How cannabis use is changing across the US

Voters in four states last week weighed in on ballot initiatives that would legalize the recreational or medical use of marijuana.

Nebraska’s measures passed, and the state joined over two dozen other states that have legalized the drug in some way, becoming part of a shifting landscape of cannabis use in the United States. Ballot initiatives to legalize recreational use in Florida and the Dakotas failed.

Researchers tracking cannabis say that the picture of who uses the drug — and how — is evolving, and point to a few key trends.

Use appears to be rising among everyone, except teenagers

When states first legalized recreational cannabis, starting with Colorado and Washington in 2012, some panicked. “The ‘sky’s going to fall’ scenario was that all of the kids were just going to have access to all of the cannabis and it was going to be a terrible, terrible thing,” said Ryan Vandrey, a professor of psychiatry and behavioral sciences at Johns Hopkins Medicine who studies cannabis.

The largest jumps in use in recent years, though, appear to be among adults.

About 42 per cent of adults ages 19 to 30 and 29 per cent of those ages 35 to 50 have used cannabis in the past year — a historically high level of use, according to data from a nationwide survey. That shift may be in part because of changing public perceptions about the drug and whether it’s all that harmful, Vandrey said. (This is despite evidence that many cannabis products are stronger than they used to be; doctors have also raised concerns that some users can become dependent on the drug.)

Older adults are also increasingly using cannabis. In 2007, less than 1 per cent of adults 65 and older had used the drug in the past year. By 2022, that number grew to more than 8 per cent. Experts aren’t exactly sure what’s behind that trend, but they noted that some cannabis brands had ramped up marketing to older adults.

Use among teenagers, however, seems to be falling. The percentage of adolescents who say they currently use marijuana dropped from 23 per cent in 2011 to just under 16 per cent in 2021.

“It just goes to show that teenagers will do exactly the opposite of what you think they’re going to do at all times,” Vandrey said.

Part of why teenagers have not reported higher rates of marijuana use may be because of stringent age restrictions at dispensaries in states that were early to legalize cannabis, said Traci Toomey, director of the University of Minnesota School of Public Health Cannabis Research Center. “With the legalization, with those controls in place, there wasn’t necessarily easier access for young people,” she said, adding that without such strict policies, teenagers’ use might rise.

And some studies show that teenagers have shifted away from substance use in general, reporting lower rates of drinking and drug use. That could be a lingering effect of pandemic lockdowns, when they spent less time socializing in-person and more at home with parents.

Still, researchers are continuing to closely watch cannabis use rates among teenagers as they study the potential hazards of the drug while the brain is still developing.

The gender gap is narrowing

Men have historically used cannabis at far higher rates than women, said Ziva Cooper, director of the UCLA Center for Cannabis and Cannabinoids. That gap is closing. In 2023, women between the ages of 19 and 30 reported using cannabis more within the past year than men in that age range. Teenage girls have also reported using marijuana at higher rates than teenage boys.

Researchers have a few hypotheses about this shift. More women tend to use marijuana for medical reasons, Cooper said. That may be because women have higher rates of conditions the drug is often used for, like chronic pain.

It’s also possible that women have always consumed weed in numbers comparable to men’s use — but only now, with less stigma around the drug, do they feel comfortable reporting their use in surveys, Vandrey said.

More people use it daily

More Americans are now using marijuana every day than are drinking alcohol, a study published in May found. Nearly 18 million people reported using the drug every day or nearly every day, compared with just under 15 million who drank with the same frequency.

The data shows just how entrenched marijuana has become in American life, surprising even scientists like Cooper, who has closely tracked the growing popularity of cannabis.

It also raises questions about the potential health implications, Vandrey said. Statistics on the frequency of cannabis use don’t tell scientists why people are using the drug, or at what dose. They don’t capture the nuance of whether someone is taking a small amount each night to relieve chronic pain or larger doses throughout the day to get high. Scientists are still working to understand the long-term health effects of routine cannabis use, especially in the strengths and formulations of the drug available today.

Edibles and vapes are on the rise

Vapes and edibles are becoming more popular, researchers say, a potential signal that consumers are favoring more discreet options. Part of the appeal of these products is that consumers can purchase them at standardized doses, Vandrey said.

Some consumers may believe that edibles are a healthier mode of consuming cannabis, since they don’t carry the same risk of lung damage as smoking. But there isn’t conclusive evidence to say that one mode of consumption has fewer risks.

There are also simply more options on the market, like cannabis-infused drinks, which can draw in new consumers.

“I know people who would never have used before but they say, ‘Gosh, those THC seltzers are very tasty,’” Toomey said.