Cannabis use has evolved over the past four decades, driven largely by shifts in policy and social norms. Based on data from the National Survey on Drug Use and Health (NSDUH), it highlights key phases of cannabis use in America.
The trends show significant fluctuation in cannabis use. In the late 1970s, cannabis use was relatively high but declined sharply during the "Reagan-Bush drug war" era, hitting its lowest levels by 1992. However, as state-level medical marijuana legalization efforts gained momentum, use began to recover between 1992 and 2008. From 2008 onward, cannabis use has surged, driven by federal non-interference in state-led legalization initiatives.
The rise in cannabis consumption has been particularly marked among frequent users. Past-year use more than doubled between 2008 and 2022, while days of use per capita increased by over 200%. The most significant change has been in daily or near-daily use (DND), which increased 15-fold since 1992. This was driven both by more people using cannabis regularly and a greater proportion of monthly users transitioning to daily use.
While alcohol use remains more prevalent in the U.S., cannabis use patterns are shifting rapidly. By 2022, more people reported DND cannabis use than DND alcohol use, reversing a long-standing trend. Cannabis users also reported more frequent use compared to alcohol, with the median cannabis user consuming on 15-16 days per month, while the median alcohol user drank on just 4-5 days.
Cannabis is no longer predominantly used by young people. In 2022, people aged 35 and older accounted for a larger share of cannabis consumption than those under 35, marking a shift in the typical cannabis user profile.
The increasing normalization of cannabis, particularly the sharp rise in DND use, raises potential public health concerns. More research is needed to understand the effects of this trend and to monitor potential health consequences. Additionally, as cannabis laws continue to evolve, evaluating how these policy changes influence usage patterns will be key to shaping future regulation.
It’s important to recognize the limitations of this data, which relies on self-reported information. Social desirability bias, changing perceptions, and the emergence of new cannabis products may affect the accuracy of these figures.
Cannabis use in the U.S. has changed dramatically over the last four decades, with significant increases in both overall use and frequent consumption. As legalization continues to expand, it is critical to monitor these trends closely, investigate the public health implications, and ensure that policy development is guided by comprehensive research.
Citation: Caulkins JP. Changes in self-reported cannabis use in the United States from 1979 to 2022. Addiction. 2024; 119(9): 1648–1652. https://doi.org/10.1111/add.16519
TopicLake Insights Publication. AI Assisted ✎
