US Cannabis Use Trends at the Intersection of Serious Psychological Distress and Race/Ethnicity, 2008-2019

Objective Mental health conditions and race/ethnicity are independently associated with cannabis use. However, the current prevalence of and trends in cannabis use at the intersection of serious psychological distress (SPD) and race/ethnicity are unknown. Methods This study assessed past 30-day cannabis use using data from the 2008-2019 National Survey on Drug Use and Health (n = 484,732). Joinpoint regression examined trends over time, stratified by SPD and race/ethnicity. Results The prevalence of past 30-day cannabis use in the US increased significantly between 2008 and 2019 regardless of racial/ethnic group identification and past-month SPD status. The prevalence of cannabis use in 2019 was significantly greater for individuals with (27.9%) versus without SPD (10.7%) overall (p < 0.001) and within each race/ethnicity. Conclusions Because cannabis use prolongs and exacerbates psychiatric symptoms, the disproportionately high and increasing prevalence of cannabis use among people with SPD emphasizes the importance of continued surveillance of cannabis use in this group. This is especially true among intersectional priority populations where particularly large disparities in the prevalence of cannabis use are observed (e.g., Hispanic with SPD versus Hispanic without SPD). Additionally, trends highlight the need to screen all patients for cannabis use, especially patients with SPD and related conditions.