Medicinal cannabis use among young adults during California’s transition from legalized medical use to adult-use: a longitudinal analysis

ABSTRACT

Background: In 2016, California transitioned from legalized medical cannabis use to adult-use. Little is known about how this policy change affected medicinal cannabis use among young adults.

Objectives: To identify longitudinal groups of medicinal cannabis users and concurrent changes in health- and cannabis use-related characteristics among young adults in Los Angeles between 2014 and 2021.

Methods: Cannabis users (210 patients and 156 non-patients; 34% female; ages 18–26 at baseline) were surveyed annually across six waves. Longitudinal latent class analysis derived groups from two factors – cannabis patient status and self-reported medicinal use. Trajectories of health symptoms, cannabis use motives, and cannabis use (daily/near daily use, concentrate use, and problematic use) were estimated across groups.

Results: Three longitudinal latent classes emerged: Recreational Users (39.3%) – low self-reported medicinal use and low-to-decreasing patient status; Recreational Patients (40.4%) – low self-reported medicinal use and high-to-decreasing patient status; Medicinal Patients (20.3%) – high self-reported medicinal use and high-to-decreasing patient status. At baseline, Medicinal Patients had higher levels of physical health symptoms and motives than recreational groups (p < .05); both patient groups reported higher level of daily/near daily and concentrate use (p < .01). Over time, mental health symptoms increased in recreational groups (p < .05) and problematic cannabis use increased among Recreational Patients (p < .01).

Conclusions: During the transition to legalized adult-use, patterns of medicinal cannabis use varied among young adults. Clinicians should monitor increases in mental health symptoms and cannabis-related problems among young adults who report recreational – but not medicinal – cannabis use.

KEYWORDS:

• Medicinal cannabis use
• young adults
• cannabis legalization
• longitudinal latent class analysis

Acknowledgments

The authors would like to acknowledge the National Institute on Drug Abuse for funding the Cannabis, Health, and Young Adults (CHAYA) study, CHAYA’s Community Advisory Board for overseeing the research, and the following individuals who supported the development of this manuscript: Meagan Suen, Alisha Osornio, and Susie Choi.

Disclosure statement

Drs. Ataiants, Fedorova, and Lankenau receive research funding from Agronomed Biologics for a separate set of medical cannabis studies. Drs. Wong, Odejimi, and Conn declare no conflicts of interest.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00952990.2024.2308098

Additional information

Funding

This research was supported by the National Institute on Drug Abuse of the National Institutes of Health under award number [DA034067 (PI: S.E. Lankenau)]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.