Study examines low-risk cannabis use years after legalization

A new study led by Marie-Pierre Sylvestre, professor at the Université de Montréal School of Public Health, examines cannabis use 4 to 5 years after Canadian legalization by adopting a different perspective: rather than focusing solely on at-risk cases or those associated with problems, it identifies the socio-demographic, mental health, and lifestyle profiles of those who present a low risk of cannabis use disorder (CUD).

The study, of which Guillaume Dubé is the lead author, analyzed data from 731 Quebec adults in their mid-thirties. The results show that among the 44% of participants who used cannabis in the past year, 63% presented a low risk of developing cannabis use disorder (CUD).

Distinct profiles according to risk

The researchers identified marked differences between groups. "Lower-risk cannabis users resemble non-users more than higher-risk users," explains Guillaume Dubé. "The latter are more often male, have lower levels of education, and present more mental health problems, particularly anxiety."

Jean-Sébastien Fallu, professor at the Université de Montréal School of Psychoeducation and co-author of the study, emphasizes the importance of these findings: "This research supports a change in attitude and perspective: rather than focusing almost exclusively on at-risk consumption profiles or those associated with problems, let's turn our attention to an aspect too often unconsidered, even obscured-that is, non-problematic cannabis use."

A beneficial factor: occasional use

Unsurprisingly, frequency of use remains the factor most strongly associated with high CUD risk. However, the study reveals that other risk factors could play an important role, such as simultaneous cannabis and tobacco use and smoking in general, as well as anxiety symptoms. The study also suggests that cannabis use in a social context, rather than alone, is associated with a lower risk of CUD.

After taking various factors into account in their analysis, the research team also highlighted that women and people who simultaneously use cannabis and alcohol were more likely to have lower-risk use.

We also observed that people who used alcohol and cannabis simultaneously had a lower risk of CUD than those who used cannabis without alcohol. This may seem surprising, but we hypothesized that when these two substances are used together, it's in a social context, which is the true beneficial factor. This remains to be demonstrated, however."

Guillaume Dubé, lead author

Conversely, tobacco and cannabis use is an important risk factor that differentiates higher-risk users from lower-risk users.

Public policy: stop demonizing cannabis

Marie-Pierre Sylvestre emphasizes the practical implications: "Our results underscore the importance of harm reduction strategies and evidence-based education for cannabis-related policies."

The team recommends that public health provide factual information about the potential effects of cannabis, both positive and negative.

"Like alcohol, cannabis has been consumed since the dawn of humanity. Psychoactive substance use carries risks, regardless of the substance. For adults who wish to use cannabis, there are practices to maximize its benefits and reduce these risks," concludes Guillaume Dubé.

About the study

This research is based on the longitudinal Nicotine Dependence in Teens (NDIT) study, which has been following Quebecers since 1999. The analyzed data were collected in 2022-2023, 4 to 5 years after cannabis legalization in Canada.