Cannabis and COVID-19: Reasons for Concern.

Margriet W Van Laar,Pieter E Oomen,Charlotte J A Van Miltenburg,Wayne D Hall,Tom P Freeman,Eefje Vercoulen

doi:10.3389/fpsyt.2020.601653

Margriet W Van Laar, Pieter E Oomen + Show 4 more

Open Access

https://doi.org/10.3389/fpsyt.2020.601653

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Abstract

The lockdown measures implemented to curb the spread of SARS-CoV-2 may affect (illicit) drug consumption patterns. This rapid response study investigated changes in cannabis use in a non-probability sample of cannabis users in the Netherlands during the early lockdown period. We fielded an online cross-sectional survey 4–6 weeks after implementation of lockdown measures in the Netherlands on March 15, 2020. We measured self-reported \\motives for changes in use, and assessed cannabis use frequency (use days), number of joints per typical use day, and route of administration in the periods before and after lockdown implementation. 1,563 cannabis users were recruited. Mean age was 32.7 ± 12.0 years; 66.3% were male and 67.9% used cannabis (almost) daily. In total, 41.3% of all respondents indicated that they had increased their cannabis use since the lockdown measures, 49.4% used as often as before, 6.6% used less often, and 2.8% stopped (temporarily). One-third of those who were not daily users before the lockdown became (almost) daily users. Before the lockdown, most respondents (91.4%) used cannabis in a joint mixed with tobacco and 87.6% still did so. Among users of joints, 39.4% reported an increase in the average number consumed per use day; 54.2% stayed the same and 6.4% used fewer joints. This rapid response study found evidence that during the lockdown more users increased rather than decreased cannabis consumption according to both frequency and quantity. These data highlight the need to invest more resources in supporting cessation, harm reduction, and monitoring longer term trends in cannabis use.

Highlights

Worldwide some 192 million people have used cannabis in the last year [1]
2,412 respondents reached the landing page of the questionnaire; 836 respondents were excluded because they closed the survey before answering the last mandatory question and 13 respondents were excluded for different reasons
The final sample consisted of 1,563 cannabis users (Table 1)

Summary

Introduction

The most prevalent route of cannabis administration remains smoking (with and without tobacco) [2]. Smoking tobacco results in worse COVID-19 outcomes, and smokers show an upregulation of the angiotensin converting enzyme II-receptor, which is the main entry point for the SARS-CoV-2 virus [4, 5]. This is relevant, as a 2016 study reported that 77.2–90.9% of European cannabis users preferred tobacco-based routes of administration [2]. The respiratory risks of cannabis vaping are unclear, but vaping may increase risk of infection with SARS-CoV-2 and/or worsening of COVID-19 outcomes [6]

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Conclusion