AddictionChanges in Self-Reported Cannabis Use in the United States from 1979 to 2022

ℹ️ Observational Association Only Evidence

This secondary analysis examined 27 US national household surveys conducted between 1979 and 2022, representing more than 1.6 million participants. The study evaluated long-term trends in self-reported cannabis use and compared them with alcohol consumption patterns. Rather than focusing solely on prevalence, the analysis assessed frequency of use, including daily or near-daily (DND) consumption. The findings indicate substantial growth in cannabis use over recent decades, particularly among high-frequency users. Although these trends paralleled periods of cannabis policy liberalization, the study did not establish a causal relationship between policy changes and reported use patterns.

Clinical Considerations

• The analysis included 1.64 million participants across 27 national surveys conducted from 1979 through 2022.
• Between 2008 and 2022, self-reported past-year cannabis use increased by 120%, while reported cannabis-use days per capita increased by 218%.
• The number of daily or near-daily cannabis users increased approximately 15-fold from 1992 to 2022, rising from 0.9 million to 17.7 million individuals.
• For the first time, survey estimates identified more daily or near-daily cannabis users than daily or near-daily alcohol users in 2022 (17.7 million vs 14.7 million).
• Among past-month users, 42.3% of cannabis consumers reported daily or near-daily use compared with 10.9% of alcohol consumers.
• The study relied on self-reported survey data and acknowledged that changing social acceptance, survey methodology changes, and evolving product diversity could influence reporting patterns.

Practice Applications

• Recognize that contemporary cannabis-use patterns increasingly involve frequent or near-daily consumption rather than occasional recreational use.
• Monitor frequency of cannabis use in clinical assessments, as prevalence alone may not adequately characterize exposure.
• Interpret population-level trends cautiously because the study did not establish causality between cannabis policy changes and use patterns.
• Discuss cannabis use with patients using current epidemiologic data that reflect evolving consumption patterns and demographic shifts.
• Consider frequent cannabis use as a distinct behavioral pattern that may warrant separate assessment from occasional use in clinical and behavioral health settings.