Among people with HIV, those who used cannabis for medical or emotional reasons also used more other substances | Research

The takeaway

In a sample of 333 people living with HIV, those who used cannabis for medical or emotional reasons had higher rates of polysubstance use than those who used recreationally.

Harm reduction advocates, HIV care providers, substance use researchers

beta = -0.24 lower polysubstance use for recreational vs. medical/emotional cannabis users

What the researchers found

Cannabis use was associated with higher use of most other substances. Among regular cannabis users, those motivated by recreational reasons reported lower polysubstance use than those in the medical/emotional motivation group. Mixed-motivation users showed no significant difference from the medical/emotional group.

Why it matters

This study challenges the assumption that medical cannabis use is inherently lower-risk. People using cannabis to manage symptoms or emotions may also be managing pain or distress with multiple substances, pointing to a population that could benefit from integrated care.

The numbers in context

78% of the sample currently used cannabis. Three motivation classes emerged: medical/emotional (24.4%), recreational (37.0%), and mixed (38.6%). Recreational users had significantly lower polysubstance use than medical/emotional users (beta = -0.24, 95% CI [-0.47, -0.01]).

How the study worked

Researchers surveyed 333 people with HIV in Florida who reported past-year substance use. Latent class analysis identified three cannabis motivation groups (medical/emotional, recreational, mixed). Polysubstance use was measured as the count of non-cannabis substances used in the past 12 months.

What this study cannot tell us

Cross-sectional design cannot establish causation. Self-reported data. Single geographic region (Florida). The sample was drawn from people with HIV, limiting generalizability.

How to read the evidence

Cross-sectional design with a moderate sample from a single region; latent class analysis provides nuanced subgroup identification but cannot establish causation.

When this study was published

2026 study using data from an ongoing Florida cohort

The bigger picture

As medical cannabis programs expand, understanding who uses cannabis and why matters for anticipating broader substance use patterns, especially in populations already navigating complex health conditions.

Questions still open

Would longitudinal tracking show medical/emotional cannabis users escalating polysubstance use over time? Could targeted interventions for this subgroup reduce co-occurring substance use?

Common questions

Does using cannabis medically lead to using more drugs?

This study found an association, not causation. People using cannabis for medical/emotional reasons may already be managing complex symptoms that drive use of multiple substances.

Were recreational cannabis users at lower risk?

They reported fewer other substances on average, but all groups in the sample had relatively high rates of substance use.

Read the original research

Associations between cannabis use, cannabis use motivations and past year polysubstance use among people living with HIV in Florida.

AIDS care, 1-14

View on PubMed ↗Publisher’s paper ↗

Citation

McNeely, Kayla V; Seegulam, Vijaya L; Cook, Robert L; Zhou, Zhi; Wang, Yan; Porges, Eric C; Cohen, Ronald A; Somboonwit, Charurut; Sherbuk, Jacqueline E; Ibanez, Gladys; Chichetto, Natalie E. (2026). Associations between cannabis use, cannabis use motivations and past year polysubstance use among people living with HIV in Florida.. AIDS care, 1-14. https://doi.org/10.1080/09540121.2026.2614344