Why young cancer survivors blur medical and recreational use

Many young adults (YAs) who use cannabis use it both medically and nonmedically, which poses particular risks (eg, problematic use). Given the relevance of cannabis use among those with cancer, this qualitative study assessed YA cancer survivors' experiences with and distinctions between medical and nonmedical use. From April to June 2025, we conducted qualitative interviews with 23 YA survivors (ages 18-39) reporting past-month cannabis use (Mage = 33.65 [SD = 5.99], 73.9% female, 73.9% White, M = 1.22 [SD = 1.09] years post-treatment). Data regarding experiences with and distinctions between medical versus nonmedical use were analyzed using deductive-inductive thematic analysis. The majority first used nonmedically (60.9%) and currently used both medically and nonmedically (56.4%). Some participants believed that the distinction was clear (ie, medical use addresses specific symptoms). Some likened nonmedical use to how people generally use alcohol (eg, to relax or socialize). Some distinguished medical versus nonmedical use based on the context (eg, daytime for nonmedical and bedtime for medical) or product used (eg, sativa for nonmedical and indica for medical). Some believed that people had overly restricted definitions of medical use (eg, for those in chemotherapy or hospice), which disregards other medical uses (eg, for pain, anxiety, and insomnia). The majority said the medical versus nonmedical distinction was unclear, particularly regarding use for anxiety. Some underscored that using cannabis to treat symptoms (eg, pain, nausea, and anxiety) provided both symptom relief that enabled enjoyable activities and the recreational "high." The findings underscore the need to enhance medical oversight of cannabis use among YA cancer survivors to minimize risks and facilitate potential therapeutic benefits.