For the first time in history, cannabis has surpassed alcohol as Americans' daily drug of choice.
In 2022 there were 17.7 million people who reported using cannabis every day or almost every day, compared to 14.7 million who reported using alcohol with the same frequency, according to a study published Wednesday in the journal Addiction that analyzed data from the United States. National survey on drug use and health.
Although many more people drink than use cannabis, frequent use has become slightly less common than it was about 15 years ago, the study found. But the percentage of people in the United States who frequently use cannabis increased 15-fold in the three decades after 1992, when daily cannabis use hit its lowest point.
The legalization of cannabis has also accelerated rapidly since the 1990s. The drug is now legal for recreational use in 24 states and Washington, D.C., and for medical use in 38 states and D.C.
The sharp increase in the prevalence of high-frequency cannabis use over the past three decades could be attributed in part to a growing acceptance of the drug, said Jonathan P. Caulkins, a professor of public policy at Carnegie Mellon University's Heinz College. And because the survey data was self-reported, people may now feel more comfortable disclosing how often they use them.
Even so, “I don't think for most daily or near-daily consumers this is a health-promoting activity,” he added. “For some it's really harmful.”
Several experts not involved in the research said the study's findings were concerning. Those in favor of legalizing cannabis argue that making the drug widely available would distance people from the harms of alcohol, said Beatriz Carlini, a research associate professor in the department of psychiatry at the University of Washington in Seattle.
But the study data, which shows only a slight decline in frequent alcohol consumption, suggests that this was not the case.
“It's disheartening,” he said.
Dr. Carlini and others have noted that concentrations of THC, the psychoactive component of marijuana, have increased dramatically over the years.
In 1995, the concentration of THC in cannabis samples seized by the Drug Enforcement Administration was approximately 4%. In 2021 it was around 15%. And now cannabis producers are extracting THC to produce oils, edibles, wax, sugar-sized crystals, and glass-like products called shatter with THC levels that can exceed 95%.
Over the past decade, research has shown that frequent cannabis use – and particularly the use of high-potency products with THC levels above 10% – is a risk factor for the onset of schizophrenia and other psychotic disorders.
“But that's not to say that less frequent use — monthly or yearly — is necessarily safe,” said Dr. Michael Murphy, an assistant professor of psychiatry at Harvard Medical School and a psychiatrist at McLean Hospital in Belmont, Massachusetts.
“As we see higher rates of cannabis use among young people, I expect to see higher rates of psychotic disorders,” he said.
The risks of developing psychotic symptoms are greatest for those who use cannabis before age 25, people who use it frequently, those with a genetic predisposition (for example, a parent or sibling with a psychotic disorder), or individuals who have experienced stressful events such as abuse, poverty or abandonment during childhood.
In states that have legalized cannabis for recreational use, anyone 21 or older can purchase it.
Those who use cannabis frequently are also at risk of developing cannabis dependence and cannabinoid hyperemesis syndrome, a condition that causes recurrent vomiting, experts said.
This latest study comes on the heels of the Biden administration's decision last week to downgrade marijuana from the most restrictive drug category, known as Schedule I, to Schedule III, which includes drugs deemed to have a low to low risk of abuse. moderate.
The survey did not collect information on THC concentrations in products purchased by regular users or how often respondents used cannabis each day.
“Many people go home and smoke a cigarette after work or have a gummy to go to sleep at night,” said Aaron Smith, co-founder and CEO of the National Cannabis Industry Association. He didn't see this kind of casual daily use as a problem, he added.
At the same time, there may be young people who use during the day “and are exposing themselves to much more THC than those who only take one hit a day,” said Ziva D. Cooper, director of the Center for Cannabis and Cannabinoids at the University of California, Los Angeles. “Mental health and physical health outcomes will likely vary dramatically when considering these different groups of people.”