Many states across the United States have legalized recreational Cannabis over the past decade. With recreational cannabis legalization (RCL), the impacts that it has on substance use during early adulthood have been an area of concern. Many studies have shown that there is an increase in the prevalence of 30-day cannabis use, frequency use, and Cannabis use disorder (CUD) among young adults exposed to RCL in comparison to unexposed peers. The study builds off prior RCL studies, and its goal is to use latent profile analysis to identify patterns of alcohol and cannabis use and how they have changed with RCL.
This study consists of 845,589 undergraduate students ages 18 to 24. These students represented 49 states and all completed the National College Health Assessment. Responses were collected from Fall 2008 through Spring 2018. Cannabis use days, alcohol use days, binge drinking, alcohol volume, RCL, participant-level covariates, and institution-level and design covariates were all measured. Examples of institution-level covariates were the enrollment size of the university and geographic location. Design covariates included whether the survey was administered in odd or even years or spring versus fall. This article was one of the first to look at the effects of RCL on multiple substances, not just a single substance.
The results of this study showed that students’ RCL exposure was related to a higher chance of being in each of the classes that included cannabis use, which all involved the co-use of substances. More specifically, the chances of being in heavy Co-use and Predominantly heavy cannabis use were much higher for those students who were exposed to RCL. RCL was also found to be associated with lower chances of being in the alcohol-only use classes. This study shows the importance of expanding prevention approaches, and the development of a multilevel policy is needed with the increase of recreational cannabis legalization.
Takeaway: Students’ RCL exposure was related to a higher chance of being in each of the classes that included cannabis use, which all involved the co-use of substances.