Publication Details
Driving under the influence of cannabis among US young adults who use cannabis: Evidence from the 2021 2024 national survey on drug use and health
Type: article
Author(s): Tang, Yuni; Rudisill, Toni M.
Url: https://linkinghub.elsevier.com/retrieve/pii/S1054139X26002181
Publication Date: Aug-2026
Journal: Journal of Adolescent Health
Issn: 1054139X
Doi: 10.1016/j.jadohealth.2026.05.015
Abstract: Purpose To estimate the prevalence of driving under the influence of cannabis (DUIC) and identify associated factors among US young adult drivers reporting past-year cannabis use. Methods This cross-sectional study analyzed pooled 2021 2024 National Survey on Drug Use and Health. The analytic data were restricted to drivers aged 18 25 years who reported past-year cannabis use (N = unweighted 17,141; weighted N = 10,814,381). The outcome was self-reported past-year DUIC. Independent variables included demographics, substance use, mental health, cannabis-related perceptions, and driving behaviors. These relationships were assessed by modified Poisson regression. Results The weighted prevalence of DUIC was 28.0%, representing approximately over three million young adults. DUIC prevalence increased with cannabis use frequency, from 2.51 times higher among those using cannabis 12 49 days (adjusted prevalence ratio [APR]: 2.51; 95% confidence interval [CI]: 2.29 2.75) to 3.63 times higher among those reporting use on 300 365 days (APR: 3.63; 95% CI: 3.60 3.76), compared with those using cannabis 1 11 days. Cannabis use disorder (APR: 2.34; 95% CI: 2.06 2.65), simultaneous alcohol and cannabis use (APR: 1.29; 95% CI: 1.28 1.30), and perceived easy cannabis availability (APR: 2.36; 95% CI: 2.33 2.39) were also associated with higher prevalence of DUIC. Nonenrollment in school and living in a state with a medical cannabis law were associated with lower DUIC prevalence. Discussion DUIC is highly prevalent among US young adults who use cannabis, with a clear graded association across categories of cannabis use frequency. Public health interventions should address frequent use, cannabis use disorder, alcohol-cannabis co-use, and perceived cannabis availability.