A study by researchers at Columbia University Mailman School of Public Health and Oregon State University based on national data found that in states where recreational marijuana has been legalized, young adults who were not in college more often became frequent users of the drug than those in other states. The findings are published in the American Journal of Preventive Medicine(link is external and opens in a new window).

After state legalization, young adults also were more likely to meet the criteria for cannabis use disorder, meaning that they continued to use the drug despite problems it caused in their lives. These patterns were not found in young adults who were in college.

The study used data from the National Survey on Drug Use and Health from 2008-2019, which surveyed college-eligible young adults ages 18-23 about their drug and alcohol use. The dataset is representative of the demographics of young adults nationally and at the state level, and the study covers a longer stretch of time post-legalization than previous research, according to the researchers.

“It might surprise people that research has been mixed on whether young adults’ cannabis use has increased since legalization,” said David Kerr, PhD, professor in OSU’s School of Psychological Science and first author. “Our results show that prior to legalization 23 percent of non-college young adults used cannabis in the past month, compared to 28 percent after legalization.” 

While the percentage of non-college young adults who reported past-month cannabis use increased by 5 percentage points, it only increased by 1 percentage point among college students in the same age bracket, from 20 percent to 21 percent.

Frequent cannabis use—using the drug at least 20 times in the past month—also increased more among non-college young adults, from 12 percent to 14 percent. The prevalence for college students was 7 percent and did not change after legalization. Kerr noted that the research did not account for the fact that the potency of cannabis is higher in legal states and has increased dramatically over time.

Cannabis use disorder among non-college participants also grew from 12 percent to 15 percent while staying the same, at 10 percent among college students. 

“Our research doesn’t address why these changes are occurring, but if you’ve been to a state that has legalized recreational cannabis use you’ll notice the drug is widely available and prominently advertised. Americans’ beliefs about the benefits and harms of cannabis use are also changing rapidly,” Kerr said, citing a report from the Monitoring the Future study showing that  in 2020 only 21 percent  of young adults believed regular cannabis use puts people at risk of harm, compared to 58 percent  of young adults 20 years ago. 

Increased acceptance of cannabis use at the societal level could affect the rate at which users experience cannabis use disorder, the authors note, because many of the negative consequences associated with the disorder are social in nature. 

“Cannabis use disorder involves inability to fulfill major obligations at work, school or home, and then continued use,” Kerr said. “It is possible that there may be fewer social consequences now that the environment is more accommodating,” he said. “If so, then our findings may actually have underestimated these increases,” he added.

The study also found that in states where legalization occurred, recent cannabis use increased more among young adults ages 21-23 (from 21 percent to 26 percent) than among 18-20-year-olds (from 22 percent to 23 percent).

“That’s consistent with our prior work, that it increased more among the people who could legally buy it and use it,” Kerr said. “It suggests the law provisions requiring people to be at least 21 are at least somewhat effective.” 

“Researchers should continue to monitor changes in prevalence of cannabis use, frequent cannabis use and cannabis use disorder among young adults while the cannabis landscape in the U.S. continues to evolve,” said senior author Silvia Martins, MD, PhD, professor of Epidemiology at Columbia Mailman School of Public Health. “It is also important to better understand why increases to date were more pronounced in young adults not in college.”  

Co-authors are Natalie Levy, Columbia University Mailman School of Public Health; Harold Bae, Oregon State University; and Anne Boustead, Arizona State University.

The research was funded by a grant from the National Institute on Drug Abuse.

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Young adults ages 19 to 30 nearly doubled their past 12-month use of non-LSD hallucinogens in the United States from 2018 to 2021, according to a study by the Columbia University Mailman School of Public Health and the University of Michigan. The results are published in the journal Addiction.(link is external and opens in a new window)
 
In 2018, the prevalence of young adults’ past-year use of non-LSD hallucinogens was 3.4 percent. In 2021, that use increased to 6.6 percent.
 
“While non-LSD hallucinogen use remains substantially less prevalent than substances such as alcohol and cannabis use, a doubling of prevalence in just three years is a dramatic increase and raises public health concerns,” said study co-author Megan Patrick, a research professor in the Survey Research Center at the University of Michigan Institute for Social Research and co-principal investigator of the Monitoring the Future study. She also noted: “The increase in non-LSD hallucinogen use occurred while LSD use remained stable, and was around 4 percent in 2018 and 2021.”
 
The findings come from the Monitoring the Future study, conducted by a team of professors at the University of Michigan’s Institute for Social Research and funded by the National Institute on Drug Abuse, which is part of the National Institutes of Health. In the Monitoring the Future panel study, annual samples of 12th grade students are followed longitudinally into adulthood. The study focuses on substance use and health.
 
The researchers examined the use of these hallucinogens by sex and found that the use of non-LSD hallucinogens was greater for males. They also found that white young adults used such hallucinogens at a higher rate than Black young adults. Use of non-LSD hallucinogens was also greater for those whose parents had a college education, a proxy for socioeconomic status.
 
While Monitoring the Future does not identify whether young adults were using these drugs recreationally or because they believed their use to be of therapeutic benefit, previous research has shown that nonmedical hallucinogen use is associated with risks of substance use disorders, injury including self-harm and anxiety, according to the study.
 
“The use of psychedelic and hallucinogenic drugs for a range of therapeutic uses is increasing, given accumulating yet still preliminary data from randomized trials on clinical effectiveness,” said Katherine Keyes, professor of epidemiology at Columbia Mailman School and lead author of the study. “With increased visibility for medical and therapeutic use, however, potentially comes diversion and unregulated product availability, as well as a lack of understanding among the public of potential risks.” While the survey did not query whether young adults used non-LSD hallucinogen use a therapeutic or medical reason, Dr. Keyes notes “Approved therapeutic use of psychedelics under a trained health professional’s care remains uncommon in the US, thus the trends we observe here are undoubtedly in non-medical and non-therapeutic use.”
 
In each survey across young adulthood, from ages 19 to 30, the participants were asked: “How often in the past 12-months have you used LSD (‘acid’)?” They were also asked if they had used hallucinogens other than LSD such as mescaline, peyote, “shrooms” or psilocybin, or PCP. Responses ranged from none to 40 times or more. Of the non-LSD drugs listed, ‘shrooms’/psilocybin had the highest prevalence.
 
“The use of hallucinogens other than LSD, such as psilocybin in so-called ‘shrooms,’ has increased among young adults in the U.S. This is a rising concern for young adult health,” Patrick said. “We will continue to track these trends to see if the increases continue. We need additional research, including about the motivesfor hallucinogen use and how young adults are using these substances, in order to be able to mitigate the associated negative consequences.”
 
Research reported in this press release was supported by the National Institute on Drug Abuse of the National Institutes of Health under award numbers R01DA016575 and R01DA001411. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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