Background: While recreational cannabis use is common, medical cannabis programs have proliferated across North America, including a federal program in Canada. Few comparisons of medical and recreational cannabis users (RCUs) exist; this study compared these groups on key characteristics. Methods: Data came from a community-recruited sample of formally approved medical cannabis users (MCUs; n = 53), and a sub-sample of recreational cannabis users (RCUs; n = 169) from a representative adult survey in Ontario (Canada). Samples were telephone-surveyed on identical measures, including select socio-demographic, substance and medication use, and health and disability measures. Based on initial bivariate comparisons, multivariate logistical regression with a progressive adjustment approach was performed to assess independent predictors of group status. Results: In bivariate analyses, older age, lower household income, lower alcohol use, higher cocaine, prescription opioid, depression and anxiety medication use, and lower health and disability status were significantly associated with medical cannabis use. In the multivariate analysis, final model, household income, alcohol use, and disability levels were associated with medical cannabis use. Conclusions/Scientific Significance: Compared to RCUs, medical users appear to be mainly characterized by factors negatively influencing their overall health status. Future studies should investigate the actual impact and net benefits of medical cannabis use on these health problems.

Background: The motives for cannabis affect on cannabis use and cannabis use consequences. Coping with stress is among the frequent motives for cannabis use. However, non stressed youth may use cannabis for self-enhancing motives like boosting confidence. Both motives are associated with higher frequency of cannabis use and more negative consequences (e.g., effects on schoolwork quality). Interventions targeting these distinctive motives may need to be tailored to assist youth trying to reduce cannabis use. The purposes of this study were: to examine the effect of cannabis use interventions on the change in motives of use; and whether motives for use are associated with hours per week using cannabis. Methods: Participants were from a cross national study including US and Canadian youth (n= 781). Participants included in the current analysis were from two Canadian Universities (n = 397, 54% female, median age = 21) were randomized into either the Cannabis eCHECKUP TO GO or Healthy Stress Management (HSM) intervention. Both interventions were administrated online and assessed at baseline and at a 4- to 6-week follow-up. Eligible youth reported using cannabis more than once a week and wanted to reduce their cannabis use. The 19 items to the question “what do you like about cannabis” were used as an assessment of motives for use (e.g., I feel more courageous, I feel more confident, cannabis helps me reduce stress, cannabis helps me sleep). Confirmatory Factor Analysis showed that a 2-factor model of cannabis use motives (self-confidence and stress-coping) fit the data adequately (CFI = 0.795, RMSEA [90% CI] = .063 [.057, .069]) after removing 2 poorly fitting items. Results: Across conditions self-confidence motives (T1: eCHECKUP condition M = 4.05(2.55), HSM condition M = 4.13(2.43); T2: eCHECKUP condition M = 4.09(2.50), HSM condition M = 4.36(2.28)) were endorse less than stress-coping motives (T1: eCHECKUP condition M = 6.48(1.92), HSM condition M = 6.25(1.78); T2: eCHECKUP condition M = 6.20(1.99), HSM condition M = 6.32(1.96)). Stress-coping motives were significantly correlated with the time spent high (hours a week) (T1 r= .21, T2: r=.26). A repeated measures MANOVA showed a significant interaction between time and intervention condition for the stress-coping motives only (F(1)= 4.08, p = .04). Participants in the Healthy Stress Management condition reported a significant decrease in the amount of stress-coping motives at the follow-up. Conclusions: These results demonstrate that motives of cannabis use can change over the course of a short online intervention for students seeking to reduce their use. In particular, the Healthy Stress Management condition helped participants reduce their stress-coping motives at T2. Neither intervention affected self confidence motives in the short term. These may be harder to address and may fuel continued use over time, even for youth hoping to change.