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

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.

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.

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 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.

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.