Young adults who said they used cannabis medically were less likely to use illicit drugs | Research

The takeaway

Among young adult cannabis users in Los Angeles, self-reported medical use was associated with lower odds of illicit drug use, while use of cannabis concentrates and edibles predicted higher odds of other drug use.

Young cannabis users, medical cannabis patients, and anyone interested in how different cannabis use patterns relate to other substance use.

Medical cannabis users had 50% lower odds of illicit drug use; concentrate users had 2.8x higher odds

What the researchers found

Self-reported medical cannabis use was associated with 50% lower odds of illicit drug use (AOR 0.5). Use of cannabis concentrates increased odds of illicit drug use 2.8x, and edible use doubled the odds of prescription drug misuse. Using cannabis alone (vs. socially) halved prescription misuse odds.

Why it matters

This distinguishes between different cannabis use patterns rather than treating all use as equivalent. The finding that cannabis form (concentrates, edibles) matters more than frequency challenges the gateway drug framing that focuses on amount of use.

The numbers in context

210 medical cannabis patients, 156 non-patient users, aged 18-26. Medical use: AOR 0.5 for illicit drugs. Concentrate use: AOR 2.8 for illicit drugs. Edible use: AOR 2.0 for prescription misuse. Solitary use: AOR 0.5 for prescription misuse. White race: AOR 3.0 for illicit drugs.

How the study worked

Baseline survey of 210 medical cannabis patients and 156 non-patient cannabis users aged 18-26 in Los Angeles (2014-15), using logistic regression to examine associations between cannabis practices and other drug use.

What this study cannot tell us

Cross-sectional design cannot determine directionality. Small sample from one city. Self-reported medical use may reflect rationalization rather than genuine medical motivation. Baseline data only from a longitudinal study.

How to read the evidence

Moderate: reasonably sized cross-sectional study with appropriate statistical controls, but cannot establish causation.

When this study was published

Published in 2019, using 2014-15 data.

The bigger picture

The pattern suggests that how and why people use cannabis matters more than whether they use it. Medical users and solitary users appeared lower-risk, while concentrate and edible users showed higher-risk profiles, possibly reflecting different underlying motivations.

Questions still open

Does medical cannabis access actually reduce illicit drug use, or do lower-risk people self-select into medical use? Why are concentrate users at higher risk for other drug use? Would these patterns hold in older populations?

Common questions

Does medical cannabis lead to other drug use?

This study found the opposite: self-reported medical cannabis use was associated with 50% lower odds of illicit drug use. However, the form of cannabis mattered, with concentrate use linked to higher other drug use.

Why might the form of cannabis matter?

The study found that concentrate and edible use, but not frequency of overall cannabis use, predicted other drug use. This may reflect different risk profiles or motivations among people who seek out newer, more potent cannabis forms.

Read the original research

Illicit drug use and prescription drug misuse among young adult medical cannabis patients and non-patient users in Los Angeles.

Drug and alcohol dependence, 198, 21-27

View on PubMed ↗Publisher’s paper ↗

Citation

Fedorova, Ekaterina V; Schrager, Sheree M; Robinson, Lucy F; Cepeda, Alice; Wong, Carolyn F; Iverson, Ellen; Lankenau, Stephen E. (2019). Illicit drug use and prescription drug misuse among young adult medical cannabis patients and non-patient users in Los Angeles.. Drug and alcohol dependence, 198, 21-27. https://doi.org/10.1016/j.drugalcdep.2019.01.026