| Journal | Rhode Island medical journal (2013) |
| Study Type | Clinical Study |
| Population | Human participants |
This surveillance data provides critical insight into real-world cannabis use patterns among high-risk populations, particularly those with polysubstance use and disability. Understanding cannabis as part of complex substance use profiles is essential for developing appropriate clinical interventions and harm reduction strategies.
This convenience sample study analyzed 673 participants in Rhode Island’s Harm Reduction Surveillance System from 2021-2024, finding cannabis was the third most commonly used substance (69% in past 30 days) after alcohol (73%) and crack cocaine (72%). The population showed high disability prevalence (86%) and concerning trends in decreased harm reduction practices by 2024, including reduced fentanyl test strip use and less frequent supervised substance use. Cannabis use occurred within a polysubstance context including stimulants and opioids, highlighting the complexity of substance use patterns in this vulnerable population.
“This data reinforces what I see clinically – cannabis is rarely used in isolation among high-risk populations, and we cannot address cannabis therapeutically without understanding the full substance use context. The high disability prevalence suggests potential self-medication patterns that warrant clinical attention rather than criminalization.”
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Table of Contents
- FAQ
- How common is cannabis use among people who use non-prescribed substances?
- What role does cannabis play in the context of polysubstance use and overdose risk?
- Are harm reduction practices declining among people who use cannabis and other substances?
- What is the relationship between disability and substance use patterns including cannabis?
- How should clinicians approach patients who use cannabis alongside other substances?
FAQ
How common is cannabis use among people who use non-prescribed substances?
In this Rhode Island surveillance study, cannabis was the third most commonly reported substance, used by 69% of participants in the past 30 days. This high prevalence indicates that cannabis is frequently part of polysubstance use patterns, following alcohol (73%) and crack cocaine (72%).
What role does cannabis play in the context of polysubstance use and overdose risk?
Cannabis appears to be commonly used alongside higher-risk substances including fentanyl/heroin (39% of participants) and cocaine (42%). While cannabis itself has low overdose risk, its frequent co-occurrence with opioids and stimulants suggests it may be part of complex substance use patterns that require comprehensive harm reduction approaches.
Are harm reduction practices declining among people who use cannabis and other substances?
Yes, the study found concerning decreases in key harm reduction practices in 2024 after improvements from 2021-2023. Specifically, there were declines in consistent fentanyl test strip use and using substances in the presence of others, which are critical safety measures for overdose prevention.
What is the relationship between disability and substance use patterns including cannabis?
The study found that 86% of participants reported having a disability, indicating a strong association between disability status and substance use. This suggests that substance use, including cannabis, may be related to self-medication for disability-related symptoms or reflects healthcare access disparities in this population.
How should clinicians approach patients who use cannabis alongside other substances?
Clinicians should recognize that cannabis use often occurs within polysubstance patterns and assess for use of higher-risk substances like fentanyl and cocaine. A non-judgmental, harm reduction-informed approach focusing on safety practices and addressing underlying needs, particularly in patients with disabilities, is most appropriate for this population.