Patterns of Cannabis Use and Socio-Cognitive Factors of People who Use Cannabis across Cannabis Sources in Uruguay

Introduction: Uruguay became the first country to regulate the commercialization of cannabis, offering three legal outlets: home cultivation, cannabis clubs, and pharmacies. Despite this, black-market sources remain popular. This observational (survey-based), cross-sectional study assessed the association of age, sex, and cannabis acquisition sources with patterns of cannabis use and consequences among Uruguayan residents, as well as on psychological distress, protective behavioral strategies (PBS), and cannabis use motives. We also tested the atemporal, contemporary, sequential mediation of motives and PBS in the association between distress and the cannabis outcomes. Method: People who use cannabis selected via a non-probabilistic, convenience sample (N = 928, Mage = 30.4 years), completed a survey assessing frequency, potency, consequences, and related psychological variables. Results: Cannabis clubs were the most common legal source and were associated with higher use (p < .001, η2p = .04) and increased risk of cannabis use disorder (p < .05, V = .08). Those who relied on illicit sources reported greater psychological distress and use of high-potency cannabis. Distress was indirectly associated with frequency and consequences via coping motives and reduced PBS. Conclusions: Gaps in access to potent legal cannabis may drive continued illicit use. Psychological distress is a key factor in cannabis-related harm. Interventions should address high-potency demand and promote harm-reduction strategies.