marker of problematic cannabis use and warrants further investigation.
Copyright (c) 2026 Julia Donner, Alexia N. Obrochta, Anita Cservenka http://creativecommons.org/licenses/by-nc-nd/4.0
Effects of Cannabis Use on Physical Pain and the Moderating Role of Depressive Symptoms
Objective: While cannabis has several empirically supported medical benefits, the literature is mixed regarding the effectiveness of cannabis in reducing symptoms of physical pain. Depressive symptoms are a potentially important moderator of the relationship between cannabis and pain that could help explain the mixed literature. The current study aimed to assess whether the magnitude of pain relief from cannabis use was higher in individuals with elevated depressive symptoms. Method: Seventy-six participants (64.5% female; 80.3% White; Mage = 22.19 years [SD = 5.69]) who self-reported using cannabis at least once per week were recruited in northeastern Ohio. Multi-level modeling was utilized to examine the effect of daily cannabis use and depressive symptoms on pain ratings over one week. Additional analyses examined a sub-sample of participants with more than minor pain (N = 36). Results: It was found that using cannabis on any given day was associated with lower average pain ratings (B = -0.60, 95%CI[-1.10 - -0.09]) within the sub-sample. Within the entire sample, depressive symptoms were associated with higher average pain ratings (B = 0.21, 95%CI [0.09-0.32]). Depressive symptoms did not moderate the relationship between cannabis use and pain. Conclusions: We found that cannabis use was associated with lower reported pain in the sub-sample. Further research is needed to explore the impact of the type of pain on the efficacy of cannabis. Experimental studies exploring the ideal therapeutic dose for cannabis and controlling for route of administration are needed to further inform this research concerning the subjective effects of cannabis.
Copyright (c) 2026 Samantha G. Cassidy, Jackson T. Jin, Angela J. Zaur, William V. Lechner http://creativecommons.org/licenses/by-nc-nd/4.0
Modes of Preconception Cannabis Use and Prevalence of Cannabis Use Disorder
Objective: This cross-sectional study examined associations between modes of cannabis use (smoke, vape, edibles, and/or dabs) during the year before pregnancy and cannabis use disorder (CUD). Method: Patients were universally screened for substance use at entrance to prenatal care in an integrated healthcare delivery system (January 2020-July 2024). CUD diagnoses were ascertained from ICD-10 codes in electronic health records during the year before pregnancy. At entrance to prenatal care, patients self-reported frequency of cannabis used during the year before pregnancy (monthly or less, weekly, daily, none) and modes of use during the year before pregnancy (smoke, vape, edibles, dabs). Mode was categorized as no cannabis use, only smoking, only vaping, only dabbing, only edibles, or multiple modes. Results: Of 159,270 pregnancies among 130,712 women (mean age of 31.8 [SD = 5.2]), 16.6% used cannabis during the year before pregnancy (4.4% only smoked, 1.0% only vaped, 0.1% only dabbed, 3.8% only used edibles, and 7.2% used multiple modes); 908 (0.6%) had a CUD diagnosis in the year before pregnancy. Compared to no cannabis use, use of multiple modes was associated with the greatest CUD prevalence (adjusted prevalence ratio, aPR:11.11, 95% CI: 9.09-13.58), followed by only smoking (aPR:10.10, 95% CI: 8.11-12.58), only dabbing (aPR: 8.99, 95% CI: 3.98-20.30), only vaping (aPR: 5.03, 95% CI:3.04-8.33), and only using edibles (aPR:3.21, 95% CI: 2.15-4.79). Comparing modes, only smoking was associated with greater CUD than only vaping (aPR 2.01, 95% CI: 1.22-3.30) and only using edibles (aPR 3.15, 95% CI: 2.11-4.70); and only dabbing was associated with greater CUD prevalence than only using edibles (aPR 2.80, 95% CI: 1.15-6.82). Conclusions: Use of multiple cannabis modes and use of smoked or dabbed modes, compared with edibles or vaping, were associated with a higher prevalence of preconception CUD. Conclusions: Use of multiple modes of cannabis or smoking or dabbing rather than edibles or vaping were associated with a greater likelihood of CUD.
Copyright (c) 2026 Kelly C. Young-Wolff, Catherine A. Cortez, Sara R. Adams, Alisa A. Padon, Judith J. Prochaska, Qiana L. Brown, Aurash Soroosh, Cynthia I. Campbell, Monique B. Does, Deborah Ansley, Carley Castellanos, Asma H. Asyyed, Andrea Green, Joshua R. Nugent http://creativecommons.org/licenses/by-nc-nd/4.0
Clinical Experience and Student Support for Medical Cannabis Use: A Secondary Analysis
Objective: As medical cannabis (MC) legalization expands across the United States, understanding the factors shaping healthcare students’ support for its use is essential to informing educational practices and reducing stigma in clinical care. Method: This secondary analysis examined factors associated with students’ support for medical cannabis use (SFMCU), including clinical experience, personal cannabis use, demographic characteristics, and variation across patient vignettes. Participants (N = 349) were recruited from sciences and healthcare majors at multiple higher education institutions. SFMCU was measured using four clinical vignettes, and linear mixed-effects modeling was employed to account for both within- and between-subject variability. Results: Students with clinical experience demonstrated significantly lower SFMCU compared to those without such experience (p < .001). Personal cannabis use was also associated with higher SFMCU, with users reporting greater support than non-users (p < .001). Older age and male gender predicted higher SFMCU (p < .05). Support varied by vignette type, with participants reporting greater SFMCU for post-traumatic stress disorder and insomnia compared to depression (p < .001). Conclusions: Findings indicate that clinical experience, personal cannabis use, and demographic factors each influence students’ attitudes toward MC. Students with healthcare experience exhibited lower support, possibly reflecting exposure to traditional medical norms or institutional stigma. These results underscore the need to integrate evidence-based MC education into healthcare curricula to enhance student knowledge, address misconceptions, and prepare future professionals to engage in informed, stigma-free patient care.
Copyright (c) 2026 Andrew W. Tong, Chloe J. DuBoux, Rebecca H. Seuferer, Francis W. Siu, Bryan Magana, Joshua M. Gold, Thomas A. Clobes, Julia Bensing-Ruiz http://creativecommons.org/licenses/by-nc-nd/4.0
Abstracts from the 2025 Scientific Meeting of the Research Society on Marijuana July 18-20, 2025
Copyright (c) 2025 Lauren Micalizzi, Kyra Farrelly, Stephanie Penta http://creativecommons.org/licenses/by-nc-nd/4.0
A Meta-Analysis of Cannabis Research: Evidence of Lasting Neurocognitive Effects Continues to be Lacking
Objective: There have been widespread increases in cannabis use as recreational and medical use has become legal across the globe. Changes to the chemical makeup of cannabis may have changed residual effects experienced by individuals who use cannabis, and more individuals may be affected. Method: We conducted a meta-analysis examining the neurocognitive effects of cannabis after abstinence lasting a period of at least 25 days (Prospero: CRD42023466560). Databases used were PsychInfo, PsycArticles, PubMed, and Medline. Previous research has reported mixed results, with some studies finding significant differences between abstinent individuals who use cannabis and matched healthy controls, and others finding no evidence of significant differences. Bias was assessed using Joanna Briggs Critical Appraisal for Analytical Cross-Sectional studies and fail-safe N testing. Random-effects modeling and standardized mean differences were used to assess overall effects on neurocognitive functioning. Results: Our meta-analysis found no significant effects within the domains of overall effects (ES = 0.17), attention (ES = 0.22), forgetting/retrieval (ES = 0.31), learning (ES =0.29), or verbal/language (ES = 0.41). We identified a significant small effect size within the domain of abstraction/executive function (ES =0.27). However, due to the limited literature in this area, our analysis was under-powered and should be interpreted with caution. Conclusions: Limited conclusions can be made about the neurocognitive effects of cannabis after abstinence. We describe many deficiencies in existing studies of residual effects of cannabis and provide recommendations for improvement.
Copyright (c) 2026 Mark J. Crisafulli, Jessica N. Flori, Michael E. Dunn http://creativecommons.org/licenses/by-nc-nd/4.0
Examining Cannabis Flower and Concentrate Quantity Estimation Accuracy Differences With and Without Visual Cues
Objective: Cannabis consumers tend to overestimate cannabis quantities. However, it is unknown whether visual cues, such as pictures or physical piles of cannabis products, help consumers more accurately estimate cannabis quantities. In this study, we evaluate whether picture cues and physical cannabis cues improve the accuracy of flower and concentrate quantity estimations compared to when no visual cues are provided. Method: Sixty participants in a private cannabis club were asked to prepare their preferred method of cannabis administration (i.e., joint, bowl, dab) with their typical amount of cannabis product. Research staff measured the weight of the prepared product and participants were not informed of this weight. Participants were then asked to estimate the weight of their prepared cannabis and were randomized to receive either pictures of different weights of cannabis (picture cues), physical piles of cannabis products (physical cues) or no visual cues to reference when estimating their prepared product weight. The sample was 66% White, 58% Non-Hispanic, 54% female, and the average age was 30.7 years (SD = 7.7). Accuracy of estimations was assessed using Wilcoxon Rank Sign tests, and groups differences were assessed using Kruskal-Wallis tests due to violations of normality. Results: Among flower products, the no cue and picture cues produced estimations that were statistically distinguishable from 1 (n = 172, W = 1.66, p < .05, r = -0.64; n = 147, W = 1.43, p < .05, r = -0.60, for the no cue and picture cue conditions, respectively); however, the physical cues produced estimates that were statistically indistinguishable from 1 (n = 174, W = 1.25, p = 0.13, r = -0.24). Among concentrate products, the no cue and physical cue conditions had estimations that were statistically indistinguishable from 1 (n = 48, W = 0.42, p < .19, r = -0.21; n = 124, W = 1.94, p = .25, r = -0.15 for the no cue and physical cues conditions, respectively), but the picture cues did not (n = 117, W = 3.77, p < .05, r = -0.75). Conclusions: These data suggest that physical cues may be helpful in improving accuracy of estimation of cannabis quantities; however, overall, visual cues may not be helpful in improving accuracy of estimation of cannabis quantities.
Copyright (c) 2026 Bradley T. Conner, Mohammad I. Habib, Mark A. Prince http://creativecommons.org/licenses/by-nc-nd/4.0
Emerging Adult Perspectives on Cannabis Use to Inform Brief Early Intervention: A Qualitative Study
Objective: While cannabis brief interventions for emerging adults (age 18-25) are feasible, evidence for their efficacy is limited and mixed. The goal of the current study was to leverage qualitative research methods to inform novel content to improve the efficacy of cannabis brief interventions. Method: Twelve emerging adults (67% female, Mage = 21.1, 50% white) who frequently use cannabis (3+ times per week in the past month) participated in qualitative interviews focused on eliciting perceptions of: (1) personalized normative feedback (PNF), (2) severity of cannabis use consequences, (3) problematic cannabis use, and (4) the reasons emerging adults use cannabis.. Results: While participants were intrigued by PNF, they did not expect this type of approach to significantly impact their use unless they were already motivated to change. Participants believed that more common consequences associated with cannabis use were less severe, and participants’ perceptions of problematic cannabis use were extreme, rather than considered on a continuum, but tended to minimize symptoms of physiological dependence. Finally, participants indicated that some reasons for use may be more acceptable than others and that using out of boredom could be problematic, especially if combined with highly convenient methods of use (e.g., pens/carts/vapes). Conclusions: Taken together, our results provide nuance to emerging adult cannabis use and may be useful in informing future cannabis brief intervention approaches for this population.
Copyright (c) 2026 Kathryn S. Gex, Rachel L. Tomko, Kevin M. Gray, Shannon Phillips http://creativecommons.org/licenses/by-nc-nd/4.0
Sleep Motives and Expectancies for Cannabis Use in Pregnancy
Objective: Sleep difficulties are a common motive for cannabis use during pregnancy. However, evidence supporting cannabis use as an effective sleep aid is limited, while substantial research demonstrates the efficacy of cognitive behavioral treatments. This study characterized the sleep complaints of adults using cannabis during pregnancy to inform prevention and intervention efforts. Method: Pregnant adults reporting cannabis use (a) in the month prior to or (b) after becoming pregnant were recruited from across the United States between May and August of 2025. Participants completed a cross-sectional research survey, and those who passed all fraudulent responding criteria were included in data analysis. Descriptive statistics, chi-square, and t-tests compared the demographic and clinical characteristics of pregnant adults who did and did not report using cannabis to help their sleep. Results: Of the 210 valid respondents (100% assigned female at birth, 93% cisgender; age M = 29.3 years; 53% White, 38% Black; 58% in second trimester), 185 persisted in cannabis use during pregnancy and 119 reported using “mostly” or “almost always” to help their sleep. Those using cannabis for sleep reported greater insomnia severity, earlier bedtimes, and more wake after sleep onset than those using cannabis for other reasons, but they were less likely to report taking >30 minutes to fall asleep, consistent with expectancies that cannabis would help their sleep. Three out of four using cannabis for sleep (78%) expressed interest in alternative sleep treatments. Conclusions:Sleep is a common reason for cannabis use during pregnancy that appears to be a promising target for prevention and intervention efforts.
Copyright (c) 2026 Mary Beth Miller, Margaret Lloyd Sieger, Katie R. Moskal, Emily Marut, Shikha Gupta, Andrea M. Wycoff http://creativecommons.org/licenses/by-nc-nd/4.0
Self-Reported Cannabis Use in Pregnancy and Maternal Psychological Health
Objective: Cannabis use is increasing in the United States, including among pregnant women. Legalization of cannabis and decreased public perceptions of risk have contributed to increased cannabis use. Relatively few studies have examined the association of cannabis use with maternal mental health in pregnancy, particularly among Black women who have higher rates of adverse pregnancy outcomes. Method: Biosocial Impacts on Black Births (BIBB) is a prospective study conducted from 2017-2022 in three prenatal care sites in Michigan, Ohio and Florida with pregnant Black women (n = 1,066). We examined the associations between self-reported cannabis use in pregnancy and psychological health. Psychological health was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), the Cohen’s Perceived Stress Scale, and the Psychological General Well-Being (PGWB) Index. Results: Over 20% of women (n = 227) reported cannabis use during pregnancy. The mean age was 27 years, >60% of the participants completed a high school education, and 85% were living with the father of the baby. The most common reasons for use were to reduce stress and nausea. After controlling for confounding by state of residence, maternal age, education level, marital status, current financial status, gestational age at enrollment, and tobacco use, cannabis use in pregnancy was associated with higher levels of depressive symptoms (B = 3.44; 95% CI: 1.8, 5.1), higher perceived stress (B = 2.78; CI: 1.8, 3.7), and lower levels of maternal psychological well-being (B = -4.5; CI: -7.1, -1.9). Conclusions: These findings highlight the importance of health care provider awareness about prenatal cannabis use and psychological health in pregnant women. Prospective studies are needed to examine factors related to cannabis use in pregnancy to potentially reduce adverse outcomes associated with use.
Copyright (c) 2026 Melissa Hawkins, Dawn Misra, Elaine E. O. Opyene , Rhonda Dailey, Carmen Giurgescu http://creativecommons.org/licenses/by-nc-nd/4.0
Perceived Ethnic Discrimination and Negative Emotional Reactivity to Minority Stress: Association with Cannabis Use Processes Among United States Hispanic/Latinx Adults
Objective: Cannabis use has been increasing among the Hispanic/Latinx population in the United States (US). Little research has expressly focused on culturally relevant factors related to cannabis use processes and problems among this group. The present investigation sought to help bridge this gap and test the main and interactive effects of perceived ethnic discrimination and negative emotional reactivity to minority stress in terms of cannabis use processes, including perceived barriers for cannabis reduction, cannabis use problems, and cannabis use motives, among Hispanic/Latinx adults in the US. Method: Participants were recruited through Qualtrics Panels and included 521 adults who engaged in current (past month) cannabis use (Mage = 36.52 years, SD = 10.26; 55.1% male). Results: In adjusted models, for perceived barriers for cannabis reduction and cessation as well as cannabis use problems, both perceived ethnic discrimination and negative emotional reactivity to minority stress were independently associated with higher odds of endorsement. For cannabis use motives, negative emotional reactivity to minority stress was positively associated with enhancement, social, coping, and expansion motives, whereas perceived ethnic discrimination was a contributor to conformity motives; effects ranged from small to medium. No interactive effects emerged as statistically significant. Conclusions: The current findings suggest that among the U.S. Hispanic/Latinx population, screening and intervening upon perceived ethnic discrimination and negative emotional reactivity to minority stress may help mitigate challenges with the continued use of cannabis.
Copyright (c) 2025 Michael J. Zvolensky, Bryce K. Clausen, Ava A. Jones, Rodrigo Castillo-Avilés, Jessica M. Thai, Justin M. Shepherd, Lucas Bogiaizian, Brooke Y. Redmond, Lorra Garey http://creativecommons.org/licenses/by-nc-nd/4.0
Current and Projected Cannabis Demand Predict Future Consumption in Young Adults Who Use Cannabis
Objective: Cannabis demand, as measured by the Marijuana Purchase Task (MPT), holds associations with concurrent cannabis consumption and associated risks (e.g., cannabis use disorder [CUD]). As few studies have examined prospective associations between cannabis demand and future cannabis use, the current study examined this association in young adults who use cannabis. In addition, the present study explored the novel construct of projected future cannabis demand and its associations with future cannabis use. Method: Participants first completed a current Time1 (T1) MPT, projected future Time2 (T2) MPT (i.e., “three months from now”), and measures of past-month cannabis use frequency and CUD symptoms during an initial session. They returned three months later (T2) to complete a current T2 MPT and measures of cannabis use and CUD symptoms. Results: Measures across the three MPTs (observed T1, projected future T2, and observed T2) indicate relatively stability of demand across time and accuracy in projecting future demand. Prospective associations between T1 demand measures and cannabis use were observed, with both observed T1 and projected future T2 demand measures associated with T2 cannabis use frequency. Conclusions: Results of the current study highlight the potential of current and projected future cannabis demand measures to better understand the trajectory of cannabis use in this high-risk population.
Copyright (c) 2025 Rebecca Kurnellas, Cassandra A. Sutton, Daiil Jun, Hailey Taylor, Aaron P. Smith, Ricarda Foxx, Ali M. Yurasek, Richard Yi http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use Motives Across the Reproductive Continuum: An Integrative Literature Review
Objective: Cannabis is one of the most used substances in pregnancy, with an estimated 10% of U.S. pregnancies affected by cannabis use. Although research has linked fetal cannabis exposure to potential risks, many pregnant women continue to use cannabis for diverse medical and nonmedical reasons. Motives for substance use are modifiable targets for intervention that can be leveraged for tailored intervention and prevention strategies, yet little work has been done to integrate women’s motives for cannabis use across the reproductive continuum. Method: To address this gap, this integrative review examines literature on cannabis motives across reproductive time periods using the Whittemore and Knafl approach, to map the range of motives reported across studies, synthesize distinct motives into meaningful categories, and examine how motives are related to cannabis use behavior—including frequency, initiation and persistence. Results: Overall, 33 studies met inclusion criteria with 27 focused on the prenatal period and no studies exclusively on preconception, for a total of 45 period-specific observations. Across the reproductive continuum, medical/therapeutic motives were frequently reported (97%) and were linked to persistent and frequent use. Coping motives were also linked to use behavior and were more prominent during postpartum compared to preconception or prenatal periods (100% vs. 80% vs. 79%, respectively). Recreational and social motives appeared more often preconception. Conclusions: Altogether, motives for cannabis use were varied and dynamic, but medical motives were the most consistent across the reproductive continuum. Motives can provide a framework for non-stigmatizing intervention that distinguishes symptom driven use, bridges provider communication barriers, and acknowledges patient reported benefits.
Copyright (c) 2026 Alysa Roland http://creativecommons.org/licenses/by-nc-nd/4.0
Use of Cannabis Protective Behavioral Strategies During Pregnancy
Objective: Prenatal cannabis use is increasing in prevalence and associated with potential harm to maternal-fetal health. Pregnant individuals who use cannabis seek information about prenatal cannabis use informally (e.g., online) and adopt practices perceived to reduce harm. However, no evidence-based harm reduction interventions address prenatal cannabis use. Cannabis protective behavioral strategies (PBS) are associated with less cannabis use and fewer cannabis-related negative consequences among non-pregnant populations. There is a lack of research exploring PBS during pregnancy. Method: This study combined two samples of pregnant individuals who use cannabis (N = 48; Mage = 30.33; 2% American Indian or Alaska Native, 2% Asian, 19% Black, 15% multiracial, 58% White). Participants completed the Protective Behavioral Strategies for Marijuana scale (PBSM; Pedersen et al., 2017), adapted for pregnancy, and an open-ended question about prenatal PBS. We examined relationships between prenatal cannabis use, PBS, consequences, and perceived harm of prenatal cannabis use. Results: Participants reported using PBS (M = 4.07, SD = 0.93) and experiencing consequences in the past 30 days (M = 3.77, SD = 3.30). Higher perceived harm of cannabis to fetal health (B = 0.02, p = .010) and use in later trimesters (second: B = 0.69, p = .011; third: B = 0.82, p = .013) were positively associated with PBS. PBS was associated with lower weekly (IRR = 0.79, 95% CI [0.69, 0.90], p < .001) and daily prenatal cannabis use frequency (IRR = 0.41, 95% CI [0.33, 0.51], p = .001) but was not significantly associated with consequences. Open-ended responses revealed pregnancy-specific practices perceived to reduce harm (e.g., “I had a date set to quit and slowly decreased the amount I was smoking”). Conclusions: Results underscore the need for harm reduction research and validation of PBS and consequence measures for prenatal cannabis use to support informed decision-making among pregnant individuals who use cannabis.
Copyright (c) 2026 Olivia L. Bolts, Lindy K. Howe, Lauren Micalizzi, Eric R. Pedersen, Jane Metrik, Cynthia L. Battle, Rachel L. Gunn http://creativecommons.org/licenses/by-nc-nd/4.0
Perspectives of Prenatal Cannabis Use in Young Pregnant Individuals
Objective: Adolescent pregnancy is associated with socioeconomic disadvantages and higher risks of adverse obstetric, fetal, and developmental outcomes. Pregnant adolescents and young adults also use cannabis at a higher rate than older individuals, which may compound these risks. In considering clinical interventions aimed at reducing prenatal cannabis exposure, it is critical to understand the perspectives of young pregnant individuals, including why some individuals in this age group abstain and why others use cannabis but stop for pregnancy. This qualitative study aimed to identify beliefs, attitudes, and perceptions of cannabis use in young pregnant patients. Method: We conducted qualitative semi-structured interviews of young pregnant individuals with and without prenatal cannabis use as part of the YoungMoms study. Interviews were transcribed, coded, and reviewed for patterns and themes.Results: Thirty-eight participants completed the interviews including 12 that continued to use cannabis during pregnancy, 15 that stopped upon pregnancy recognition, and 11 that had never used cannabis. The average age of the participants was 19 years (range: 17–21) and 68% identified as Black/African American. Participants voiced the following themes: 1) using prenatal cannabis to relieve physical symptoms and stress; 2) believing prenatal cannabis to be less harmful than other substances such as prescribed medications, while also voicing concern about potential risks; 3) relying on both non-professional and professional resources to shape their perspectives; and 4) recognizing and asserting autonomy regarding the rationales, decisions, and strategies to continue and/or reduce cannabis use during pregnancy. Conclusions: Young pregnant patients described mixed beliefs about the safety of prenatal cannabis use and felt that cannabis could be helpful to treat symptoms of nausea and stress. Participants highlighted a desire to make their own decisions and sought information from trusted sources. These findings suggest young pregnant patients may be receptive to patient-centered approaches when discussing prenatal cannabis use.
Copyright (c) 2026 Alison E. Sanfacon, Shinnyi Chou, Samantha Saloom, Dahlia Lehman, Judy C. Chang, Natacha M. De Genna http://creativecommons.org/licenses/by-nc-nd/4.0
Intentions and Motives for Cannabis Use in Pregnancy and Postpartum: Preliminary Daily Diary Findings on Planned and Unplanned Use
Objective: Perinatal cannabis use is a significant public health concern linked to adverse maternal and neonatal outcomes. Despite growing evidence of prenatal cannabis use (PCU) risks, many individuals use it to manage symptoms such as nausea, anxiety, or pain. The Theory of Planned Behavior (TPB) identifies intentions as key predictors of substance use. While intentions and use patterns have been well studied in non-pregnant populations, research on prenatal intentions for cannabis use is limited. This pilot ecological momentary assessment (EMA) study examines: (a) cannabis use and non-use days in terms of intentions and use; (b) associations between daily intentions and use across prenatal and postpartum; and (c) motives linked to planned versus unplanned use. Method: Pregnant participants (N = 20; Mage = 30.15) reporting current prenatal CU completed two 14-day EMA bursts (in pregnancy and at 6-weeks postpartum) tracking daily CU, motives, and intentions. Planned use days were coded based on morning endorsement of intention to use, followed by reported use; unplanned use days were coded based on no morning intention, followed by reported use. Results: Planned use was most common both in pregnancy and postpartum, followed by planned nonuse, unplanned use, and foregoing plans to use. Intentions strongly predicted daily cannabis use (OR = 5.78, p < .001), with no significant difference between pregnancy and postpartum. Common motives across both planned and unplanned days included relaxation, pain relief, and sleep improvement. Some motives, including appetite increase and anxiety reduction, were more frequent on planned days, while enhancement motives were more common on unplanned days. Conclusions: Findings support TPB’s relevance to perinatal cannabis use, highlighting distinct motives for planned versus unplanned use. Larger samples are needed to expand these insights.
Copyright (c) 2026 Lindy K. Howe, Lauren Micalizzi, Sara E. Simmons, Jane Metrik, Cynthia L. Battle, Rachel L. Gunn http://creativecommons.org/licenses/by-nc-nd/4.0
Mediating the Impact of Prenatal Cannabis Exposure on Neurobehavioral Disinhibition: The Role of Delayed Developmental Milestone Attainment
Objective: Environmental perturbations such as prenatal cannabis exposure (PCE) during critical periods may lead to disruptions in biological systems that have downstream consequences on behavior and development. Developmental milestones have served as a measure of normative development that allows providers and parents to identify areas for intervention. However, little is known about the direct impacts of PCE on development milestone attainment and whether failures to attain development milestones mediate later disruptions in executive functioning and behavioral disinhibition. Method: Data from the Adolescent Brain Cognitive Development (ABCD) study were used to examine prenatal cannabis effects on development while using a propensity score approach to control for familial and environmental characteristics. Results: PCE was not significantly associated with any delays in gross motor or language attainment; however, after accounting for confounders via propensity score for PCE (pPCE), PCE was significantly associated with delays in ‘saying his/her first word’ (Odds Ratio = 1.51, 95% Confidence Interval: [1.08, 2.10]). Upon examining the mediating effects, there were no significant total direct or total indirect effects on executive functioning. However, pPCE was associated with behavioral disinhibition and a significant mediation of PCE on behavioral disinhibition via delays in saying his/her first word were observed. Conclusions: This study suggests that delays in saying his/her first word serves as a risk factor for later behavioral disinhibition/externalizing problems. Importantly, the current study didn’t examine language development, rather delays in saying his/her first word can provide insight into the possible impacts prenatal cannabis exposure has on developmental milestone attainment.
Copyright (c) 2026 Ami S. Ikeda, Manjushri Karthikeyan, H.M. Sean Lee, Valerie S. Knopik , Rohan H.C. Palmer http://creativecommons.org/licenses/by-nc-nd/4.0
Prenatal Cannabis Use and Child Diagnoses of Depressive and Anxiety Disorders
Objective: Prenatal cannabis use is associated with adverse pregnancy and neonatal outcomes, but research on its association with child anxiety and depressive disorders is limited. This study aimed to test the hypothesis that prenatal cannabis use is associated with child anxiety or depressive disorder diagnoses. Methods: Population-based retrospective birth cohort study of children (N=115,553) born between 1/1/2011-12/31-2017 to pregnant individuals (N= 97,376) universally screened for prenatal cannabis use. Cox proportional hazards regression models examined associations between cannabis use during early pregnancy (at ~8-10 weeks gestation based on self-reported use or a positive urine toxicology test for delta-9-tetrahydrocannabinol [THC]) and child anxiety and depressive disorders from ages 6 to 13 years based on diagnosis codes, adjusting for maternal sociodemographic and clinical characteristics. Results: The median (IQR) age at pregnancy onset was 31 (6) years. Most pregnancies (61.4%) were to non-White individuals; 4.4% screened positive for any cannabis use; 3.7% had a positive toxicology test and 1.9% self-reported use. Overall, 9,230 children were diagnosed with an anxiety disorder at (median (IQR)) age of 8 (3) years and 1,224 with depressive disorder at median (IQR) age of 9 (3) years. Prenatal cannabis use was associated with lower risk of child anxiety disorders (aHR:0.84:95%CI: 0.75-0.95) which remained significant when defined by a toxicology test but not when defined by self-report. Maternal prenatal cannabis use was not associated with child depressive disorders (aHR:1.15:95%CI: 0.85-1.54). Conclusions: Prenatal cannabis use during early pregnancy was not associated with an increased risk of offspring anxiety or depressive disorders.
Copyright (c) 2026 Kelly C. Young-Wolff, Mahlet Shenkute, Nina Oberman, Stacey E. Alexeeff, Lisa A. Croen, Jamie O. Lo, Deborah Ansley, Carley Castellanos, Kathryn K. Ridout, Matthew E. Hirschtritt, Lyndsay A. Avalos http://creativecommons.org/licenses/by-nc-nd/4.0
Provider Perspectives of Conversations and Practices Surrounding Perinatal Cannabis Use
Objective: To explore practices and perspectives of perinatal providers related to cannabis use during pregnancy and postpartum. Method: A mixed methods approach was employed using data collected from 18 perinatal providers practicing in the United States.Results: Most (72%) providers surveyed conduct universal evidence-based screening for perinatal cannabis use. Providers report these conversations are important and relevant, but only 55% report comfort with the topic. Four higher-order themes and five sub-themes emerged to further describe providers experiences of these conversations, including barriers and beliefs. Conclusions: Providers believe conversations about peripartum cannabis use are important, but describe needing additional support navigating up-to-date information, legal statues, and patient perceptions.
Copyright (c) 2026 Marie A. Hayes, Sara M. Witcraft, Emily Johnson, Kathleen Brady, Constance Guille http://creativecommons.org/licenses/by-nc-nd/4.0
“1, 2, 3, Release”: Cannabis Consumption and Mental Health and Well-Being During Pregnancy, Lactation and Parenthood
Objective: This paper presents rich and in-depth insights emerging from “Wading through the Weeds” (WttW), a participatory arts-based research study that used the Photovoice method to centre the lived experience of 23 mothers throughout Canada who consumed cannabis during pregnancy, lactation and motherhood. Method: Specifically, this paper examines and elucidates the ways that the mothers in our study used cannabis to address mental health challenges during the perinatal period and beyond. Results: A significant theme emerging from our research findings was the connection between the mothers’ decision to consume cannabis to cope with and/or overcome mental health challenges and a strong belief that cannabis supported them with their perinatal and maternal health and well-being. This included multiple stressors such as financial and interpersonal concerns, experiences of anxiety and depression, histories of addiction, trauma, and abuse, and managing of symptoms associated with Post Traumatic Stress Disorder (PTSD) that impacted their everyday lives. Conclusions: Our inquiry suggests that there is a dire need for public health decision-makers, clinicians, and social workers to understand and respond to the historical context, current realities, and intersecting identities of pregnant, lactating and parenting people who consume cannabis. Responses that run counter to the current context, where stigma and fear prevent parents from accessing cannabis information and support, have the potential to more effectively support the mental health and wellbeing of these parents during the perinatal period.
Copyright (c) 2026 Saara Greene, Allyson Ion, Rochelle Maurice, Gabrielle Griffith, Mary Vaccaro, Alexe Bernier, Rachael Berwald http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Dispensary Staff ("Budtender") Perspectives on Trustworthiness of Social Media Information: A Qualitative Study
Objective: Scientific and medical sources continue to be outpaced by the burgeoning cannabis marketplace regarding emerging forms of cannabis, leaving consumers with a great deal of uncertainty about safety and efficacy that may be addressed in cannabis dispensary and online settings. The present study examines how cannabis dispensary staff (“budtenders”) use and evaluate the trustworthiness of online information about cannabis, especially social media content. Method: Qualitative semi-structured interviews were conducted with San Francisco Bay Area budtenders (n = 18) and analyzed thematically. Results: Social media was not viewed as a reliable information source for dispensary-based social interactions. Budtenders were skeptical of most commercially-oriented social media content and frustrated with inconsistent content moderation practices of social media platforms. Budtenders instead preferred offline information sources and relationships, as well as information derived from first and secondhand experiences with cannabis products. When evaluating information on social media, online settings promoting privacy, community moderation, and accountability were seen as features of trustworthy environments. Budtenders also expressed a range of confidence in medical, natural healing, and personal experience frameworks of health and cannabis knowledge production; concordance of social media content with these frameworks was an additional signal of trustworthy information. Conclusions: This research highlights the role of budtenders in evaluating and triangulating emerging online cannabis information sources for consumers and the varied features and signals that cue budtenders to consider some online information as more trustworthy and credible for cannabis consumers.
Copyright (c) 2025 Meredith C. Meacham, Maha N. Mian, Danielle Schell, Coye Cheshire http://creativecommons.org/licenses/by-nc-nd/4.0
A Factor Analysis of the Marijuana Motives Measure in an Anxiety and Related Disorders Sample
Objective: Motivational models of cannabis use, amongst other substances, suggest that individuals are driven to use it to achieve variable personally important outcomes. Understanding individuals’ personal motivations for cannabis use is essential to screen for problematic use and intervene where appropriate. Importantly, more research is needed to understand how individuals transition from recreational to problematic use, as well as maintenance factors. As such, the use of psychometrically sound measures of motives for cannabis use is necessary, particularly in populations of individuals with anxiety and related disorders (ARDs), where there is a high rate of cannabis use. Method: We examined the factor structure of the Marijuana Motives Measure (MMM) to confirm its structural validity in a clinical sample. Treatment-seeking adults from an outpatient anxiety clinic in Canada (N = 253) completed the MMM and several symptom questionnaires. Results: Confirmatory factor analysis exhibited strong fit indices and good internal consistency across subscales ranging from .88-.93. Significant positive correlations were observed amongst most subscale pairs, the highest between expansion and coping (cor = 0.78). Scores on a measure of cannabis use disorder symptoms showed the strongest association with the coping subscale (tau = 0.54). Conclusions: The MMM demonstrated structural and convergent validity in this sample, adding evidence supporting its use in an adult, treatment-seeking population with ARDs.
Copyright (c) 2026 Yash M. Joshi, Spencer Metcalfe, Arij Alarachi, Andrew M. Scott, Mélise J. Ouellette, Karen Rowa http://creativecommons.org/licenses/by-nc-nd/4.0
Cannabis Use Transitions During Early Pregnancy
Objective: Cannabis use during pregnancy is increasing; however, the prevalence and correlates of cannabis use transitions between preconception and early pregnancy (e.g., persistent use, new uptake, discontinuation) are understudied. Method: Data were from a prospective cohort of United States and Canadian residents trying to conceive who completed online questionnaires during preconception (every 2 months for up to 12 months) and early pregnancy (<12 weeks gestation). Among 9,200 participants who conceived between 2013-2025, we examined associations of sociodemographic characteristics, preconception behaviors, and nausea and vomiting during pregnancy (NVP) with: a) any past-month cannabis use in pregnancy; b) persistent cannabis use (vs. discontinuation) among participants using cannabis during preconception; and c) new uptake of cannabis (vs. persistent nonuse) among participants not using cannabis during preconception. Results: In the full sample (n = 9,200), 284 (3.1%) reported persistent cannabis use, 911 (9.9%) discontinued use, 45 (0.5%) reported new uptake, and 7,960 (86.5%) reported persistent nonuse between preconception and early pregnancy. Among individuals using cannabis during preconception (n = 1,194), 23.8% continued use in pregnancy; among preconception daily cannabis users (n = 8,006), 54.8% continued use in pregnancy. Lower education and income, being unmarried, age <25 years, and history of diagnosed depression and/or anxiety were associated with any cannabis use, persistent use, and new uptake during pregnancy. Preconception alcohol and cigarette use were associated with any cannabis use but not persistent use in pregnancy. NVP was inversely associated with any cannabis use, persistent use, and new uptake during pregnancy. Conclusions: Findings highlight a need for cannabis cessation interventions during preconception and early pregnancy, particularly for reproductive-aged individuals with comorbid mental health issues who use cannabis frequently.
Copyright (c) 2026 Alyssa F. Harlow, Jessica L. Barrington-Trimis, Ruth J. Geller, Kenneth J. Rothman, Amelia K. Wesselink, Lauren A. Wise http://creativecommons.org/licenses/by-nc-nd/4.0
Analysis of Novel Cannabis Products Labeled as Containing THC-JD
Objective: THC-JD (tetrahydrocannabioctyl) is a semi-synthetic cannabinoid with an eight-carbon C3 side chain, present in only trace amounts in hemp, requiring synthesis for commercial use. It has been promoted as potentially 19 times more potent than delta-9-THC, consistent with enhanced CB1 receptor affinities for cannabinoids with 7-8 carbon C3 side chains. While one peer-reviewed report identified THC-JD (tetrahydrocannabioctyl) in Japanese online products, an anecdotal report from the U.S. suggests mislabeling. Method: To inform regulatory efforts and consumer awareness and to address these discrepancies, this study chemically analyzed five U.S. commercial cannabis vape products marketed as containing THC-JD. Results: Utilizing GC-MS analysis with a delta-8-THC-JD reference standard, no THC-JD was detected in any of the five commercial samples. Instead, the most prevalent compound in four of the five samples was delta-8-THC. Conclusions: The absence of THC-JD in these products raises critical concerns for consumer safety, regulatory compliance, and industry integrity, as consumers risk unknowingly ingesting uncharacterized or mislabeled substances. The lack of standardization in THC-JD products raises critical concerns for regulatory compliance and industry integrity. Further studies are needed to characterize THC-JD products and evaluate their potential health risk to consumers.
Copyright (c) 2026 Kaelas R. Munger, Carlton C. B. Bone, Killian M. Anreise, Robert M. Strongin http://creativecommons.org/licenses/by-nc-nd/4.0
Dispensing Medical Advice: San Francisco Bay Area Budtender Recommendations for Pain and Sleep Relief
Objective: Evidence regarding the efficacy of various forms of cannabis and cannabinoid concentrations is limited, and cannabis industry regulatory infrastructure is still in development. Meanwhile, most US states have legalized medical or adult use cannabis. This study aimed to understand what advice cannabis budtenders in the San Francisco Bay Area were providing to customers for pain and sleep trouble – two of the conditions most cited as reasons for using cannabis medicinally. Method: We visited 35 of 42 cannabis dispensaries in Alameda and San Francisco Counties in California, and using a “secret shopper” approach, asked the budtenders for recommendations on products, dosage, and strains to best alleviate pain and sleep trouble. Results: For pain relief, budtenders showed a strong preference for topicals (77.1%), while edibles were most indicated for sleep trouble (60.0%). Reasons provided included budtender personal experience and product effectiveness. Cannabidiol (CBD) was endorsed most often for pain relief in high CBD:THC ratios (28.6%), 1:1 ratios (28.6%), and CBD alone (22.9%). For sleep relief, tetrahydrocannabidiol (THC) alone was most recommended (34.3%). When asked about cannabis strains for pain, 85.7% of budtenders did not express a preference, but for sleep, 57.1% of budtenders selected indica. Conclusions: This study illustrates that budtenders in the Bay Area have specific ideas about cannabis uses, including types, concentrations, and strains, despite a lack of evidence for most recommendations. Future research should prioritize study of topical preparations of cannabis for pain, edibles for sleep, and tinctures for both, which budtenders regularly recommended to customers.
Copyright (c) 2025 Pamela M. Ling, Christine Hoang, Louisa M. Holmes http://creativecommons.org/licenses/by-nc-nd/4.0
Trends in and Factors Associated with Current Cannabis Vaping Among U.S. Adolescents, 2022-2024
Objective: Electronic vapor products are widely used by adolescents and are increasingly used to vape cannabis, posing ongoing health risks. This study aimed to examine trends in and factors associated with current (past 30-day) cannabis vaping among U.S. adolescents. Method: Using pooled adolescent data from the 2022-2024 National Survey on Drug Use and Health (n = 34,875), we calculated the prevalence of current cannabis vaping overall and by sociodemographic, policy, and other substance use characteristics for each year. Employing multivariable logistic regression, we examined linear trends in cannabis vaping and associations with each covariate. Subgroup-specific trends were estimated from models that included interactions between survey year and participant characteristics, with linear combinations of coefficients used to derive subgroup estimates. Results: Current cannabis vaping increased from 2022-2024 (3.5% to 4.2%, p = .001) and among older (aged 16-17; 6.6% to 7.6%, p = .01), male (2.9% to 3.7%, p = .01), non-Hispanic White (3.8% to 4.7%, p = .01), and wealthier ($75,000+ annual household income; 3.2% to 3.8%, p = .02) adolescents, as well as adolescents covered by state medical cannabis laws (3.5% to 4.1%, p = .004). In pooled analyses, current cannabis vaping between 2022-2024 was associated with older age, compared to younger age (e.g., AOR: 4.61, 95% CI: 2.93-7.26 for 16-17 vs. 12-13-year-olds), and nicotine vaping (AOR: 24.00, 95% CI: 17.44, 32.96). Conclusions: Cannabis vaping may be rising among certain U.S. adolescent subgroups. Further research is needed to monitor trends in cannabis vaping over time, particularly among at-risk groups such as adolescents engaging in polysubstance use, among whom use has increased.
Copyright (c) 2026 Delvon T. Mattingly, Bethany Shorey Fennell, Meman Diaby, Osayande Agbonlahor, Joy Hart http://creativecommons.org/licenses/by-nc-nd/4.0
Understanding the Relationships between ADHD Symptoms and Cannabis-Related Consequences among Young Adults
Objective: The link between attention-deficit/hyperactivity disorder (ADHD) and cannabis-related problems is well documented, though research has primarily focused on cannabis use disorder (CUD) or cannabis consequences in aggregate. This study examined how inattentive (IN) versus hyperactive/impulsive (HI) ADHD symptoms relate to CUD symptoms as well as distinct domains of cannabis consequences (social-interpersonal consequences, impaired control, negative self-perception, self-care, risk behaviors, academic/occupational consequences, physical dependence, and blackout use) in young adults. Total amount of cannabis flower used over the past 90 days was explored as a potential mediator of these associations. Â Method: Young adults (N = 160; 41% male; ages 19-25, M = 22, SD = 2.06) with a history of regular cannabis use completed self-report measures of ADHD symptoms and cannabis consequences. Participants also completed a 90-day Timeline Follow Back assessing grams of cannabis flower consumed each day, along with a structured clinical interview for CUD. Results: IN symptoms were directly associated with cannabis-related occupational/academic consequences, self-care consequences, and blackouts/memory impairment, independent of quantity of cannabis consumption. HI symptoms showed positive indirect associations with physical dependence, impaired control, and CUD through greater amount of cannabis used. Conversely, IN symptoms had negative indirect associations with these outcomes, mediated by amount of cannabis used. Conclusions: Findings reveal distinct pathways through which IN and HI ADHD symptoms relate to cannabis problems in young adults. Findings highlight the need to consider ADHD symptom domains separately when assessing specific cannabis-related risks, which may have implications for tailoring interventions.
Copyright (c) 2025 Claire Minister, Christian S. Hendershot, Matthew T. Keough, Jeffrey D. Wardell http://creativecommons.org/licenses/by-nc-nd/4.0
Examining the Reliability and Utility of MouseView.js as a Method to Measure Attentional Bias for Cannabis Use
Objective: Current methods of assessing cannabis-related attentional bias such as modified Stroop tasks are characterized by several limitations, including low reliability. The goal of the present study was to explore the reliability and utility of a novel methodological tool that is a proxy for eye-tracking—MouseView.js—to examine cannabis-related attentional bias. Method: Canadian postsecondary students (N = 580) freely viewed 30 image pairs of neutral and cannabis stimuli using MouseView.js. Participants also completed self-report measures of cannabis use, including problematic cannabis use. Reliability coefficients (Cronbach’s alpha and split-half) were calculated to estimate the internal consistency of cannabis images, neutral images, and dwell difference scores. A hierarchical testing strategy was used to examine whether image (neutral vs. cannabis) and cannabis use status (non-use, recreational use, problematic use), as well as the interaction between image and cannabis use status, explain variation in dwell times. Results: A total of 368 participants (64.4%) did not use cannabis, 138 (23.8%) used cannabis recreationally, and 74 (12.8%) used cannabis at problematic levels. The reliability estimates for cannabis images, neutral images, and attentional bias scores ranged from acceptable to excellent. There was a main effect of image, such that all participants spent more time viewing cannabis relative to neutral images, indicative of an attentional bias. The main effects for cannabis use status and interactions between cannabis use status and image type were not statistically significant. Conclusions: Taken together, the present findings suggest MouseView.js may be a reliable method to assess cannabis-related attentional biases.
Copyright (c) 2026 Jana Milicevic, Samantha J. Dawson, Jenna L. Vieira, Maya C. Thulin, Nassim Tabri, Carson Pun, Hyoun S. Kim http://creativecommons.org/licenses/by-nc-nd/4.0
Correlates of Driving Under the Influence of Cannabis Among U.S. Adults in a State with Legalized Medical Cannabis
Objective: Driving under the influence of cannabis (DUIC) is a modifiable risk factor for cannabis harm. To inform the development of effective measures to mitigate DUIC, this study assessed factors associated with DUIC risk. Method: Data were from a 6-wave cross-sectional survey (2020–2023) of N = 11,051 adult Oklahomans. The analytic sample consisted of 3,012 adults who reported past 30-day cannabis use. Participants self-reported sociodemographic characteristics (age, sex, race and ethnicity, education, family finances, rurality), substance use patterns (past 30-day alcohol use, medical cannabis license, daily cannabis use, modes of cannabis use, probability of cannabis use disorder [CUD], and cannabis harm perceptions), and exposure to cannabis marketing. Univariable and multivariable logistic regression models evaluated associations between individual factors (e.g., sociodemographic characteristics and substance use patterns), marketing exposure, and modes of cannabis use (e.g., vaped cannabis) with odds of past 30-day DUIC. Results: The multivariable logistic regression model adjusting for sociodemographic characteristics indicated that daily/near daily cannabis use (AOR = 2.54, 95% CI = 2.08-3.09), probable CUD (AOR = 1.63, 95% CI = 1.36-1.94), and exposure to cannabis marketing (AOR = 1.84, CI = 1.44-2.36) were each associated with increased odds of past 30-day DUIC (vs. no DUIC). The multivariable logistic regression model adjusting for modes of cannabis use showed that past 30-day (vs. not) vaping (AOR = 1.41, 95% CI = 1.20-1.67) and dabbing (AOR = 1.71, 95% CI = 1.43-2.05) were significantly associated with increased odds of past 30-day DUIC (vs. no DUIC). Conclusions: Daily/near daily cannabis use, probable CUD, and exposure to cannabis marketing were correlates of DUIC, as were vaping and dabbing modes of cannabis use.
Copyright (c) 2026 Zachary B. Massey, Steven Pan, Summer G. Frank-Pearce, Michael A. Smith, Darla E. Kendzor, Amy M. Cohn http://creativecommons.org/licenses/by-nc-nd/4.0
Associations of Disability and Social Support with Cannabis Use Among Adults with Anxiety and Depressive Symptoms
Objective: People with (versus without) disabilities may be more likely to use cannabis medicinally, especially if they lack social support to cope with symptoms. However, associations of social support and disability with cannabis use remain largely unexplored. Method: Adults with clinically significant anxiety and/or depressive symptoms participating in a clinical trial completed a baseline survey assessing past-month medical and recreational cannabis use, self-perceived disability (yes/no), perceived social support, and sociodemographics. Regression models examined the association between disability and social support, and the main and interactive effects of disability and social support on past-month medical and recreational cannabis use, adjusting for race and ethnicity, gender, age, and income. Results: The sample (N = 822) was 25.3% American Indian, 25.1% Black, 25.1% White, and 24.6% Latinx (64.6% female; Mage = 38.3 [SD = 12.8]). Half (51.1%) self-reported a health condition that limited activities (i.e., disability); 24.9% reported past-month medical cannabis use, and 25.4% reported past-month recreational cannabis use. Participants with a self-reported disability reported lower average social support than those without (p = .031). A significant (p = .045) disability X social support interaction indicated that social support was associated with lower odds of medical cannabis use among those without (p = .038), but not with (p = .525), disability. Disability and social support were not significantly associated with recreational cannabis use (p-values > .05). Conclusions: Individuals with disabilities had elevated odds of using medical cannabis, regardless of social support. Social support is imperative for well-being, and cannabis use may alleviate some symptoms; however, more accessible, comprehensive healthcare may be needed to support individuals with disabilities.
Copyright (c) 2025 Erin A. Vogel, Katelyn F. Romm, DJ McMaughan, Michael J. Zvolensky, Lorra Garey, Michael S. Businelle http://creativecommons.org/licenses/by-nc-nd/4.0