A new study published in the American Journal of Preventive Medicine has found that individuals who use cannabis frequently or suffer from cannabis use disorder are more likely to miss work. The study analyzed data from over 46,000 employed adults in the United States, revealing that recent cannabis use is linked to increased absenteeism, both due to illness or injury and intentional skipping of work. This connection grows stronger with more frequent use and more severe cases of cannabis use disorder.
Cannabis use is becoming increasingly common in the United States, especially as laws continue to shift toward legalization for both medical and recreational purposes. Over 23% of adults in the U.S. report using cannabis in the past year, a trend that is expected to rise. Despite this, researchers have not yet fully understood how cannabis use impacts the workplace, especially in terms of absenteeism, which can significantly affect productivity and economic outcomes.
Previous studies on cannabis and absenteeism have been inconsistent. Some research has suggested that cannabis use increases absenteeism, while others have found no connection or even a decrease in absences following cannabis legalization. This study aimed to resolve these contradictions by analyzing recent, comprehensive data from a nationally representative survey. By looking at both cannabis use frequency and the severity of cannabis use disorder, the researchers hoped to provide clearer insights into how cannabis affects workplace attendance.
The researchers also drew inspiration from similar research on alcohol use. Alcohol use disorder has been shown to significantly increase workplace absenteeism. Given the similarities between alcohol and cannabis as commonly used substances, the researchers suspected a similar relationship might exist for cannabis use and cannabis use disorder.
“Cannabis use has increased dramatically in the United States over the past decade, likely driven by changes in legalization and decreasing perceived risk associated with use,” said study author Dr. Kevin H. Yang, a third-year resident physician in the Department of Psychiatry at UC San Diego School of Medicine. “As a researcher at UCSD, I’m part of a team interested in examining the various public health aspects of cannabis use, looking at both the benefits as well as risks. Given the changing landscape, we wanted to understand how cannabis use might impact important areas of life, including workplace absenteeism.”
To investigate this question, the researchers used data from the 2021-2022 National Survey on Drug Use and Health (NSDUH), which surveyed over 46,000 adults who were employed full-time. The survey is designed to be representative of the U.S. population, meaning the findings could be generalized to the broader workforce.
Participants were asked about their cannabis use, including whether they had used cannabis in the past month, how frequently they used it during that time, and whether they met the criteria for cannabis use disorder. Cannabis use disorder is diagnosed based on the standards set by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which considers factors like how much control a person has over their cannabis use and whether it negatively impacts their life.
Workplace absenteeism was measured in two ways: the number of workdays missed due to illness or injury, and the number of days skipped for other reasons, such as not wanting to go to work. The researchers controlled for other factors that might affect absenteeism, such as age, sex, race, education level, household income, and the use of other substances like alcohol or nicotine.
The data were analyzed using statistical models that allowed the researchers to see how cannabis use and cannabis use disorder affected absenteeism after accounting for these other factors. They also conducted sensitivity analyses, which included part-time workers, to ensure their findings were robust across different employment situations.
The study found a clear link between recent cannabis use and increased workplace absenteeism. People who had used cannabis within the past 30 days missed more days of work than those who had not used cannabis recently. This was true both for absences due to illness or injury and for skipping work for other reasons.
Specifically, those who had used cannabis in the past month missed an average of 1.47 days due to illness or injury, compared to just 0.95 days for those who had never used cannabis. Similarly, recent cannabis users skipped an average of 0.63 workdays because they simply did not want to go, compared to 0.28 days for those who had never used cannabis.
The frequency of cannabis use also played a role. People who used cannabis more frequently—especially those who used it almost daily—were even more likely to miss work. For example, those who used cannabis between 20 and 30 days per month were 1.36 times more likely to miss work due to illness or injury and 1.83 times more likely to skip work compared to those who hadn’t used cannabis recently.
Cannabis use disorder also had a significant impact on absenteeism. Individuals with mild, moderate, or severe cannabis use disorder were more likely to miss work for both reasons compared to those without the disorder. The severity of the disorder was closely linked to how much work was missed, with individuals suffering from severe cannabis use disorder being nearly three times more likely to skip work than those without the disorder.
“One surprising finding was the dose-response relationship we observed between cannabis use disorder severity and skipping work; as cannabis use disorder severity increased from mild to moderate to severe, we saw a stepwise increase in the rate of skipping work,” Yang said.
These findings suggest that not only is cannabis use associated with more missed work, but the intensity of cannabis use and the presence of cannabis use disorder further exacerbate this trend.
“The key takeaway is that recent and frequent cannabis use, as well as cannabis use disorder, are associated with higher rates of workplace absenteeism due to both missing work because of injury/illness and skipping work,” Yang said. “These findings underscore the need for workplace drug prevention and treatment policies, as well as further research to better understand these relationships.”
As with any study, there are some limitations to consider. One limitation is that the study was cross-sectional, meaning it looked at data from one point in time. As a result, the researchers could not determine whether cannabis use caused the absenteeism or if other factors were at play.
“For instance, it’s possible that cannabis use leads to missing work, or that people who are more likely to miss work are also more likely to consume cannabis,” Yang explained. “Additionally, our data relies on self-reporting, which can be subject to various types of biases, including recall bias and social desirability bias.”
The study also did not differentiate between medical and recreational cannabis use, which could be an important factor. People using cannabis for medical reasons might have different patterns of absenteeism compared to those using it recreationally.
“We aim to conduct longitudinal studies to better understand the causal relationships between cannabis use, cannabis use disorder, and workplace outcomes,” Yang said. “We’re also interested in qualitative studies to understand why people are consuming cannabis, why people are missing out on work, and what the relationship between those two are.”
The study, “Cannabis Use, Use Disorder, and Workplace Absenteeism in the U.S., 2021−2022,” was authored by Kevin H. Yang, Letitia Mueller, Omar El-Shahawy, and Joseph J. Palamar.
