Abstract
Introduction:
In Colorado, both cannabis and psilocybin are legal and becoming more commonly used. However, there is almost no research detailing the public health concerns regarding negative outcomes (e.g., dependence) of cannabis and psilocybin co-use and motives that may perpetuate these negative outcomes (e.g., coping, boredom).
Methods:
Using data from a larger observational study on cannabis and metabolic processes, regular cannabis users (use ≥7 times/month; n = 97, 35.1% female, 89.7% WHITE) who used psilocybin in the past 3 months (n = 34) were compared with those who had not used psilocybin in the past 3 months (n = 63) on cannabis dependence as measured by the Marijuana Dependence Scale and endorsement of 12 cannabis motives from the Comprehensive Marijuana Motives Questionnaire. Correlations between motives and dependence were also examined and compared across groups.
Results:
Findings revealed that individuals who had recently used psilocybin had greater cannabis dependence scores than those who had not used recently [F (1, 95) = 5.53, p = 0.02], and more strongly endorsed that their cannabis use was motivated by enjoyment [F (1, 91) = 4.31, p = 0.04], boredom [F (1, 91) = 9.10, p < 0.01], and availability [F (1, 91) = 9.46, p < 0.01]. Correlations between dependence scores and coping and boredom motives were also significantly positive for both groups (all p values <0.05) whereas positive correlations with experimentation, celebration, and availability motives were only significant for recent psilocybin users (all p values <0.05).
Discussion:
These results suggest there are motivational differences for cannabis use among those who co-use cannabis and psilocybin, and there may be a greater risk for harm for these individuals.
Keywords: cannabis, psilocybin, cannabis use motives, coping, polydrug use
Introduction
In the state of Colorado, cannabis became legalized for recreational use in 2014. As of 2022, mushrooms containing psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) and psilocin (4-hydroxy-N,N-dimethyltryptamine) are also legal. Although Colorado was one of the first states to decriminalize mushrooms, more states are likely to follow this trend in the coming years, especially given psilocybin’s potential for therapeutic benefits including treatment applications for several mental health disorders. 1
Despite the medicinal potential of psilocybin, there are public health concerns surrounding its use. The situation is quite similar to cannabis which, despite growing evidence for health benefits,2–4 still has the potential for misuse and harmful consequences. 5 Further, with the legalization of both drugs, there is the potential for polydrug use which may only exacerbate risk for harm. Polydrug use occurs when individuals engage in simultaneous use, that is, use multiple substances at the same time in the same drug use event or alternatively, concurrent use, where substances are not used at the exact same time but within the same time period (e.g., past 3 months). Though research on the use of cannabis in combination with psychedelics is limited, there is evidence that cannabis co-use with other drugs (e.g., alcohol, tobacco) is associated with negative outcomes including increased quantity and frequency of substance use, substance use disorder symptoms, and other behavioral issues.6,7 Given the associations of polydrug use with harmful outcomes and the increased potential for co-use with psilocybin and cannabis owing to recent legislation, studies examining both concurrent and simultaneous use of these substances are warranted.
Assessing individuals’ motivations for using substances can give insight into potential harms, as motivations are heavily tied to quantity and frequency of use as well as problems associated with use. Research on motivations for substance use by Cox and Klinger 8 focused on alcohol use and proposed a 4-factor model of motivation including social (i.e., celebratory), conformity (i.e., peer acceptance), coping (i.e., decreasing negative affect), and enhancement (i.e., increasing positive affect) motives. However, this model misses important substance use motivations unique to cannabis and psychedelic drugs, such as expansion (i.e., expanding knowledge and altering sensory perception) and experimentation (i.e., trying something new) as well as other general motives that may be relevant to drug use more broadly (e.g., sleep and boredom). Later research has thus extended Cox and Klinger’s original model to include a wider variety of motives.9,10
Studies utilizing this broader conceptualization of motives have demonstrated significant overlap between reported motives for cannabis and psilocybin use. In particular, several studies have documented that users of both substances commonly report motives for enhancement, expansion, and coping motives.9,11–16 Most importantly, the motives for use that overlap between cannabis and psilocybin are related to negative cannabis outcomes. For example, both coping and expansion motives are associated with cannabis dependence17,18 and coping and enhancement motives are associated with increased quantity of cannabis use. 19 Though there is currently no specific research on the relationship between motives for use and negative outcomes in the context of psilocybin use, it is logical to assume that individuals who co-use may be even more likely to endorse these same motives and thus may be most vulnerable to problems.
The current study sought to explore whether there were differences in cannabis dependence as measured by the Marijuana Dependence Scale (MDS 20 ) and cannabis use motivations assessed via the Comprehensive Marijuana Motives Questionnaire (CMMQ 10 ) among individuals who regularly use cannabis and who had used psilocybin in the past 3 months (hereafter referred to as recent psilocybin users, n = 34) compared with those who had not (hereafter referred to as nonrecent psilocybin users, n = 63). We hypothesized that recent psilocybin users would have higher MDS scores and more strongly endorse coping, expansion (referred to as “altered perception” in the CMMQ), and enhancement (referred to as “enjoyment” in the CMMQ) motives than nonrecent psilocybin users. Because the CMMQ captures nine other motives, we compared these across groups, though given the lack of evidence on these motives in the context of psilocybin, we did not have specific directional hypotheses. As a final aim, we also explored correlations between all 12 motives and cannabis dependence across the two groups. We hypothesized that there would be correlations between dependence and coping, enjoyment, and altered perception motives for both groups, but that these would be stronger for recent psilocybin users relative to nonrecent psilocybin users. We had no hypotheses for the other nine motives in relation to dependence.
Methods
Participants
The present data came from a larger study that investigated the effects of different cannabis strains on metabolic processes and glucose regulation. The study was approved by the University of Boulder Institutional Review Board and is in accordance with the Declaration of Helsinki as revised in 2013. Mailed flyers, social media, and posted advertisements within the community were primarily used to recruit participants. Interested participants were screened for eligibility either through an online survey or by phone for the following criteria: aged 21–40 years old, stable weight, good health (e.g., no acute illness or chronic condition such as asthma or diabetes), verified not pregnant nor trying to conceive (if female), and no engagement in hazardous substance use (i.e., scores of ≥8 on the Alcohol Use Disorder Identification Task or positive illicit drug screen). Participants also had to have inhaled cannabis at least once in their lifetime with no negative reaction, use at least weekly for one year in their lifetime, and currently use cannabis twice a week.
Procedures
Participants were asked to come to two in-person appointments over the course of 4 weeks, but only the data from the baseline appointment were used in the current analysis. During the baseline appointment, participants provided informed consent and completed a series of measures (listed below) in an electronic format using REDCap, a secure data gathering system.
Measures
Demographics. Participants reported their age, gender, sex assigned at birth, race, relationship status, employment, and socioeconomic status.
Comprehensive Marijuana Motives Questionnaire. Cannabis use motives were measured by the CMMQ 10 which looks at endorsement of 12 cannabis use motives (see Table 2 for full list with example items per motive) via 36 items with each motive calculated as the average of the 3 relevant items. Participants are asked “How often do you use marijuana:” followed by a series of reasons which are rated on a Likert scale from 1 = “Almost Never/Never” to 5 = “Almost Always/Always.” Reliability as assessed by Cronbach’s alpha was acceptable to excellent for all motives (0.70–0.90) except for conformity which had very low reliability (0.23).
Table 2.
Comprehensive Marijuana Motives Questionnaire Motive Bivariate Correlations and Descriptive Information
| M (SD) | Skew | Kurtosis | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. Enjoyment | 4.24 (0.79) | −1.08 | 0.57 | — | |||||||||||
| 2. Conformity | 1.23 (0.37) | 1.45 | 0.85 | 0.12 | — | ||||||||||
| 3. Coping | 2.00 (0.89) | 0.83 | 0.29 | 0.11 | 0.32 ** | — | |||||||||
| 4. Experiment | 1.83 (0.96) | 1.14 | 0.65 | 0.16 | 0.24 * | 0.32 ** | — | ||||||||
| 5. Boredom | 2.39 (1.11) | 0.39 | −0.70 | 0.28 * | 0.38 *** | 0.24 * | 0.55 *** | — | |||||||
| 6. Alcohol | 1.53 (0.75) | 1.76 | 3.75 | 0.18 | 0.38 *** | 0.19 | 0.22 * | 0.34 *** | — | ||||||
| 7. Celebration | 3.10 (1.12) | −0.26 | −0.75 | 0.35 *** | 0.27 * | 0.18 | 0.52 *** | 0.49 *** | 0.17 | — | |||||
| 8. Alt Perc | 3.24 (1.19) | −0.39 | −0.71 | 0.27 * | 0.19 | 0.29 ** | 0.37 *** | 0.23 * | −0.10 | 0.38 *** | — | ||||
| 9. Soc Anxiety | 2.42 (1.15) | 0.49 | −0.85 | 0.27 * | 0.01 | 0.19 | 0.22 * | 0.00 | 0.01 | 0.40 *** | 0.18 | — | |||
| 10. Risk | 3.15 (1.19) | −0.30 | −0.92 | 0.37 *** | 0.18 | 0.12 | 0.41 *** | 0.30 ** | 0.12 | 0.51 *** | 0.29 ** | 0.47 *** | — | ||
| 11. Sleep | 2.75 (1.28) | 0.15 | −1.34 | 0.07 | −0.09 | 0.04 | 0.26 * | 0.15 | 0.03 | 0.20 | 0.08 | 0.31 ** | 0.47 *** | — | |
| 12. Availability | 2.20 (0.97) | 0.60 | −0.19 | 0.28 * | 0.40 *** | 0.24 * | 0.56 *** | 0.62 *** | 0.37 *** | 0.48 *** | 0.27 * | 0.13 | 0.44 *** | 0.25 * | — |
p < 0.05.
p < 0.01.
p < 0.001.
Alt Perc, altered perceptions; Experiment, experimentation; Risk, relative low risk; Soc Anxiety, social anxiety. Range for motives = 1 to 5. Example items per motive: Enjoyment (e.g., “To feel good”); Conformity (e.g., “To be cool”); Coping (e.g., “To forget your problems”); Experimentation (e.g., “To see what it felt like”); Boredom (e.g., “To relieve boredom”); Alcohol (e.g., “Because you were drunk”); Celebration (e.g., “To celebrate”); Altered Perceptions (e.g., “To allow you to think differently”); Social Anxiety (e.g., “To make you feel more confident”); Relative Low Risk (e.g., “Because it is safer than using alcohol”); Sleep (e.g., “To help you sleep”); and Availability (e.g., “Because it is there”).
Psilocybin Use. Recent psilocybin use was measured as part of a Substance Use History Questionnaire with the question “In the last 3 months, how frequently have you used mushrooms?” Answers were fixed and ranged from “never” to “everyday”. Individuals who reported never using psilocybin in the last 3 months were coded as nonrecent psilocybin users whereas those who reported using psilocybin at any frequency in the past three months were coded as recent psilocybin users (i.e., they used at least once in this period).
Cannabis Use. Cannabis use variables (e.g., days of use) were measured via a version of the Timeline Followback that was modified for online use (O-TLFB 21 ). Individuals were asked to report whether they used a particular substance (e.g., alcohol, cannabis) on each of the previous 30 days. For days when cannabis was used, participants additionally reported information on the form used (e.g., flower, concentrate, edibles), which is included for descriptive purposes.
Cannabis Dependence. Cannabis dependence was measured through a modified version of the MDS 20 which includes 11 items querying past-year Diagnostic and Statistical Manual 5 (DSM-5 22 ) criteria for cannabis use disorder. Responses were in yes/no format and summed so that higher scores indicated greater dependence symptomatology. Cronbach’s standardized α was 0.69.
Data Analysis
Demographic (e.g., race, age) and cannabis (e.g., days of use, dependence scores) variables were compared across recent versus nonrecent psilocybin users via analysis of variance (ANOVA) and chi-square tests. Skew and kurtosis values were inspected for each CMMQ motive to evaluate normality. Bivariate correlations across CMMQ motives were calculated across the whole sample using the r_corr function from the Hmisc package in R. 23 Motives were compared between the groups via a multivariate ANOVA (MANOVA) using the manova function from the Stats package. 24 A MANOVA was utilized owing to the correlated nature of the dependent variables and so that any univariate comparisons would be protected tests not requiring familywise error correction. 25 Finally, partial correlations between cannabis dependence and motives controlling for age, sex assigned at birth, and cannabis use frequency were calculated per group using the pcor function in the ppcor package, 26 and Fisher’s Z tests were conducted to assess if these correlations differed between groups using the cocor.indep.groups function from the cocor package.27,28
Results
Descriptives
Demographic data and cannabis use and dependence information for the two groups as well as across the whole sample can be seen in Table 1. Participants were on average approximately 35 years old, mostly male and white, and had at least some higher education. Approximately 68% of nonrecent psilocybin users had used psilocybin at some point in their lifetime (not shown in Table). Overall, participants used cannabis on average 21.73 out of the previous 30 days (range 1–30) and primarily used flower products, which was not unexpected as the larger study required the use of flower products for participation. The sample as a whole also displayed mild cannabis dependence symptomatology based on MDS scores (i.e., 2–3 symptoms 22 ). However, as predicted, there was a significant difference between groups on MDS scores [F (1, 95) = 5.53, p = 0.02] with higher scores for recent psilocybin users compared with nonrecent psilocybin users. Indeed, psilocybin users continued to display mild dependence severity whereas nonpsilocybin users did not (i.e., average was below 2 symptoms). In contrast, there were neither differences on any demographic variable nor frequency of cannabis use between groups (all p values >0.12).
Table 1.
Demographic Information Separately by Group and Across the Whole Sample
| Variables | Recent psilocybin users (n = 34) | Nonrecent psilocybin users (n = 63) | Everyone (n = 97) |
|---|---|---|---|
| Gender (%) | |||
| Female | 38.24 | 33.33 | 35.05 |
| Male | 58.82 | 66.67 | 63.92 |
| Other | 2.94 | 0.00 | 1.03 |
| Highest education level (%) | |||
| Some college or less | 61.76 | 66.67 | 64.95 |
| Bachelors’ degree or higher | 38.24 | 33.33 | 35.05 |
| Employment status (%) | |||
| Employed | 82.35 | 79.37 | 80.41 |
| Unemployed | 17.65 | 20.63 | 19.59 |
| Race/Ethnicity (%) | |||
| White | 88.24 | 85.71 | 86.60 |
| Not White | 11.76 | 14.29 | 13.40 |
| Income (%) | |||
| Below $30,000 – $59,000 | 44.12 | 52.38 | 49.48 |
| $60,000+ | 55.88 | 47.62 | 50.52 |
| Age [M (SD)] | 30.44 (5.14) | 29.56 (4.97) | 29.87 (5.02) |
| Cannabis use [M (SD)] | |||
| Total days any cannabis used | 21.50 (7.02) | 21.86 (7.89) | 21.73 (7.56) |
| Total days flower product used | 15.50 (10.18) | 16.30 (11.29) | 16.02 (10.87) |
| Total days edible product use | 1.12 (2.63) | 1.60 (4.07) | 1.43 (3.62) |
| Marijuana Dependence Scale [M (SD)] * | 2.62 (2.31) | 1.63 (1.75) | 1.98 (2.01) |
p < 0.05.
Note: Cannabis information references past month use.
Table 2 shows descriptive statistics and bivariate correlations between the 12 CMMQ motives across the whole sample; all motives were moderately to highly correlated with at least one other motive. The largest associations were between availability and boredom (r = 0.62), availability and experimentation (r = 0.56), and boredom and experimentation (r = 0.55). The highest endorsed motive was enjoyment (M = 4.24) followed by motives for altered perception (M = 3.24), because there is relatively low risk (M = 3.15) and celebration (M = 3.15).
Comparisons of motives between recent versus nonrecent psilocybin users
The MANOVA comparing motives across groups was significant [F (12, 80) = 1.97, p = 0.04] indicating overall differences cannabis motive endorsement for recent versus nonrecent psilocybin users. Univariate statistics indicated that while endorsement for several motives, including coping and altered perception, was not different across groups (see Table 3), there were differences on enjoyment, boredom, and availability motives. Specifically, recent psilocybin users reported greater endorsement of these motives (enjoyment: M = 4.47, SD = 0.76, boredom: M = 2.86, SD = 1.10, and availability: M = 2.60, SD = 1.05) compared with those who had not used recently (enjoyment: M = 4.12, SD = 0.78, boredom: M = 2.13, SD = 1.05, and availability: M = 1.99, SD = 0.87).
Table 3.
Group Comparison Results per Motive
| Motives | F value | p value |
|---|---|---|
| Enjoyment | 4.31 | 0.04 |
| Conformity | 1.24 | 0.27 |
| Coping | 0.75 | 0.39 |
| Experiment | 1.53 | 0.22 |
| Boredom | 9.10 | 0.003 |
| Alcohol | 0.34 | 0.56 |
| Celebration | 1.50 | 0.22 |
| Alt Perc | 2.09 | 0.15 |
| Soc Anxiety | 1.19 | 0.28 |
| Risk | 0.01 | 0.93 |
| Sleep | 1.94 | 0.17 |
| Availability | 9.46 | 0.003 |
Alt Perc, altered perceptions; Experiment, experimentation; Risk, relative low risk; Soc Anxiety, social anxiety.
Partial correlations between MDS and motives
Table 4 shows partial correlations between MDS scores and each motive by group controlling for age, sex assigned at birth, and cannabis use frequency, as well as Z-scores comparing the correlations between the groups. Among recent psilocybin users, there were significant correlations between MDS and coping, experimentation, boredom, celebration, and availability motives. Among nonrecent psilocybin users, there were significant correlations between MDS and sleep, coping, conformity, and boredom motives. All correlations were positive such that greater endorsement was related to higher MDS scores except for the correlation between MDS and sleep in the case of the nonrecent psilocybin users. Neither of the motivations associated with MDS (i.e., boredom and coping motives) were statistically significantly different between groups based on Fisher Z comparisons (p values >0.38). There were significant differences between groups on the correlations between MDS and motives for experimentation, celebration, risk, and sleep (all p values <0.05) such that these correlations were stronger for recent versus nonrecent psilocybin users.
Table 4.
Comprehensive Marijuana Motives Questionnaire (CMMQ) Motive Partial Correlations between Marijuana Dependence Scale Scores and Motives, Controlling for Age, Sex Assigned at Birth, and Cannabis Use Frequency, and Z-Score Comparisons of CMMQ Motives between Groups
| Recent psilocybin users Correlation Coefficients |
Nonrecent psilocybin users Correlation Coefficients |
Z-scores | |
|---|---|---|---|
| 1. Enjoyment | 0.11 | 0.07 | −0.18 |
| 2. Conformity | 0.28 | 0.29 * | 0.05 |
| 3. Coping | 0.31 * | 0.40 ** | 0.47 |
| 4. Experiment | 0.56 ** | 0.10 | −2.40 * |
| 5. Boredom | 0.37 * | 0.29 * | −0.41 |
| 6. Alcohol | 0.31 | 0.19 | −0.58 |
| 7. Celebration | 0.42 * | −0.03 | −2.15 * |
| 8. Alt Perc | 0.28 | 0.11 | −0.80 |
| 9. Soc Anxiety | 0.11 | −0.03 | −0.64 |
| 10. Risk | 0.31 | −0.19 | −2.32 * |
| 11. Sleep | 0.11 | −0.41 ** | −2.47 * |
| 12. Availability | 0.47 * | 0.15 | −1.62 |
p < 0.05.
p < 0.01.
Alt Perc, altered perceptions; Experiment, experimentation; Risk, relative low risk; Soc Anxiety, social anxiety.
Discussion
Legalization has provided greater access to both cannabis and psilocybin, raising public health concerns regarding co-use and necessitating strategies that may help identify those at most risk of harm. Accordingly, this study aimed to investigate differences in cannabis dependence and cannabis use motivations across individuals who regularly use cannabis and had used versus had not used psilocybin recently.
Although the prediction that recent psilocybin users would have higher dependence scores compared with nonrecent psilocybin users was supported, contrary to hypotheses, there was no difference in coping or expansion (i.e., altered perception) motives between groups. However, there were differences in enhancement (i.e., enjoyment) motives in addition to availability and boredom. Similar to coping and expansion motives, enhancement motives have been noted in the literature as being correlated with cannabis problems17,18 and are commonly endorsed by both individuals who use cannabis as well as those who use psilocybin.9,16 Interestingly, availability and boredom have also been indicative of cannabis-related harm in various studies. For example, boredom motives are positively associated with cannabis problems, 29 even when accounting for cannabis use frequency. 30 Boredom motives are also negatively associated with self-efficacy for avoiding use, and availability motives are positively associated with internalizing symptoms. 30 Further, in longitudinal treatment work, reductions in boredom motives predicted decreased cannabis use frequency at 12 months and cannabis use disorder symptoms at 15 months. 31 Although no study has examined psilocybin and these motives as they relate to harm specifically, research shows that some individuals use psychedelics, including psilocybin, for alleviating boredom.32–35 Given associations of this motive with negative consequences from cannabis use, a similar association could also exist for psilocybin, but more research is needed. Overall, the research demonstrating the harm associated with these motives in the context of cannabis and our findings that these motives were more strongly endorsed by recent psilocybin users suggest that individuals who use both cannabis and psilocybin may be more at risk for harm.
Our study additionally explored the relationship between cannabis dependence symptoms and cannabis motives and compared the strength of these relationships across groups. We found significant correlations between MDS scores and several motives, with two motives, boredom and coping, equally strongly associated with dependence across groups. In contrast, the relationship between MDS and experimentation, availability, and celebration motives were exclusive to recent psilocybin users indicating that these motives may be problematic specifically for those who co-use psilocybin and cannabis. Likewise, sleep and conformity motives were only associated with dependence among nonrecent psilocybin users, though interestingly the association was negative for sleep (i.e., use for sleep was correlated with less dependence). These findings continue to suggest greater risk of harm for cannabis–psilocybin co-users, particularly in the case of experimentation and celebration motives which were only significantly associated with dependence among this group, as well as boredom and availability motives, which were likewise associated with dependence scores among this group but were additionally more strongly endorsed in these individuals relative to nonrecent psilocybin users.
It is important to note these findings in the context of the larger polydrug use literature. Research demonstrates that co-use of several substances is associated with greater consumption and risk of harm more generally7,36 which presents the possibility that the current findings may be due to greater overall polysubstance use. As such we compared the groups on other substances including hazardous alcohol use via the Alcohol Use Disorder Identification Task as well as total number of cigarettes and days of cigarette use based on O-TLFB data; in all cases, there were no significant differences (all p values >0.21). Use of any other illicit drugs (e.g., ketamine, meth) was nearly nonexistent in this sample so was not examined.
The present findings should also be considered within the confines of the study limitations. The most notable limitation is that the data came from a pre-existing dataset for which the current analyses were not the primary purpose. Thus, there are no data on the dose of psilocybin used (i.e., macro or micro dose) and no information on whether cannabis and psilocybin were used simultaneously. Future studies should aim to gather more detailed information on cannabis and psilocybin use (e.g., amount of psilocybin, if cannabis and psilocybin use was concurrent or simultaneous, motivations for psilocybin use). In particular, longitudinal and experimental work in this context may be helpful for understanding co-use relationships. An additional limitation is that the sample size is relatively small and was primarily white, well-educated, and male, and participants were specifically selected who did not engage in hazardous substance use as assessed by AUDIT score and use of illicit drugs. Commensurate with those inclusion criteria, our sample also had low levels of dependence on cannabis as assessed by the MDS. Thus, the generalizability of our findings is limited to individuals who use cannabis frequently but who are at low risk for dependence. Finally, there is a need to develop measures to better identify differences in positive and negative coping patterns. Specifically, a more sensitive scale that could provide insight into whether people are using substances (e.g., psilocybin, cannabis) to escape problems versus attempting to work through problems more adaptively (e.g., use with therapeutic guidance) would be helpful. With the potential efficacy of these substances in medicinal settings, making this distinction could provide a more nuanced understanding of possible risks and benefits.
Despite these limitations, this study provided new and important contributions to the emerging literature on psilocybin use. Findings suggest that cannabis and psilocybin co-use may result in more harmful consequences compared with just cannabis use as well as be motivated by different reasons for use, which may help explain risk for harm. Specifically, compared with nonrecent psilocybin users, recent psilocybin users had higher MDS scores and more strongly endorsed motives correlated with this (i.e., boredom, availability). In addition, celebration, availability, and experimentation motives were further related to dependence only within recent psilocybin users such that using for these purposes may be particularly problematic for co-users. More work investigating motivational differences and use patterns of cannabis and psilocybin co-use will continue to provide insight on balancing the potential for benefit of these substances with a full understanding of their risks.
Authors’ Contributions
M.S.: Writing—original draft (lead); review and editing (equal); and investigation (equal). H.S.: Writing—original draft (lead); review and editing (equal); and investigation (equal). A.B.: Conceptualization (lead); writing—review and editing (equal); funding acquisition (lead); and supervision (equal). C.S.: Writing—original draft (supporting); formal analysis (lead); writing—review and editing (equal); and supervision (equal).
Acknowledgments
The authors acknowledge Greg Giordano and Jinqiu Yang for their contributions in the recruitment of participants and collection of the data. The authors also thank the participants who volunteered their time to this research.
Footnotes
Funding Information: This work was supported by the National Institute of Drug Abuse (1RO1DA50515 to ADB). The content is solely the responsibility of the authors and does not represent the opinion of NIDA and they played no role in the study design; the collection, analysis, and interpretation of data; the writing of the report; or in the decision to submit the article for publication.
Author Disclosure of Interest
The authors have no competing, personal financial, funding, employment, or other conflicts of interest.
Cite this article as: Stanger MK, Soffer HO, Bryan AD, Skrzynski CJ (2026) Comparing cannabis use motivations and dependence across regular cannabis users who have or have not recently used psilocybin, Cannabis and Cannabinoid Research 11:3, 261–268, DOI: 10.1089/can.2024.0059.
Abbreviations
- CMMQ
Comprehensive Marijuana Motives Questionnaire
- MDS
Marijuana Dependence Scale
- psilocin
4-hydroxy-N,N-dimethyltryptamine
- psilocybin
4-phosphoryloxy-N,N-dimethyltryptamine
References
- 1.van Amsterdam J, van den Brink W. The therapeutic potential of psilocybin: A systematic review. Expert Opin Drug Saf. 2022; 21(6):833–840; doi: 10.1080/14740338.2022.2047929 [DOI] [PubMed] [Google Scholar]
- 2.Bidwell LC, Martin-Willett R, Skrzynski C, et al. Acute and extended anxiolytic effects of cannabidiol in cannabis flower: A Quasi-Experimental ad libitum use study. Cannabis Cannabinoid Res. 2024; 9(4):1015–1027; doi: 10.1089/can.2023.0187 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Giordano G, Martin-Willett R, Gibson LP, et al. Cannabis use in cancer patients: Longitudinal associations with pain, cognition, and quality of life. Accepted pending minor revisions. Published online 2022.
- 4.Haroutounian S, Ratz Y, Ginosar Y, et al. The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain a prospective open-label study. Clin J Pain. 2016; 32(12):1036–1043; doi: 10.1097/AJP.0000000000000364 [DOI] [PubMed] [Google Scholar]
- 5.Duperrouzel JC, Granja K, Pacheco-Colón I, et al. Adverse effects of cannabis use on neurocognitive functioning: A systematic review of meta- analytic studies. J Dual Diagn. 2020; 16(1):43–57; doi: 10.1080/15504263.2019.1626030 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.Crummy EA, O’Neal TJ, Baskin BM, et al. One is not enough: Understanding and modeling polysubstance use. Front Neurosci. 2020; 14:541662; doi: 10.3389/FNINS.2020.00569/BIBTEX [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Thompson K, Holley M, Sturgess C, et al. Co-use of alcohol and Cannabis: Longitudinal associations with mental health outcomes in young adulthood. Int J Environ Res Public Health. 2021; 18(7):3652; doi: 10.3390/IJERPH18073652 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Cox WM, Klinger E. A motivational model of alcohol use. J Abnorm Psychol. 1988; 97(2):168–180. [DOI] [PubMed] [Google Scholar]
- 9.Basedow LA, Kuitunen-Paul S. Motives for the use of serotonergic psychedelics: A systematic review. Drug Alcohol Rev. 2022; 41(6):1391–1403; doi: 10.1111/dar.13480 [DOI] [PubMed] [Google Scholar]
- 10.Lee CM, Neighbors C, Hendershot CS, et al. Development and preliminary validation of a comprehensive marijuana motives questionnaire. J Stud Alcohol Drugs. 2009; 70(2):279–287; doi: 10.15288/jsad.2009.70.279 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Benschop A, Liebregts N, van der Pol P, et al. Reliability and validity of the Marijuana motives measure among young adult frequent cannabis users and associations with cannabis dependence. Addict Behav. 2015; 40:91–95; doi: 10.1016/J.ADDBEH.2014.09.003 [DOI] [PubMed] [Google Scholar]
- 12.Dash GF, Anderson KG, Dash GF, et al. Marijuana use, motives, and change. J Psychoactive Drugs. 2015; 47(2):100–106; doi: 10.1080/02791072.2015.1031412 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Hutten NRPW, Mason NL, Dolder PC, et al. Motives and side-effects of microdosing with psychedelics among users. International Journal of Neuropsychopharmacology. 2019; 22(7):426–434; doi: 10.1093/IJNP/PYZ029 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Kettner H, Mason NL, Kuypers KPC. Motives for classical and novel psychoactive substances use in psychedelic polydrug users. Contemp Drug Probl. 2019; 46(3):304–320; doi: 10.1177/0091450919863899 [DOI] [Google Scholar]
- 15.Kosiba JD, Maisto SA, Ditre JW. Patient-reported use of medical cannabis for pain, anxiety, and depression symptoms: Systematic review and meta-analysis. Soc Sci Med. 2019; 233:181–192; doi: 10.1016/J.SOCSCIMED.2019.06.005 [DOI] [PubMed] [Google Scholar]
- 16.Lee CM, Neighbors C, Woods BA. Marijuana motives: Young adults’ reasons for using Marijuana. Addict Behav. 2007; 32(7):1384–1394; doi: 10.1016/J.ADDBEH.2006.09.010 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Chabrol H, Ducongé E, Casas C, Roura C, Carey KB. Relations between cannabis use and dependence, motives for cannabis use and anxious, depressive and borderline symptomatology. Addictive behaviors. 2005;30(4):829–840. [DOI] [PubMed] [Google Scholar]
- 18.Patterson A, Vu M, Haardörfer R, et al. Motives for alcohol and marijuana use as predictors of use and problem use among young adult college students. J Drug Issues. 2020; 50(4):359–377; doi: 10.1177/0022042620917101 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 19.Bonar EE, Goldstick JE, Collins RL, et al. Daily associations between cannabis motives and consumption in emerging adults. Drug Alcohol Depend. 2017; 178:136–142; doi: 10.1016/J.DRUGALCDEP.2017.05.006 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Stephens RS, Roffman RA, Curtin L. Comparison of extended versus brief treatments for marijuana use. J Consult Clin Psychol. 2000; 68(5):898–908; doi: 10.1037/0022-006X.68.5.898 [DOI] [PubMed] [Google Scholar]
- 21.Martin-Willett R, Helmuth T, Abraha M, et al. Validation of a multisubstance online Timeline Followback assessment. Brain Behav. 2020; 10(1):e01486; doi: 10.1002/brb3.1486 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 22.American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed.. American Psychiatric Association; 2013. doi: 10.1176/appi.books.9780890425596 [DOI] [Google Scholar]
- 23.Harrell FE, Jr. Hmisc: Harrell Miscellaneous. R package version 4.4-0. Published online 2020. Available from: https://CRAN.R-project.org/package=Hmisc
- 24. R Core Team (2023). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/
- 25. Stevens J. Applied multivariate statistics for the social sciences. Mahwah, NJ: Lawrence Erlbaum Associates; 2002.
- 26.Kim S. ppcor: Partial and semi-partial (Part) correlation. R package version 1.1. Published online 2015. Available from: https://CRAN.R-project.org/package=ppcor
- 27.Diedenhofen B, Musch J. Cocor: A comprehensive solution for the statistical comparison of correlations. PLoS One. 2015; 10(3):e0121945. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 28.Team RS. R studio: Integrated development for R studio. Published online 2020. Available from: http://www.rstudio.com/
- 29.Morris PE, Buckner JD. Cannabis-related problems and social anxiety: The roles of sex and cannabis use motives updated. Addict Behav. 2023; 137:107528; doi: 10.1016/J.ADDBEH.2022.107528 [DOI] [PubMed] [Google Scholar]
- 30.Blevins CE, Banes KE, Stephens RS, et al. Motives for marijuana use among heavy-using high school students: An analysis of structure and utility of the Comprehensive Marijuana Motives Questionnaire. Addict Behav. 2016; 57:42–47; doi: 10.1016/J.ADDBEH.2016.02.005 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.Blevins CE, Banes KE, Stephens RS, et al. Change in motives among frequent cannabis-using adolescents: Predicting treatment outcomes. Drug Alcohol Depend. 2016; 167:175–181; doi: 10.1016/j.drugalcdep.2016.08.018 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 32.Evens R, Reiche S, Marek RM, et al. Psychedelic experiences during the early COVID-19 pandemic: Findings from an International Online Survey. Front Psychiatry. 2021; 12:732028; doi: 10.3389/FPSYT.2021.732028/BIBTEX [DOI] [PMC free article] [PubMed] [Google Scholar]
- 33.Lake S, Lucas P. The Canadian psychedelic survey: Characteristics, patterns of use, and access in a large sample of people who use psychedelic drugs. Psychedelic Medicine. 2023; 1(2):98–110; doi: 10.1089/PSYMED.2023.0002 https://home.liebertpub.com/psymed [DOI] [PMC free article] [PubMed] [Google Scholar]
- 34.Glynos NG, Kruger DJ, Kolbman N, et al. The relationship between naturalistic psychedelic use and clinical care in Canada. J Psychoactive Drugs. 2023; 55(5):660–671; doi: 10.1080/02791072.2023.2242353 [DOI] [PubMed] [Google Scholar]
- 35.Glynos NG, Fields CW, Barron J, et al. Naturalistic psychedelic use: A world apart from clinical care. J Psychoactive Drugs. 2023; 55(4):379–388; doi: 10.1080/02791072.2022.2108356 [DOI] [PubMed] [Google Scholar]
- 36.Edwards KA, Vowles KE, Witkiewitz K. Co-use of alcohol and opioids. Curr Addict Rep. 2017; 4(2):194–199; doi: 10.1007/S40429-017-0147-X/METRICS [DOI] [Google Scholar]