Prevalence of Cannabis Use and Cannabis Route of Administration among Massachusetts Adults in Buprenorphine Treatment for Opioid Use Disorder

Abstract

Background

Recent prevalence estimates of cannabis use among individuals receiving medication treatment for OUD (MOUD) are lacking, and no study has characterized cannabis route of administration (cROA) in this population. These knowledge gaps are relevant because cannabis’ effects and health outcomes vary by cROA and the availability and perceptions of cROA (e.g., vaping devices) are changing.

Methods

The Vaping In Buprenorphine-treated patients Evaluation (VIBE) cross-sectional survey assessed the prevalence and correlates of cannabis use and cROA among adults receiving buprenorphine MOUD from 02/20 to 07/20 at five community health centers in Massachusetts, a state with legal recreational and medical cannabis use.

Results

Among the 92/222 (41%) respondents reporting past 30-day cannabis use, smoking was the most common cROA (75%), followed by vaping (38%), and eating (26%). Smoking was more often used as a single cROA vs. in combination others (p = 0.01), whereas vaping, eating, and dabbing were more often used in combination with another cROA (all p < 0.05). Of the 39% of participants reporting multiple cROA, smoking and vaping (61%), and smoking and eating (50%), were the most prevalent combinations. Nonwhite race (vs. white) and current cigarette smoking (vs. no nicotine use) were associated with past 30-day cannabis use in multiple logistic regression.

Conclusions

Prevalence of past 30-day cannabis use among individuals receiving buprenorphine MOUD in Massachusetts in 2020 was nearly double the prevalence of cannabis use in Massachusetts’ adult general population in 2019 (21%). Our data are consistent with state and national data showing smoking as the most common cROA.

Keywords:

• Cannabis
• marijuana
• route of administration
• mode of cannabis use
• buprenorphine
• opioid use disorder

Disclosure statement

Dr. Rigotti receives royalties from UpToDate, has consulted for Achieve Life Sciences, and consulted (without pay) for Pfizer. Dr. Kalkhoran has received royalties from UpToDate. Dr. Wakeman receives royalties from UpToDate and has received salary support from OptumLabs, Celero Systems, and Alosa Health. The remaining authors have no potential conflict of interest to disclose.

Contributors

Design and conduct of the study: Drs. Rigotti and Streck

Data Collection: Ms. Kalagher, Dr. Gupta

Data Analysis: Drs. Streck and Regan

Manuscript Drafting: Drs. Streck and Rigotti

Review of Manuscript for content: Drs. Kalkhoran, Bearnot, Gupta, Regan, Wakeman, and Ms. Kalagher.

All authors have read and approved of the final manuscript.

Additional information

Funding

This work was supported by the National Institute on Drug Abuse (NIDA K12 DA043490; Rigotti) and sundry funds provided by Dr. Rigotti.