Identifying Cannabis Use Patterns via Latent Profile Analysis

Abstract

Epidemiological surveys consistently report that cannabis use prevalence peaks during the college years. College students who use cannabis do so in a variety of contexts (e.g., at a party, when experiencing craving, for physical pain). Cannabis use is associated with risk for experiencing undesirable consequences. Protective Behavioral Strategies (PBS) are behaviors one can engage in to reduce use or to mitigate the risk of experiencing unwanted consequences. However, research has yet to explore which strategies are most effective in which specific contexts of use. It is likely that a strategy that works well to reduce the risk of consequences in one context may not work well in another context. We aimed to identify unobserved patterns of cannabis use contexts in a sample of college students, and examined whether these patterns of cannabis use contexts differed in cannabis use frequency, cannabis-related negative consequences (both at the item level and the cumulative number of consequences), and PBS use (also examined at the item and cumulative levels). Using Latent Profile Analysis of self-reported data, we identified three latent profiles of cannabis users. Profile 1 (Social Use Profile; n =100) reported use cannabis in predominantly social or uplifting contexts, profile 2 (Physical & Emotional Pain Profile; n =109) reported use primarily in the contexts of relieving physical and emotional pain, and profile 3 (All Contexts Profile, n =56) reported frequent use in all contexts assessed. The Social Use Profile was associated with the least frequent cannabis use, the most PBS use, and fewest consequences compared to the other profiles. The Physical and Emotional Pain Profile was associated with moderate levels of cannabis use, consequences, and PBS use. The All Contexts Profile was associated with the most frequent cannabis use in all contexts. This included the contexts that were least associated with the Social Use Profile and the Physical & Emotional Pain Profile, which were related to a craving to use cannabis and using cannabis in response to a fight with friends, family members, or partners. The All Contexts Profile was also associated with the most cannabis-related consequences, and the lowest level of PBS use. Beyond the examination of overall indices of cannabis use, consequences, and PBS use, our data indicated that each profile was associated with the experience of specific consequences of use in differing frequencies and the use of certain PBS to a differing degree across profiles. This study provides preliminary evidence that the contexts in which people use cannabis may be associated with use level, number of consequences experienced, and PBS use. Future prevention and intervention efforts may consider identifying those whose use pattern is consistent with profiles identified in this study that carry greater risk of cannabis-related consequences. This would include screening for use in many different contexts (All Contexts use pattern) or for use primarily when in physical or emotional pain (Physical & Emotional Pain use pattern), as these use profiles carry greater risk for frequent use, experiencing more consequences, and engaging in fewer protective strategies.