Public support for the legalization of marijuana (cannabis) for medical or recreational use by adults has grown rapidly over the past two decades. In 2020, more than two-thirds (68 %) of American adults supported the legal use of marijuana, which is a sharp increase from 2000 when only 34 % of adults held this view (Brenan, 2020). Furthermore, 60 % of adults residing in the United States (U.S.) in 2021 were in favor of legalizing both medical and recreational cannabis use (Van Green, 2021). In response to changing public views, 36 states and four U.S. territories have adopted medical marijuana laws that allow licensed physicians to prescribe marijuana for adult patients, and more than 15 states have authorized the sale of marijuana for adult recreational use (Haffajee and Mauri, 2021). Between 2002 and 2019, past-year prevalence of marijuana use among U.S. adults increased from 10.4 % to 18.0 % (Center for Behavioral Health Statistics and Quality, 2020). Furthermore, a recent study using 2016–2019 national survey data found that high-frequency marijuana users (6 to 29 days per month) were more likely to be young adults, males, and low-income households (Jeffers et al., 2021).

Adults with disabilities are known to have a higher prevalence of substance use (illicit drugs and marijuana) compared to those without disabilities (Glazier and Kling, 2013, Kitsantas et al., 2021). Furthermore, more than 26 percent of U.S. adults reported having a disability in 2019 (Varadaraj et al., 2021). Despite the higher prevalence of substance use in this population, little is known in the literature about recent disparities in marijuana use among working-age (18–64 year) adults with disabilities, or by type of disability. A recent study by Casseus et al. (2021) found that young adults (i.e., college students) with disabilities in 2017 had greater odds of illicit drug use compared to those without disabilities. However, the study did not separately examine marijuana use in the analysis (Casseus et al., 2021). Also, another recent study found that women of reproductive age with disabilities had a higher prevalence and odds of marijuana use compared to those without disabilities (Kitsantas et al., 2021).

Marijuana, which is known to provide relief from chronic neuropathic pain in adults (Treede et al., 2019), is currently used as an anti-emetic following chemotherapy treatment, and relieves pain and symptoms of multiple sclerosis in adults (Haffajee and Mauri, 2021). Furthermore, overlapping conditions such as depression and chronic neuropathic pain occur among people who use marijuana and people with disabilities (First et al., 2020, Stetten et al., 2020). Prior studies have shown that young adults with disabilities have a higher rate of chronic pain compared to those without disabilities (de la Vega et al., 2018, First et al., 2020, Nahin, 2015, Pitcher et al., 2019). Furthermore, chronic musculoskeletal pain is associated with depressive symptoms (de la Vega et al., 2018, Stommen et al., 2012). Since young adults with physical disabilities and older adults with reduced mobility due to neuropathic conditions have a higher prevalence of chronic pain and depressive symptoms (Haslam et al., 2021, Stommen et al., 2012), marijuana use to treat chronic pain may be higher among adults with disabilities. However, to date, no study has examined the association between disability type and marijuana use among working-age (18–64 years) adults.

It is not known whether the prevalence and risk factors associated with marijuana use vary for working-age adults with and without disabilities based on nationally representative surveys using a federally recognized set of standardized questions on disability. Therefore, this study aims to address this gap in knowledge by (1) estimating the national prevalence of past-month marijuana use by disability status and type; (2) examining various factors that influence past-month marijuana use overall; and (3) examining these factors on past-month marijuana use in a stratified analysis by disability status.