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Cannabis legislation in the US has been a rollercoaster. Over the last few decades, cannabis legislation around the world has been constantly changing. In the United States the legislation around cannabis use is particularly confusing. At a federal level cannabis is illegal, however, many individual states and the District of Columbia (D.C.) have taken steps to legalise cannabis for medical and/or recreational reasons. This blog post explores the trends in self-reported cannabis use in the US from 1979 to 2022, against the backdrop of these evolving policies.

A Brief History of Cannabis Policy in the US

To understand the trends, it’s crucial to look at the history of cannabis policy in the US. We can broadly divide it into four periods:

Today, 38 states and D.C. allow the use of cannabis for medical reasons. Furthermore, 24 states and D.C. have legalised recreational cannabis and a further seven states have decriminalised its use. In the recent 2024 elections, voters in Nebraska supported the legalisation of cannabis for medicinal use. This changing landscape has significantly impacted cannabis consumption patterns.

Cannabis Use: The Numbers Tell a Story

A recent study analysed data from the National Survey on Drug Use and Health (NSDUH) and the National Household Survey on Drug Abuse (NHSDA) to understand how cannabis use has changed over time. Here are some key findings:

Cannabis vs. Alcohol: A Shifting Dynamic

Interestingly, the study also compared cannabis use with alcohol use:

Understanding the Data

Worldwide, including in the US, far more people consume alcohol than cannabis. Nonetheless, the findings of this analysis of self-reported cannabis and alcohol use show cannabis use is increasing in the US.

While these findings highlight a significant increase in cannabis use, particularly high-frequency use, it’s important to consider some limitations:

Despite these limitations, the study clearly shows a considerable increase in cannabis use in the US, coinciding with evolving cannabis policies.