Changes in cannabis-attributable hospitalizations following nonmedical cannabis legalization in Canada

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: This study of 26.9 million individuals in four Canadian provinces found that cannabis legalization with restrictions was not associated with an increase in hospitalizations due to cannabis but commercialization was. The findings suggest that commercialization of cannabis may be associated with increases in cannabis-related health harms, including cannabis-induced psychosis. 

Authors: Daniel T. Myran, M.D., M.P.H., of the Ottawa Hospital Research Institute in Ottawa, Ontario, Canada, is the corresponding author. 

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2023.36113)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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JOURNAL

JAMA Network Open

Factors associated with marijuana use among high-risk college students

Peer-Reviewed Publication

TEXAS A&M UNIVERSITY

The past decade has seen a significant increase in marijuana use among U.S. college students. This increase has coincided with notable changes in national and local cannabis laws and policies, and perceptions of the associated drug’s risk over the same period. However, cannabis use by students continues to be a public health challenge throughout the country. Universities have long relied on education programs to address these risks; however, many of these programs have limitations and fail to consider some of the modern risk factors for cannabis use among young adults.

A new study led by Benjamin Montemayor, PhD, assistant professor in the Department of Health Behavior at the Texas A&M University School of Public Health, looks into cannabis use patterns, motivations and risk factors for cannabis use among college students at a large public university in the southeastern United States. Results were published in the journal Cannabis.

Although many states have decriminalized or outright legalized cannabis, the drug remains illegal at the federal level and as such is largely banned on university campuses. Despite changes in perceived risks associated with cannabis use, using it can be problematic for college students, especially when used together with alcohol. For example, cannabis use is frequently associated with poorer academic performance and health outcomes such as substance use disorders, with upwards of 70 percent of college students who actively use marijuana meeting the criteria for a potential cannabis use disorder.

To further explore reasons and risk factors for cannabis use among college students, the researchers surveyed 99 students who had violated campus drug use policy. The survey asked students to report how many days of the past month they had used cannabis and how much cannabis (in grams) they typically used per day. The researchers also asked respondents to report their reasons for using cannabis, such as using it to relax or relieve tension, as a sleeping aid, as part of socializing with friends, to experiment or to escape from problems. The researchers finally asked respondents about various risk factors for cannabis use, such as how many students at their university they think also use cannabis, how their friends and families might view them decreasing their cannabis use, perceptions of risks associated with using cannabis regularly, concurrent alcohol co-use, and at what age they started using cannabis. The researchers examined the associations between the quantity of cannabis use per day and the various risk factors, controlling for demographic data such as sex, race and ethnicity, age, years in school and fraternity or sorority membership.

The researchers found that the top three reasons for cannabis use reported by students were to relax or relieve tension, to feel good or get high, and to have a good time with friends. The average age at which respondents reported they started using cannabis was 17 years. On average, students used cannabis on seven out of the past 30 days, with 8 percent reporting daily use of cannabis. The students used more than a quarter of a gram per day, on average, with 40 percent reporting having consumed at least one gram of cannabis per day on days they used. More than half of the sample of students also used alcohol in the past month.

The researchers found that students in the study believe nearly half (47 percent) of all other students on campus also use cannabis and believe their friends or family would think it’s a good idea for them to personally reduce their cannabis use. Finally, the researchers found a low perception of risk overall associated with cannabis use.

Analysis of the data found an association between cannabis use quantity per day and frequency, with students who reported higher quantity of cannabis use per day also reporting more days per month of cannabis use. The study also found a significant association between cannabis use and perceived risk, with more use per day associated with those who had the lowest perceived risk scores. Finally, race and ethnicity were reported to have a significant association with cannabis use, with students who identified as a racial or ethnic minority reporting greater cannabis use.

Modern cannabis interventions fail to address the complicated nature of cannabis in our society partly because of a lack of current information on the diverse ways students are experimenting with cannabis (for example, dabbing and gravity bongs) and the associated hazards. Cannabis has been around for centuries. To be effective, intervention programs should address the specific sociocultural contexts that impact cannabis use, such as culture, religion and values, and the way in which national and state policies conflict and potentially generate permissive norms that cannabis use is allowed on campus.

The findings of this study highlight the need for cannabis intervention programs that address psychosocial risk factors and motivations for cannabis use that are tailored to meet the needs of different racial, ethnic and cultural groups. Better understanding the motivations behind marijuana use and the various factors and perceptions associated with use in college students could help reduce risks presented by drug use.

“Policies are changing, and cannabis use at large is outpacing the rate at which research is coming out,” Montemayor said. “If we fail to adapt our programs to keep up with the way cannabis use has become an ingrained part of our society then we are failing to prioritize the health and safety of the student body.”

Montemayor also cited the Department of Health and Human Service’s recommendation to reclassify cannabis from a Schedule 1 drug, where it has been since the 1970s alongside heroin and crack, to a Schedule 3 drug as one reason why designing and implementing cannabis use programs on campus is as important an issue as it ever has been for universities around the nation.

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JOURNAL

Cannabis

DOI

10.26828/cannabis/2023/000191 

ARTICLE TITLE

Risk Factors for Quantity of Cannabis Use Per Day among College Students Who Violated Their University Drug Use Policy