Working under the influence of cannabis amongst medical cannabis patients with chronic pain.

Lee CA, Tomlinson DC, Bohnert KM, Bonar EE, Coughlin LN, Ilgen MA. Working under the influence of cannabis amongst medical cannabis patients with chronic pain. The American journal on addictions. 2025 Mar 14 DOI: 10.1111/ajad.70028.

Related HSR&D Project(s)

• RCS 19-333 – Research Career Scientist Award

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Abstract:

BACKGROUND AND OBJECTIVES: Cannabis use is increasing in the United States, and, on average, those consuming medical cannabis report more frequent cannabis use than those who use recreationally. The present analyses focus on the prevalence and correlates of working under the influence of cannabis (WUIC) amongst individuals with chronic pain who use cannabis medically. METHODS: Adults were recruited from medical cannabis certification clinics in Michigan and individuals who were employed in the past 6 months were included in the analytic sample (N = 362). Unadjusted and adjusted logistic regressions were estimated to examine factors associated with WUIC. Descriptive analyses examined WUIC by types of employment. RESULTS: WUIC was reported by 34% (n = 123) of employed medical cannabis patients. After adjusting for other factors, older age and having episodes of 6+ drinks were significantly associated with lower odds of WUIC. History of driving under the influence of cannabis, reporting three+ hours high on cannabis per day, and using 0.5 oz+ of cannabis per week were all significantly associated with higher odds of WUIC. DISCUSSION AND CONCLUSIONS: Amongst individuals who use cannabis for pain and are in the workforce, WUIC is relatively common. This may be particularly concerning in jobs that are safety-sensitive. Prevention efforts for WUIC might focus on those who use cannabis several times per day and might consider how to balance the needs for pain management with workplace-related roles. SCIENTIFIC SIGNIFICANCE: The current study extends knowledge around the prevalence and characteristics of individuals using medical cannabis who engage in WUIC.