Changes in medical and non-medical cannabis use among United States adults before and during the COVID-19 pandemic

Background During the SARS-CoV-2 pandemic, cannabis dispensaries in the United States (US) reported increased sales. Objectives This study assessed changes in cannabis use before to during the pandemic; it was hypothesized that cannabis use increased during the pandemic. Methods A US-based survey of adults assessed patterns of use before and during the pandemic. Participants recruited via social media from 8/2020 to 9/2020 self-reported medical and non-medical cannabis use. Use was categorized as <= monthly, weekly, and daily/almost daily; adjusted logistic regressions determined associations between cannabis use before the pandemic with change in frequency during the pandemic. Results Of 1,886 respondents (63% male),1,113 reported non-medical and 603 medical use of cannabis. Those reporting <= monthly non-medical use before the pandemic had higher odds of increasing use during the pandemic than those using weekly before the pandemic (AOR 3.2 [95% CI 2.2-4.5]). Those reporting <= monthly and daily medical cannabis use before the pandemic had higher odds of increasing use during the pandemic than those using weekly before the pandemic (AOR 2.3 [95% 1.3, 3.9]; AOR 2.4 [95% CI 1.2, 5.1] respectively). Conclusions The most notable increases in cannabis use during the pandemic were among those who reported using cannabis least frequently before the pandemic (two to three times odds of increased use among <= monthly use compared to weekly). These findings have important implications for potential health consequences related to increased cannabis use both during and after the pandemic, even in populations thought to be protected by minimal use prior to the pandemic.