Research Article
Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021–2022

https://doi.org/10.1016/j.amepre.2024.07.021Get rights and content

Introduction

Cannabis use and cannabis use disorder (CUD) are associated with adverse psychosocial outcomes, but their impact on workplace absenteeism remains poorly understood. Moreover, few studies have examined the role of CUD severity. This study aims to address these gaps by examining the associations between cannabis use recency, frequency, CUD severity, and workplace absenteeism.

Methods

Cross-sectional data from a U.S. representative sample of full-time employed adults aged ≥18 from the 2021 to 2022 National Survey on Drug Use and Health (N=46,499) were analyzed. The associations between cannabis use recency, past-month cannabis use frequency, CUD severity, and workplace absenteeism (measured by self-reported number of missed days due to illness/injury and skipped work in the last 30 days) were evaluated using negative binomial regression, adjusting for sociodemographic characteristics and other substance use. Data were analyzed in 2023–2024.

Results

An estimated 15.9% of full-time employed adults used cannabis in the past month, with 6.5% meeting CUD criteria. Past-month cannabis use (compared to no lifetime use), more frequent past-month cannabis use (compared to no use in the past month), and each level of CUD (compared to no CUD) were associated with increased incidence of both missing work due to illness/injury and skipping work, with a dose-response relationship observed between CUD severity and skipping work (mild: adjusted incident rate ratio [aIRR]=1.60 [95% confidence interval [CI]=1.24, 2.08]; moderate: aIRR=1.98 [95% CI=1.50, 2.61]); severe (aIRR=2.87 [95% CI=2.12, 3.88]).

Conclusions

Individuals with recent and frequent cannabis use and CUD are disproportionately prone to workplace absenteeism. Results support the enforcement of workplace drug prevention and treatment policies.

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Section snippets

INTRODUCTION

Cannabis use is prevalent in the United States (U.S.), with an estimated 23.0% of the population aged 18 or older, equivalent to approximately 58.8 million individuals, having used cannabis in the past year.1 This prevalence is on the rise in the U.S.,1, 2, 3 influenced in part by evolving permissive federal and state laws for medical and recreational use,4 reduced perceived risks and stigma,3 and expanding medicinal applications associated with cannabis use.5 While many individuals may use

Study Sample

Data of the analytical sample included 46,499 respondents aged 18 years and older who reported full-time employment in the 2021 and 2022 NSDUH, a nationally representative cross-sectional survey of noninstitutionalized individuals in the U.S.1 The survey utilized a multistage area probability sample for each of the 50 states and the District of Columbia. Multimode data collection, with some respondents answering in person and some via the web, was used in the 2021–2022 NSDUH. The primary

RESULTS

The analysis included data from 46,499 respondents aged 18 years and older who reported full-time employment in the 2021 and 2022 NSDUH, representing approximately 116.3 million individuals.
Table 1 presents the characteristics of the full-time employed adult population. The majority of the sample was male (56.5%), NH White (61.7%), and married (52.2%), and the plurality were aged 35–49 (34.5%), had a college degree or higher (41.8%), and had an annual family income ≥$75,000 (54.5%). Cannabis

DISCUSSION

In this recent cross-sectional study of full-time employed adults in the U.S., an estimated 15.9% used cannabis use in the past month, and 6.5% met the diagnostic criteria for CUD in the previous year. The study found that past-month cannabis use was associated with workplace absenteeism due to both illness/injury and skipping work, with nuanced associations based on the frequency of past-month use. Notably, a significant and previously unreported association between the severity of CUD (i.e.,

CONCLUSIONS

The study's findings provide new evidence supporting associations between recent and frequent cannabis use and increasing CUD severity with workplace absenteeism. These associations were observed for both missing work due to illness/injury and skipping work, with a dose-response relationship between CUD severity and skipping work. Given the rising prevalence of cannabis use and CUD in the U.S., coupled with the current lack of standardized treatment options for CUD, these findings underscore

Acknowledgments

The authors have no acknowledgments to report.
Funding: Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01DA 057289 (PI: Palamar). The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.
Conflict of interest: No financial disclosures have been reported by the authors of this article. All authors declare no

CRediT Author Statement

Kevin Yang: Conceptualization, methodology, investigation, writing—original draft, writing—review and editing, visualization. Letitia Mueller: Methodology, writing—original draft, writing—review and editing, visualization. Omar El Shahawy: Methodology, writing—review and editing, visualization. Joseph Palamar: Conceptualization, methodology, formal analysis, investigation, resources, writing—review and editing, visualization, supervision, funding acquisition.

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