Three patterns of medicinal cannabis use emerged among young LA adults after recreational legalization | Research

The takeaway

As California transitioned to recreational cannabis, three groups of medicinal users emerged: recreational users (39%), recreational patients (40%), and medicinal patients (20%), with recreational groups showing increasing mental health symptoms and cannabis-related problems over time.

Medical cannabis patients, cannabis policy researchers, clinicians assessing cannabis use patterns

40% were recreational patients with medical cards

What the researchers found

Longitudinal latent class analysis identified three groups: Recreational Users (39.3%) with low medicinal use, Recreational Patients (40.4%) with patient status but low medicinal use, and Medicinal Patients (20.3%) with high medicinal use. Medicinal Patients had higher physical symptoms at baseline. Recreational groups showed increasing mental health symptoms and problematic cannabis use over time.

Why it matters

The transition from medical-only to recreational legalization reshapes who identifies as a medicinal user and why. The finding that recreational patients developed more problems suggests some may have used medical cards primarily for legal access rather than therapeutic need.

The numbers in context

366 participants (210 patients, 156 non-patients, 34% female). Three classes: Recreational Users 39.3%, Recreational Patients 40.4%, Medicinal Patients 20.3%. Study period 2014-2021.

How the study worked

Annual surveys of 366 young adult cannabis users (ages 18-26 at baseline) from Los Angeles across six waves (2014-2021). Longitudinal latent class analysis derived groups from patient status and self-reported medicinal use.

What this study cannot tell us

Los Angeles sample may not represent other regions. Self-reported medicinal use is subjective. Attrition across six waves. Young adult age range (18-26) limits generalizability to older patients.

How to read the evidence

Longitudinal design with latent class analysis across six waves, but young LA-specific sample limits generalizability.

When this study was published

2024 analysis of Los Angeles data from 2014-2021

The bigger picture

The 40% of users who held medical cards but used recreationally represent a population that likely obtained cards for legal access. As recreational legalization removes this incentive, medical programs may serve a more genuinely therapeutic population.

Questions still open

Do recreational patients who develop problematic use patterns eventually seek treatment? How do genuine medicinal patients fare when they lose medical program support after recreational legalization?

Common questions

What percentage of medical cannabis patients were truly using medicinally?

Only about 20% of the sample were classified as Medicinal Patients with high self-reported therapeutic use. Another 40% held medical cards but reported primarily recreational use.

Did recreational users develop more problems?

Yes. Both recreational groups (with and without medical cards) showed increasing mental health symptoms and cannabis-related problems over the study period, while medicinal patients did not.

Read the original research

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

The American journal of drug and alcohol abuse, 50(2), 229-241

View on PubMed ↗Publisher’s paper ↗

Citation

Ataiants, Janna; Wong, Carolyn F; Odejimi, Omolola A; Fedorova, Ekaterina V; Conn, Bridgid M; Lankenau, Stephen E. (2024). Medicinal cannabis use among young adults during California's transition from legalized medical use to adult-use: a longitudinal analysis.. The American journal of drug and alcohol abuse, 50(2), 229-241. https://doi.org/10.1080/00952990.2024.2308098