Abstract

The number of states legalizing marijuana for medical and recreational use is increasing. Little is known regarding how or why adults with medical conditions use it. To report the prevalence and patterns of marijuana use among adults with and without medical conditions, overall and by sociodemographic group, and to further examine the associations between current marijuana use and the types and number of medical conditions. This survey study used a probability sample of US adults aged 18 years and older from the 2016 and 2017 Behavioral Risk Factor Surveillance System, a telephone-administered survey that collects data from a representative sample of US adult residents across the states regarding health-related risk behaviors, chronic health conditions, and use of preventive services. Current (past month) and daily (≥20 days in the last 30 days) marijuana use. The study sample included 169 036 participants (95 780 female [weighted percentage, 52.0%]). Adults with medical conditions had higher odds of reporting current marijuana use than those without medical conditions (age 18-34 years: adjusted odds ratio, 1.8 [95% CI, 1.5-2.1]; age 35-54 years: adjusted odds ratio, 1.4 [95% CI, 1.2-1.7]; age ≥55 years: adjusted odds ratio, 1.6 [95% CI, 1.3-2.0]), especially among those with asthma, chronic obstructive pulmonary disease, arthritis, cancer, and depression. Among those with medical conditions, the prevalence of marijuana use decreased with increasing age, ranging from 25.2% (95% CI, 22.0%-28.3%) for those aged 18 to 24 years to 2.4% (95% CI, 2.0%-2.8%) for those aged 65 years or older for current marijuana use and from 11.2% (95% CI, 8.7%-13.6%) to 0.9% (95% CI, 0.7%-1.2%), respectively, for daily marijuana use. Most adults who used marijuana (77.5%; 95% CI, 74.7%-80.3%), either with or without medical conditions, reported smoking as their primary method of administration. Adults with medical conditions were more likely than those without medical conditions to report using marijuana for medical reasons (45.5% [95% CI, 41.1%-49.8%] vs 21.8% [95% CI, 17.8%-25.7%]; difference, 23.7% [95% CI, 17.8%-29.6%]) and less likely to report using marijuana for recreational purposes (36.2% [95% CI, 32.1%-40.3%] vs 57.7% [95% CI, 52.6%-62.9%]; difference, -21.5% [95% CI, -28.1% to 14.9%]). This study found that marijuana use was more common among adults with medical conditions than those without such conditions. Notably, 11.2% of young adults with medical conditions reported using marijuana on a daily basis. Clinicians should screen for marijuana use among patients, understand why and how patients are using marijuana, and work with patients to optimize outcomes and reduce marijuana-associated risks.

Highlights

  • Public opinion on marijuana has changed dramatically over the last 2 decades

  • Adults with medical conditions had higher odds of reporting current marijuana use than those without medical conditions, especially among those with asthma, chronic obstructive pulmonary disease, arthritis, cancer, and depression

  • Among those with medical conditions, the prevalence of marijuana use decreased with increasing age, ranging from 25.2% for those aged 18 to 24 years to 2.4% for those aged 65 years or older for current marijuana use and from 11.2% to 0.9%, respectively, for daily marijuana use

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Summary

Introduction

Public opinion on marijuana has changed dramatically over the last 2 decades. Support for legalization has doubled since 2010, and currently, 62% of US adults support marijuana use.[1]. Few studies have examined the characteristics of marijuana users and the prevalence of use among populations with different medical conditions. Those who use marijuana believe that its benefits include pain management, ameliorating chronic conditions such as epilepsy and multiple sclerosis, and relieving anxiety, stress, and depression.[4] Current research suggests that both short- and long-term marijuana use are associated with several adverse health outcomes, including respiratory symptoms, cognitive decline, neurological changes, and psychiatric conditions including addiction.[5] Other potential long-term health consequences include cancer, chronic obstructive pulmonary disease (COPD), and heart disease.[5]

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