Research Brief
Regular Cannabis Use During the First Year of the Pandemic: Studying Trajectories Rather Than Prevalence

https://doi.org/10.1016/j.amepre.2023.01.035Get rights and content

Introduction

Cannabis use in the U.S. rose early in the COVID-19 pandemic, but it is unclear whether that rise was temporary or permanent. This study estimated the nature and sociodemographic correlates of U.S. adult subpopulations regularly using cannabis by examining weekly trajectories of use during the first year of the pandemic.

Methods

Data came from the Understanding America Study, a nationally representative panel of U.S. adults (N=8,397; March 10, 2020−March 29, 2021). A growth mixture model was deployed to identify subgroups with similar regular cannabis use. Sociodemographic correlates of subgroups were examined using multinomial logistic regression.

Results

Four cannabis-use groups were identified. Most participants did not regularly use cannabis (no regular use; 81.7%). The other groups increased regular use until April 2020 but then diverged. Some (7.1%) decreased thereafter, whereas others (3.4%) maintained their elevated use until October 26, 2020 before decreasing. The last group (7.7%) sustained their elevated use throughout. Individuals aged between 18 and 39 years, unmarried, living in poverty, without a college degree, and with longer unemployment or underemployment spells had higher odds of being in the other groups with more weekly use than in the no-regular-use group.

Conclusions

The analyses revealed population subgroups with prolonged regular cannabis use and a disproportionate concentration of socioeconomically vulnerable members of society in these subgroups. These findings elucidate important heterogeneity in the subpopulations using cannabis, highlighting the urgent need to tailor public health programs for subgroups that may have unique service needs.

Section snippets

INTRODUCTION

Studies have documented a rise in cannabis use and sales during the coronavirus disease 2019 (COVID-19) pandemic in the U.S.,1,2 mirroring previous social crises such as the Great Recession.3 However, it remains unclear whether the increase represents a momentary or sustained surge in use by population subgroups. The former would likely not have any long-term implications, whereas the latter could lead to a heightened risk of psychosis, anxiety, other mood and thought disorders, dependence,

METHODS

Data came from the Understanding America Study, a nationally representative probability-based internet panel of approximately 9,500 adults (aged ≥18 years) in the U.S.9 A subset of respondents (n=8,815) were invited to complete surveys on COVID-19−related experiences, and 8,397 respondents provided information on cannabis use at least once, constituting the final analytic sample. This study used 25 biweekly (i.e., once every 2 weeks) surveys from March 10, 2020, to March 29, 2021, with

RESULTS

Table 1 summarizes the sample's descriptive statistics. The prevalence of regular use varied minimally between 10.3% and 12.4% over time, suggesting no substantial changes at the aggregate level. Fit statistics shown in Table 2 suggest that a 4-class model fits the data the best (Figure 1). Most participants did not use cannabis regularly (no regular use; 81.7%). More than 99% of this group reported not using cannabis during the past week. Three other trajectory groups emerged. One group showed

DISCUSSION

In a previous aggregate population-level analysis from March 10 to November 11, 2020, an initial increase in cannabis use at the outset of the pandemic attenuated after June 2020.2 Closer examination of individual trajectories using Understanding America Study bimonthly measures of weekly use between March 10, 2020, and March 29, 2021, showed that these aggregate trends hide important differences in patterns of cannabis use across key subgroups. Although a group of weekly users reduced their

CONCLUSION

The analyses revealed population subgroups with prolonged regular cannabis use and a disproportionate concentration of socioeconomically vulnerable members of society in these subgroups, which can be hidden in aggregate population-wide analyses. The findings highlight the urgency of understanding the reasons behind this prolonged involvement and providing substance use services22 to socioeconomically disadvantaged groups23 to prevent worsening preexisting socioeconomic disparities in cannabis

ACKNOWLEDGMENTS

The funding agencies played no role in any aspects of the current study, including the design, data collection, data analysis, and interpretation of the study and the decision to submit the study for publication.

The Understanding America Study was supported by the Bill & Melinda Gates Foundation, a grant from the National Institute on Aging (5U01AG054580), and a grant from the National Institute on Drug Abuse (K24DA048160).

No financial disclosures were reported by the authors of this paper.

CRediT AUTHOR STATEMENT

Jungeun Olivia Lee: Conceptualization, Methodology, Validation, Supervision, Writing - original draft, Writing - review and editing. Woo Jung Lee: Software, Data curation, Formal analysis, Writing - original draft, Writing - review and editing. Alexandra F. Kritikos: Conceptualization, Writing - review and editing. Haomiao Jin: Methodology, Writing - review and editing. Adam M. Leventhal: Conceptualization, Writing - review and editing. Eric R. Pedersen: Conceptualization, Writing - review and

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