Medicinal, Recreational and Dual Cannabis Users Show Sharply Different Health Risks, Study Finds

A new analysis from the University of Delaware finds that medicinal, recreational and dual cannabis users have distinct health and behavioral profiles, as legal recreational cannabis use expands across the United States. The study, led by Tarang Parekh, assistant professor of epidemiology at the university's College of Health Sciences, examined 2018-2021 data from the U.S. Centers for Disease Control and Prevention's (CDC) Behavioral Risk Factor Surveillance System (BRFSS), a national health survey. The findings were published in the Journal of Medicine, Surgery, and Public Health.

Medicinal users, with an average age of 49 and nearly half of them women, carried the heaviest health burden of the three groups. They had more arthritis, disability, obesity and chronic disease, along with lower education and employment. Recreational users tended to be younger, healthier men with the highest levels of physical activity, though 45% reported binge drinking. Dual users, who take cannabis for both medicinal and recreational reasons and are most commonly aged 25 to 34, formed the most common pattern in the data. Researchers found they carried the heaviest burden of mental health distress and cigarette smoking.

Parekh also analyzed unpublished 2020-2021 BRFSS data from Delaware, gathered before the state's legal recreational market opened in 2023. Among Delaware's medicinal users, 84% had at least one chronic condition, 61% had arthritis and 49% had depression. Nearly half of the state's recreational users reported binge drinking, compared with 42% of dual users, of whom 44% also smoked cigarettes.

Nearly 60% of Delawareans who used cannabis in a one-month period did so on at least 11 days, the data showed. Smoking was the most common method, at 74%, followed by edibles and vaping.