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15% of Americans Now Use Cannabis Monthly, With Distinct CBD-Only and Dual-Use Patterns

Cross SectionalStrong evidence
The takeaway

National survey data shows 15.4% of Americans used cannabis and 9.8% used CBD in the past month, with dual use peaking in young adults (18-25) and CBD-only use most common among seniors 65+.

Public health professionals, cannabis researchers, policymakers, and anyone interested in how Americans actually use cannabis and CBD products.

What the researchers found

In 2023, 8.9% of Americans were exclusive cannabis users, 3.4% exclusive CBD users, and 6.4% dual users. Dual use peaked at 10.8% among 18-25-year-olds. Exclusive cannabis use peaked at 14.8% among 26-34-year-olds. CBD-only use was most prevalent among adults 65+ (5.0%). State medical cannabis legalization was associated with higher exclusive cannabis use and dual use.

Why it matters

Cannabis and CBD are often discussed together but used by different populations for different reasons. Understanding these distinct patterns helps target public health messages and research priorities to the right groups.

The numbers in context

56,705 total participants. 15.4% past-month cannabis use, 9.8% CBD use. Exclusive cannabis 8.9%, exclusive CBD 3.4%, dual use 6.4%. Dual use peak: 18-25 (10.8%). Cannabis peak: 26-34 (14.8%). CBD-only peak: 65+ (5.0%). Poor health: 3x higher odds of any use pattern. Medical legalization: 1.5x higher cannabis/dual use.

How the study worked

Analysis of the 2023 National Survey on Drug Use and Health. Adolescents (12-17, n=11,572) and adults (18+, n=45,133). Past 30-day cannabis and CBD use patterns examined. Multinomial regressions assessed associated factors including demographics, health status, and state cannabis policy.

What this study cannot tell us

Self-reported use subject to recall and social desirability bias. Past 30-day window doesn't capture frequency or dose. CBD source (hemp vs. dispensary) not distinguished. Cross-sectional — cannot determine if health status drives use or vice versa.

How to read the evidence

Large nationally representative survey with robust methodology — strong for describing population-level patterns.

When this study was published

Published in 2026 using 2023 NSDUH data, the most recent comprehensive national survey available.

The bigger picture

The finding that CBD-only use peaks in seniors while dual use peaks in young adults suggests very different motivations. Older adults may seek targeted symptom relief, while young adults may experiment with multiple cannabinoid products. Health status was the strongest predictor across all patterns.

Questions still open

  • Are seniors using CBD effectively for their health conditions? Is dual use among young adults driven by experimentation or specific therapeutic goals? How will further legalization shift these patterns?

Common questions

How common is cannabis use in America?
In 2023, 15.4% of Americans reported past-month cannabis use and 9.8% used CBD products. Combined with dual users, about 1 in 5 Americans used some form of cannabinoid product monthly.
Do people use cannabis and CBD differently?
Yes — young adults (18-25) most commonly use both together, middle-aged adults (26-34) prefer cannabis alone, and seniors (65+) are most likely to use CBD only. Poor health status tripled the odds of any use pattern.

Read the original research

CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.

Addictive behaviors, 176, 108622

Citation

Dai, Hongying Daisy; Puga, Troy B. (2026). CBD, cannabis, or both? Examining use patterns and associated factors among U.S. youth and adults.. Addictive behaviors, 176, 108622. https://doi.org/10.1016/j.addbeh.2026.108622

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