The importance of use motivations among medical cannabis patients

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Past research has shown the importance of distinguishing between different motivations for cannabis use. These can inform about the potential risks for individual users, as well as suggest actionable intervention goals for those in need.

As discussed in a previous lift article, researchers initially probed the four motives traditionally considered in alcohol research: individual enjoyment or coping, and social enjoyment or conformity. The group also added a new motive — expansion — to accommodate use driven by the unique psychoactive properties of cannabis. With time, researchers kept refining and adding new motives to the list, including boredom, rebellion, relaxation, and medical problems, to better characterize the range of reasons that drive people towards cannabis use.

These motives have been successfully validated among young adult and adolescent recreational users, and proved useful in intervention settings for the last two decades. Seeing medical users grow in numbers, researchers and practitioners have started to ask whether the same motives can be used to better understand and aid this hitherto ignored population.

A study published this August in the journal Addictive Behaviors offers the first evidence in this direction. The work was conducted by Dr. Kipling and five collaborators from the Veterans Affairs Center for Clinical Management Research and the University of Michigan, with partial funding from the U.S. National Institute on Drug Abuse.

In order to validate the relevance of these motives among medical cannabis users, the group administered a standard questionnaire to over a thousand adult patients seeking medical cannabis certification (or  recertification) at clinics in Michigan. In addition to this, the participants filled out a short mental and physical health questionnaire and were asked about frequency of use.

The participants consulted were on average 44 years old, and were mostly white males with a higher education. Pain was by far the most common cause for seeking medical cannabis certificates (93% of the cases). On average, participants had used cannabis on 72 of the last 90 days. As expected, the sample’s average physical health was substantially lower than that of the general US population (1.5 standard deviations below), whereas mental health scores fell within the normal range.

Following several analyses, the researchers concluded that specific motives accounted for 7% of the variance in frequency of use. Those using cannabis primarily for enjoyment or to attenuate sleep problems were more likely to be frequent users, whereas those looking looking to experiment or interested in the psychoactive effects of cannabis were likely to use it less frequently.

Motives reported by patients also explained about 5% of the population variability in physical health, with users driven by a need to cope with their problems or boredom reporting better condition, and those driven by sleep problems reporting worse.

This relationship was even more robust for mental health, where the motives explained 20% of the population variability. On the one hand, motives of enjoyment (e.g., ‘because it is fun’) and celebration (e.g., ‘because it was a special day’) were linked to better mental health. On the other hand, motives of coping, social anxiety (e.g., ‘ To make you feel more confident’) and sleep problems were related to worse mental health.

These results suggest that adults seeking medical cannabis certification have a wide range of motivations for use. Besides coping with their health conditions—mostly chronic pain—patients are also looking for cannabis to manage sleep problems, cope with personal issues, but also to have good experiences or celebrate special occasions. As the authors note, these individuals reported the same motives that have been identified in other populations who use cannabis recreationally. It is somewhat strange that the authors never mention whether motives vary between those looking for a first time certification or a recertification.

Most importantly, however, the data clearly shows that motives for use reported by medical cannabis patients are likely related to their physical and mental health conditions.

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Source: 420Intel – Medical Cannabis

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