It’s a question for the ages, and one many researchers have attempted to explore in the past: Does long-term cannabis use have an impact on our health? Many opponents of legal cannabis will quickly argue, “Yes! Cannabis is harmful.” A legacy user might quickly refute with the opposite: “Of course not! I’ve been smoking every day for decades, and I’m doing great.”
Available research is mixed, with some studies finding that prolonged cannabis use can lead to cognitive impairments or, looking more specifically at consumption method, finding that cannabis smoke can have an impact on lung health; though many studies exploring the latter issue admit that data is hard to analyze, given the amount of cannabis smokers who also use tobacco.
Now, a new study is throwing another perspective on the table. Published January 13 in the journal Cannabis and Cannabinoid Research, the study found that regular cannabis use does not have a negative impact on public health, despite contributing to problems related to sleep quality or dependence.
The study analyzed data from 600,000 Spanish residents who regularly consumed cannabis (within the last 30 days), using indicators designed to give an accurate picture of health. Using survey responses from cannabis users, researchers compared the data to responses from the general public. According to recent data, Spain has the highest country-wide use rate of cannabis in Europe.
Researchers selected 46 items from the Catalan public health survey concerned areas around sociodemographic data, general health, lifestyle, use of alcohol and tobacco, social support, psychological well being, depression and the use of medicines and health services.
From November 2019 to March 2022, researchers recruited volunteers who consented to the self-administered survey in the presence of a researcher. Following the COVID-19 pandemic, an online version of the survey was developed. The participants had an average age of 33; mainly worked in service, administration or trade jobs; and nearly three-quarters completed some form of higher education following senior school.
Researchers found that 60% of the sample had used MDMA; 57% had used cocaine; 51% had used LSD, mushrooms or other psychedelic substances; 40% had used amphetamines; and 23% had used ketamine.
“The study sample reported higher drug use than the general population,” authors said. “However, this higher use does not seem to be associated with harmful effects on health, as reflected in the indicators used.”
Comparing the cannabis-consuming sample to the general population, most indicators (including BMI, cholesterol, positive perception of health and intake of fruits and vegetables) did not show a deterioration. A vast majority (88%) of the sample perceived their health in a positive light compared to the general population, and 67% of cannabis users had a “normal” BMI in relation to the general population. Those in the cannabis-consuming sample also reportedly walked 10 minutes or more a day more frequently, 76% versus 70% of the general population.
Researchers also asked respondents about their mental health surrounding cannabis, specifically, “How do you feel during cannabis use?” Nearly all respondents, 94%, said they felt “happiness,” 92% said they were “full of ideas” and 81% said cannabis gave them “a better understanding of the world.”
While researchers said that most indicators didn’t show any deterioration in the health of regular cannabis users compared to the general population, they said, “It was observed that users suffered from more sleep problems and about 40% of the sample would like to discontinue cannabis use, suggesting a dependence pattern.”
Conversely, about 30% of the sample were able to discontinue prescription medication use because of cannabis, and researchers also found that social support and sleep problems, not cannabis use, predicted depression and well being scores.
“While these differences cannot be attributed solely to cannabis use, it suggests that regular users of this drug are not experiencing relevant harmful effects in terms of fundamental indicators of overall health,” researchers stated in the study discussion. “We must remember that assessing the specific impact of cannabis use on health is challenging as health is a highly complex construct affected by several variables.”
Researchers note that the timing of the study could be a potential limitation, given that some participants answered throughout the COVID-19 pandemic, versus data from the general population collected before the pandemic, meaning that the social context might have influenced the analyses. Of course, there’s also limitations associated with self-reported data.
“These findings suggest that long-term cannabis use might not play a central role in terms of public health, while other health behaviors and complex variables are more related to health,” the authors conclude. “We suggest inclusion of cannabis-related items in national surveys of health as they would provide valuable data to support the progress of public debates regarding its regulation.”
