Among 46,499 full-time US workers, recent cannabis use and cannabis use disorder showed dose-response associations with workplace absenteeism, with severe CUD linked to nearly triple the rate of skipping work.
Employers and HR professionals; occupational health researchers; workplace policy makers.
2.87x higher rate of skipping work with severe cannabis use disorder
What the researchers found
Past-month cannabis use was associated with more missed work days due to illness and more skipped work days compared to no lifetime use. A clear dose-response relationship emerged: mild CUD increased skipping work 1.6x, moderate CUD 2.0x, and severe CUD 2.9x compared to no CUD.
Why it matters
With 15.9% of full-time US workers using cannabis in the past month and 6.5% meeting CUD criteria, the workplace impact is substantial. The dose-response relationship between CUD severity and absenteeism provides concrete data for employers and policymakers grappling with cannabis in the workplace post-legalization.
The numbers in context
46,499 full-time workers surveyed. 15.9% used cannabis in past month. 6.5% met CUD criteria. Dose-response for skipping work: mild CUD aIRR 1.60 (95% CI: 1.24-2.08), moderate CUD aIRR 1.98 (1.50-2.61), severe CUD aIRR 2.87 (2.12-3.88). Past-month use also associated with more illness-related absences.
How the study worked
Cross-sectional analysis of 46,499 full-time employed adults from the 2021-2022 National Survey on Drug Use and Health. Negative binomial regression examined associations between cannabis use recency, frequency, CUD severity, and workplace absenteeism (missed days due to illness/injury and skipped work days), adjusting for sociodemographics and other substance use.
What this study cannot tell us
Cross-sectional design cannot determine whether cannabis use causes absenteeism or whether shared factors (e.g., mental health conditions) drive both. Self-reported absenteeism may be inaccurate. The study cannot distinguish between impairment-related and other reasons for missing work.
How to read the evidence
Strong: large nationally representative sample with detailed dose-response analysis, adjusted for multiple confounders including other substance use.
When this study was published
2024 study using 2021-2022 NSDUH data.
The bigger picture
As cannabis legalization expands and workplace drug testing policies evolve, empirical data on actual workplace impacts becomes critical. This national-level evidence shows that the relationship between cannabis and work performance is not binary but follows a severity gradient, which could inform nuanced workplace policies.
Questions still open
- Would workplace-based CUD treatment programs reduce absenteeism? How do cannabis-related absences compare economically to alcohol-related absences? Do different cannabis use patterns (e.g., medical vs recreational, evening vs daytime) affect workplace outcomes differently?
Common questions
How common is cannabis use among workers?
Does casual cannabis use affect work attendance?
Read the original research
Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021-2022.
American journal of preventive medicine, 67(6), 803-810
Citation
Yang, Kevin H; Mueller, Letitia; El-Shahawy, Omar; Palamar, Joseph J. (2024). Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021-2022.. American journal of preventive medicine, 67(6), 803-810. https://doi.org/10.1016/j.amepre.2024.07.021