Background: The therapeutic uses of cannabis among people who use drugs (PWUD) has received increased scientific investigation since the legalization of cannabis in 2018 and the ongoing drug toxicity crisis. We sought to build on this evidence by evaluating cannabis use patterns associated with edible cannabis products among structurally marginalized PWUD who also use cannabis.

Methods: The data were collected from a cross-sectional questionnaire administered to PWUD in Vancouver, Canada. Binary logistic regression was used to analyze the associations between cannabis use intentions and frequent (weekly) use of edible cannabis products.

Results: A total of 414 people who use cannabis were enrolled in the present study from December 2019 to November 2021. Weekly edible use was reported by 67 (16.2%) participants and 271 (65.5%) individuals reported therapeutic cannabis use. In the multivariable analysis, therapeutic cannabis use (adjusted Odds Ratio [aOR] = 2.27, 95% confidence interval [CI]: 1.20, 4.31) and using cannabis to manage chronic pain (aOR = 2.81, 95% CI: 1.09, 7.26) were significantly associated with weekly edible use. Weekly edible users were significantly more likely to report accessing cannabis from community cannabis distribution programs (aOR = 6.94, 95% CI: 3.37, 14.28) and less likely to access cannabis from friends and family (aOR = 0.29, 95% CI: 0.14, 0.60).

Conclusions: These findings build on existing studies describing therapeutic uses of cannabis among PWUD during the overdose crisis and suggest that specific cannabis products (e.g., edibles) may be associated with distinct cannabis use intentions. Longitudinal and experimental studies would be helpful to investigate the effectiveness of different cannabis products for specific therapeutic and harm reduction applications among PWUD.