“Wake-and-bake” cannabis use: Predictors and cannabis-related outcomes of use shortly after waking

Understanding young adult cannabis use patterns is as important as ever given historical increases in frequent cannabis use among young adults and continued changes in the legalization of cannabis throughout the United States. More than one-quarter of U.S. young adults report past-month cannabis use, and the prevalence of daily or near daily use (20+ past-month occasions) is steadily increasing, with nearly one-in-twelve young adults reporting daily or near daily use (Schulenberg et al., 2021). Additionally, cannabis potency has increased over the past 50 years (Freeman et al., 2021), particularly in the past decade (Chandra et al., 2019). Yet, perceived risk of cannabis use has decreased over the past 20 years, especially among young adults (Waddell, 2022). Although some risk factors for and consequences of cannabis use have been identified (Fischer et al., 2022; Leung et al., 2020), there is a need for deeper examination of specific high-risk patterns of use.

One potentially high-risk cannabis use behavior is using cannabis shortly after waking up (colloquially referred to as “wake-and-bake”). A Google search of the term “wake-and-bake” yields internet articles, edible recipes, and songs, many of which glamorize this behavior as a highly enjoyable and relaxing way to start one’s day. Yet, little empirical research exists on wake-and-bake use among young adults. Research on use of other substances, like tobacco and alcohol, suggests that using substances shortly after waking may be indicative of a problematic pattern of use. For instance, nicotine researchers rely on time from waking in the morning until the first cigarette of the day as an indicator of dependence, and time of first use is strongly associated with problematic nicotine use behaviors (Guertin et al., 2015, Selya et al., 2016, Branstetter et al., 2020). Similarly, morning alcohol use has been used in diagnostic and screening tests (Cherpitel, 1999, Babor et al., 2001) and is a central indicator of alcohol use dependence (York, 1995). Yet for one cannabis-specific diagnostic and screening measure (i.e., Cannabis Use Disorders Identification Test – Revised; Adamson et al., 2010), which was adapted from a diagnostic and screening measure for alcohol use (i.e., Alcohol Use Disorders Identification Test; Saunders et al., 1993), researchers removed the morning use item, as it was thought to be a carryover item from the alcohol measure.

An important first step towards furthering our understanding of wake-and-bake cannabis use is determining associated risks. Specifically, to what extent is this behavior associated with using greater quantities of cannabis, experiencing more negative cannabis-related consequences, and engaging in other risky behaviors, like driving under the influence of cannabis? In an ecological momentary assessment study of adolescents and young adults who used cannabis frequently, Shrier et al. (2013) found that participants took more hits of cannabis during morning cannabis use events than during events occurring in the afternoon or after midnight. In a cross-sectional study of adults who used cannabis daily, Earleywine et al. (2016) found that individuals who used cannabis in the morning reported experiencing greater cannabis-related consequences than those who did not use cannabis in the morning when controlling for the quantity of cannabis used on an average occasion. These findings suggest that wake-and-bake use may be associated with greater cannabis use and consequences. However, both studies examined general morning use (cannabis use before noon) rather than wake-and-bake use specifically (shortly after waking).

Attention on driving under the influence of cannabis seems to be increasing in the young adult substance use literature (Patrick et al., 2021, Azofeifa et al., 2019) as policies on cannabis legalization continue to evolve in the United States. Despite clear evidence that cannabis use impairs driving ability (Fischer et al., 2022; McCartney et al., 2021) and is associated with increased risk of motor vehicle accidents (Preuss et al., 2021), many young adults perceive driving under the influence of cannabis to be relatively low-risk, especially compared to perceived risks of driving under the influence of alcohol (Greene, 2018). This lower perceived risk could explain why some evidence indicates that young adults are more likely to drive under the influence on cannabis-only occasions relative to alcohol-only occasions (Hultgren et al., 2021). Since wake-and-bake cannabis use occurs at the start of one’s day prior to taking part in any potential commitments and/or responsibilities (e.g., work, school, social obligations, errands), and cannabis use can result in driving impairments for as long as five hours (Fischer et al., 2022; McCartney et al., 2021), it is important to know whether wake-and-bake use is associated with greater odds of driving under the influence of cannabis. This is especially important given the severe or fatal consequences (for the driver, passengers, individuals in other vehicles, and pedestrians) that can result from driving under the influence of cannabis.

Identifying predictors of wake-and-bake use is another important step in understanding this behavior. Regarding differences among cannabis use days, identifying which days of the week wake-and-bake use is more likely to occur would be an appropriate starting point, as prior work has shown weekend versus weekday differences in cannabis use more generally (Patrick et al., 2016). Regarding differences between young adults who use cannabis, the limited evidence indicates that wake-and-bake use may be common among individuals who use cannabis in greater amounts, experience more cannabis-related consequences, and may be at elevated risk for cannabis use disorder (CUD; Earleywine et al., 2016; Shrier et al., 2013), similar to nicotine and alcohol research showing morning use as indicative of substance use disorders (Higgins-Biddle and Babor, 2018). Young adults’ propensity to wake-and-bake may also be associated with cannabis use motives, as they may use cannabis in the morning to cope with or manage demands associated with school or work (Shrier et al., 2013).

The current study examined predictors and cannabis-related outcomes of wake-and-bake cannabis use, defined as using cannabis within 30 min of waking up. The study had two aims. Aim 1 tested daily-level associations between wake-and-bake use and three cannabis-related outcomes: number of hours high (an index of cannabis use quantity), total number of negative cannabis-related consequences, and driving under the influence of cannabis. We expected wake-and-bake use would be positively associated with each of the three cannabis-related outcomes assessed. Supplemental analyses tested daily-level associations between wake-and-bake use and each of 10 specific negative cannabis consequences. Aim 2 tested person-level (baseline number of CUD symptoms, mean alcohol use, cannabis use motives, and demographic characteristics) and daily-level predictors (previous day alcohol use, weekends versus weekdays) of wake-and-bake use.

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