The Formation of Marijuana Risk Perception in a Population of Substance Abusing Patients

Risk perception has been shown to be protective with regard to marijuana use. Notably, the risk perception of marijuana in individuals with substance abuse problems varies significantly from that of the general public. Understanding how risk perception is formed in substance users could explain these differences and help predict the consequences of policy changes. Using this framework, we explored risk perception and its formation in a sample of substance abusing veterans. Semi-structured interviews were conducted with veterans who were receiving treatment for substance abuse. Interviews were recorded digitally, transcribed verbatim, and analyzed using inductive thematic analysis. A prominent perspective among the 31 participants was that marijuana is significantly different from other drugs because it is safe, not addictive, not associated with physical withdrawal, and has less overt behavioral effects than other substances. Many of these participants drew upon their own innocuous experiences with the drug in developing this perspective, more so than information from any other source. A contrasting narrative emphasized marijuana’s capacity to cause negative social consequences, act as a gateway to the use of other, more harmful substances, and cause paranoia or worsen psychosis. In conclusion, individual experience with marijuana featured more prominently in informing risk perception than any other source of information. Our results and previous literature suggest that the significant disconnect between the individual experiences of substance users and the current clinical and legal policy towards marijuana may weaken the legitimacy of public policy or the authority of the medical community.