Number of cannabis administration modes as a behavioral indicator of cannabis use frequency among U.S. youth and young adults.

Burrow-Sánchez J.; Jackman E.; Cohen A. · Addictive behaviors reports · 2026

**Background & Methods** This cross-sectional study analyzed data from the 2023 National Survey on Drug Use and Health to examine the association between number of cannabis administration modes and past 12-month use frequency among 6,522 U.S. youth and young adults aged 12-25 who reported past-year cannabis use. Truncated negative binomial regression modeling was used to estimate cannabis use days as a function of administration-mode count while controlling for covariates. **Key Findings** - Cannabis use frequency increased substantially with number of administration modes, ranging from approximately 70 days for single-mode users to 257 days for those using five or more modes, representing a 269% difference (IRR = 3.689, p < .001). - Multimodal cannabis use demonstrated a dose-response relationship with use frequency, suggesting that the number of administration modes is a significant behavioral indicator of greater overall involvement in cannabis use. - These findings underscore that youth and young adults employing multiple cannabis administration routes exhibit substantially higher consumption frequency, with potential implications for increased risk of adverse health outcomes and cannabis use disorder. **Dosage & Administration** Not reported. The study examined cannabis administration modes (routes of consumption) as a categorical variable rather than standardized dosing quantities. **Safety & Adverse Effects** Not reported. The study did not measure or report specific adverse health or mental health outcomes. However, the authors note in the background that higher-frequency cannabis use is associated with adverse physical and mental health outcomes and elevated risk for cannabis use disorder. **Evidence Quality** This study has significant limitations. The cross-sectional design prevents establishment of temporal ordering or causality; the association between multimodal use and frequency cannot determine whether multiple routes lead to increased use or whether heavier users simply experiment with different modes. The sample is nationally representative but limited to self-reported data from the NSDUH, which may underestimate actual use patterns. The findings are descriptive rather than mechanistic, and confounding variables not controlled for in the analysis could influence the observed associations. This represents moderate-quality epidemiological evidence suitable for identifying patterns warranting further investigation but insufficient for establishing causal mechanisms.

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