A National Survey of Marijuana Use Among US Adults With Medical Conditions, 2016-2017

IMPORTANCE The number of states legalizing marijuana for medical and recreational use is increasing. Little is known regarding how or why adults with medical conditions use it.

OBJECTIVES To report the prevalence and patterns of marijuana use among adults with and without medical conditions, overall and by socio-demographic group,and to further examine the associations between current marijuana use and the types and number of medical conditions.

DESIGN,SETTING, AND PARTICIPANTS This survey study used a probability sample of US adults aged 18 years and older from the 2016 and 2017 Behavioral Risk Factor Surveillance System,a telephone-administered survey that collects data from a representative sample of US adult residents across the states regarding health-related risk behaviors,chronic health conditions,and use of preventive services.

MAIN OUTCOMES AND MEASURES Current(past month) and daily (20 days in the last 30days) marijuana use.

RESULTS The study sample included 169036 participants(95780 female[weighted percentage, 52.0%]). Adults with medical conditions had higher odds of reporting current marijuana use than those without medical conditions(age18-34years:adjusted odd sratio,1.8[95% CI,1.5-2.1]; age 35-54 years:adjusted odd sratio,1.4 [95%CI,1.2-1.7]; age 55 years:adjusted odds ratio,1.6[95%CI, 1.3-2.0]),especially among those with asthma,chronic obstructive pulmonary disease, arthritis, cancer,and depression.Among those with medical conditions,the prevalence of marijuana use decreased with increasing age,ranging from 25.2%(95% CI,22.0%-28.3%)for those aged 18 to 24 years to 2.4% (95% CI,2.0%-2.8%)for those aged 65 years or older for current marijuana use and from 11.2% (95%CI, 8.7%-13.6%)to0.9%(95%CI, 0.7%-1.2%),respectively,for daily marijuana use. Most adults who used marijuana(77.5%; 95%CI, 74.7%-80.3%),either with or without medical conditions,reported smoking as their primary method of administration.Adults with medical conditions were more likely than those without medical conditions to report using marijuana for medical reasons(45.5% [95%CI, 41.1%-49.8%] vs21.8% [95% CI, 17.8%-25.7%];difference, 23.7% [95%CI,17.8%-29.6%]) and less likely to report using marijuana for recreational purposes(36.2% [95% CI, 32.1%-40.3%] vs 57.7% [95% CI, 52.6%-62.9%]; difference,−21.5% [95% CI, −28.1% to14.9%]).

CONCLUSION SAND RELEVANCE This study found that marijuana use was more common among adults with medical conditions than those without such conditions.Notably, 11.2% of young adults with medical conditions reported using marijuana on a daily basis. Clinicians should screen for marijuana use among patients,understand why and how patients are using marijuana,and work with patients to optimize outcomes and reduce marijuana-associated risks.