Medical Cannabis Tied to Higher Addiction Risk Than Recreational Use

Medical cannabis users aged 18–49 may face higher risks of cannabis use disorder compared to recreational users.

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Medical marijuana patients under 50 face a twist: their prescribed cannabis may be more likely to trigger addiction than recreational use, according to a recent study.

In a nationwide survey of nearly 73,000 adults,  researchers found that people who have been prescribed cannabis for medical reasons had a higher risk of developing cannabis use disorder (CUD).

Prescribed Cannabis and Increased Use

The study, published in JAMA Psychiatry, analyzed data from the 2021–2022 National Surveys on Drug Use and Health, which collected information on cannabis usage, frequency, and addiction severity.

Researchers discovered that nearly 30 percent of almost 73,000 surveyed reported using cannabis in the past year. Among those, around 84 percent did not use it for medical purposes, while around 16 percent did, with a tenth of cannabis users only taking cannabis medically.

Those who used cannabis strictly for medical purposes showed more frequent usage, often on a daily basis, compared to those reporting that they only used it non-medically. However, the researchers did not say if this was linked to higher risks of cannabis abuse.

Notably, researchers found that among males aged from 18 to 34 years, 17 percent of people who used cannabis for medical reasons exhibited moderate levels of CUD, while almost 14 percent exhibited severe levels. The study authors emphasized that medical use cannabis was categorized as any cannabis recommended by medical professionals.

“These findings suggest that medically recommended cannabis is not associated with reduced addiction risk compared with non-medical use,” the authors wrote. However, the authors did not give an explanation for why medical cannabis users had a higher risk of cannabis abuse.

Additionally, it is unclear what conditions participants were using medical cannabis for, though researchers noted that it was recommended by a medical professional.

As of February 2024, 47 states, the District of Columbia, and three U.S. territories (Guam, Puerto Rico, and the U.S. Virgin Islands) allow cannabis use for medical purposes, according to the Centers for Disease Control and Prevention.

The Broader Context of Cannabis Addiction

Researchers caution that their research is limited because the findings are based on self-reported data, which could be influenced by memory and social pressure. Additionally, they suggest that the diagnostic criteria for CUD may not fully account for the nuances of medical cannabis use, potentially leading to overestimations of the condition.

However, they stressed a need for health care providers to consider the risk of addiction when recommending medical cannabis. “Clinicians should monitor for CUD emergence,” they advised.

Roughly one in 10 people who begin smoking cannabis, either medical or recreational, will become addicted, and 30 percent of current users meet the criteria for addiction, according to data from Yale Medicine. People in mid-to-late adolescence are most likely to begin using cannabis. Additionally, research suggests that developing cannabis addiction is hereditary, potentially leading to genetic tests that identify those at greatest risk for the disorder.