The prevalence and correlates of self-reported cannabis use for medicinal, dual and recreational motives in Australia: Findings from the National Drug Strategy Household Survey 2022/2023

Introduction: Cannabis has been prescribed as a medicine in Australia since 2016. The current study aimed to conduct a descriptive, epidemiological investigation on the prevalence and correlates of cannabis use for different motives (recreational-only, medical-only or dual-use) in Australia. It also aimed to examine the correlates of different cannabis use motives. Methods: The National Drug Strategy Household Survey 2022/2023 was used to estimate the prevalence and correlates of cannabis use motives among Australians. Prevalence estimates were weighted to the population and multinomial logistic regressions were used to examine the impact of age, gender, frequency of use and some of the most common conditions for which cannabis is prescribed in Australia (i.e., chronic pain, cancer and anxiety) on cannabis use motives. Results: The prevalence of medical-only cannabis use was 1.0% (95% confidence interval [CI] 0.6, 1.4%), recreational-only use was 8.6% (CI 7.5, 9.7%) and dual-use was 1.9% (CI 1.3, 2.5%). Respondents who reported chronic pain had a stronger association with medical-only (relative risk ratio [RRR] = 8.10, p < 0.001) or dual-use motives (RRR = 5.17, p < 0.001) compared to recreational-only. Respondents who usually obtained cannabis via prescription had a stronger association with medical-only motives compared to dual-use (RRR = 10.55, p < 0.001). Greater frequency of use was more strongly associated with dual-use motives compared to recreational-only. Discussion and Conclusions: The emergence of dual-use cannabis consumers is a conundrum for the current medicinal cannabis policy framework in Australia. Research on the potential harms associated with the dual-use and medical-only use of cannabis should be prioritised as prescriptions for medicinal cannabis increase and barriers to access are lessened.