Consumer Positions on Cannabis: A Proposal Grounded in Identity Processes

In the article “The Categorisation Process of Drug Users: Analysis of Central Factors for Classifying Cannabis Users,” we highlight the importance of categorising drug consumers based on multiple aspects. We propose moving beyond the classic taxonomy focused on frequency and intensity, which merely indicates how close a user is to addiction. The goal of this text is to suggest more versatile and explanatory categories. A classification system that considers more factors will enable a deeper understanding of cannabis users, allowing for more effective and efficient prevention programmes. The six categories presented below are the result of qualitative analysis conducted through focus groups and interviews as part of the research “The Nature and Extent of Cannabis Use in Spain” [1]. These categories were developed using the factors discussed in the aforementioned article.

Identity-Oriented Adolescents

The identity-oriented adolescent category comprises teenagers for whom cannabis holds a central place in their daily lives. The substance provides them with identity traits, serves as a rite of passage, and offers certain levels of well-being. A significant portion of their free time is spent under the influence of cannabis. During nighttime leisure activities, they often engage in “botellón” (drinking in public). Some may experiment with other substances, particularly stimulants. Even during formal activities, cannabis plays a prominent role. Some smoke in the morning before school or during breaks. Throughout the day, provided it is available, they seize every opportunity to smoke. Consequently, their usage is daily and intensive, often exceeding five joints a day, with ten being common. During annual celebrations, consumption can be even higher.

Most of them manage to perform everyday tasks despite the psychoactive effects, with varying degrees of success depending on the dose and the task’s demands. Many claim that smoking joints, unless in excessive quantities, is compatible with most activities, including academic tasks. However, others acknowledge that cannabis impairs their ability to focus in class. Despite this awareness, they still attend school under the influence, resulting in poor academic performance. Their daily consumption is driven more by the availability of the substance than by a voluntary decision. Financial constraints are the main limiting factor. Some would consume even more if their finances allowed, but their dependence on parental support often restricts them. When funds are scarce, they ration their use and rely on peers to share their cannabis.

Peer groups and social contexts are crucial in shaping this position. Friends provide support for their consumption habits, enabling and encouraging them. While they may smoke alone, they prefer the camaraderie of their peers. Boys typically consume cannabis while joking and engaging in playful banter, whereas girls tend to smoke in a relaxed setting, often discussing their obligations. After smoking, they often eat heavily, driven by an intense hunger. Interestingly, these adolescents frequently highlight the appetite-stimulating effect of cannabis, a phenomenon rarely mentioned by adults.

Contrary to professional perceptions of peer pressure as a driver of consumption, these adolescents rarely experience direct pressure. Instead, they subtly encourage their peers to share joints. Group dynamics revolve around cannabis use, making it an essential identity marker. Parks are their preferred consumption settings, but if their living area allows, they gravitate toward natural spaces like forests, mountains, or riverbanks. These liminal spaces provide a sense of separation and a platform for rites of passage into adulthood.

Cannabis is integral to constructing the identity of these adolescents. For many, the status conferred by being a user is positive both personally and socially, although some teenagers disdain cannabis smokers. For some, cannabis monopolises their time and dominates their conversations, granting them a certain status within their adolescent social circles. This status is even more pronounced for those who sell cannabis, as they become key figures within their peer groups.

Identity-oriented adolescents are heavily influenced by cannabis consumer culture, reinforcing their identity through cannabis-related products like grinders, Rastafarian clothing, or music celebrating cannabis. Their connection to the substance leads them to exalt its natural and therapeutic properties while downplaying or dismissing its harms, particularly in their own cases or those of their friends. They attribute adverse effects in others to pre-existing deficiencies rather than cannabis itself.

Defending cannabis is often a way of affirming their identity and worldview. This defence may rest on naïve or unscientific arguments, but it serves as a symbolic shield against certain challenges, even though it cannot protect them from more severe consequences. At times, their attitudes toward cannabis mirror the narratives of “the Drug” discourse, reflecting confusion due to a lack of alternative drug narratives beyond those imparted by parents or schools.

Beyond identity processes, cannabis use also serves as a form of self-care. Adolescents face the intrinsic challenges of this developmental stage with varying levels of difficulty. Conflicts with adults, particularly parents, and with peers cause distress. The pressures of friendships, romantic relationships, and academic responsibilities induce stress. Additionally, realising they must enter an adult world fraught with crises—such as job insecurity, climate change, and structural poverty—generates uncertainty or fear. Cannabis helps these adolescents decompress, improve their mood, and regain the strength to carry on. While they acknowledge that consumption does not resolve their problems, it provides a temporary reprieve.

Adolescents assume this position when cannabis consumption becomes routine and contributes to their identity. This can occur shortly after they begin using, but it typically develops around ages 16 or 17 after a period of experimentation. According to the 2014 ESTUDES survey, Spanish students aged 14–18 first try cannabis at an average age of 14.8 years. This category encompasses adolescents aged 14–18, sometimes extending to 20 or 21. However, the identity-oriented adolescent position is inherently tied to adolescence and cannot persist indefinitely.

Transitions out of this position occur due to three processes: (1) the end of adolescence makes cannabis rituals obsolete, (2) the diminishing influence of peer groups in daily life, and (3) the process of institutionalisation. Most identity-oriented adolescents move into the adult identity-oriented position. Others shift toward problematic usage, while some quit entirely, concluding that cannabis causes more harm than benefit.

According to the 2014 ESTUDES survey, 4.5% of boys and 2.2% of girls smoke cannabis between 10 and 30 days a month, with many falling into this category. Preventive efforts should focus on this group to mitigate problems associated with cannabis abuse. Some adolescents eventually face difficulties maintaining normal lives or experience mental health issues, necessitating professional help. Effective prevention targeting identity-oriented adolescents could significantly reduce treatment demands.

Recreational Adolescents

The recreational adolescent position consists of adolescents aged thirteen to twenty. In absolute terms, it is significantly larger than the identity adolescent position. It is composed of adolescents who consume cannabis at least once a year, which accounts for 23.5% of boys and 20.8% of girls in the school population. The frequency of consumption varies, ranging from daily (or almost daily) use to occasional use during annual celebrations. Despite some presenting a relatively high frequency of use, the minimal impact of cannabis on their identity differentiates them from the other position.

Regarding daily tasks, they never combine consumption with obligations. Students never smoke before or during school hours. Workers never do so during the workday. Therefore, they never smoke in the mornings. The vast majority consume exclusively during leisure times, especially during weekend evenings. Some use cannabis less than five times a month or on rare occasions throughout the year. The intensity of consumption is low. Those who consume during weekdays usually purchase and smoke one joint or slightly more per day, though consumption may intensify during special celebrations. Those who link their use to nightlife buy sporadically, typically coinciding with annual calendar festivities. Some never purchase and only smoke when invited.

Beyond frequency, the defining characteristic of this position is that cannabis represents a secondary or entirely accessory aspect of their lives and, consequently, is detached from any identity-related processes. This detachment is crucial, as once cannabis ceases to symbolize identity aspects, consumption becomes less intensive, less frequent, more critical, more sensible, and reserved for special occasions. Most importantly, from a public health perspective, this minimizes the likelihood of severe problems arising.

Although detached from identity processes, cannabis also functions as a rite of passage. However, consumption ceremonies are reserved for specific moments tied to nightlife. These adolescents more frequently use other ceremonies to symbolize entry into adolescence, making cannabis use a secondary, almost peripheral, ritual. The context of consumption is always removed from adult supervision (parks, open-air drinking sessions, hidden spaces, etc.). Within this framework of a rite of passage, cannabis also serves, similar to open-air drinking, a clear purpose of self-care. Using cannabis is a self-care practice because it helps release accumulated tension. Smoking with friends allows them to escape obligations and generates the well-being needed to face responsibilities with greater optimism.

As part of the rite of passage, peer groups play a crucial role in giving meaning to consumption. The vast majority in this position consume only in groups. This situation can be interpreted as group pressure. Some succumb to it to prove themselves as competent group members.

The recreational adolescent position, like the identity position, shows some confusion regarding cannabis-related discourses, the acceptability of its use, and its potential risks. Since the psychoactive substance is detached from their identity, most never adopt an enthronization discourse. Some, even though they smoke joints, accept the premises of the alarmist discourse and argue that consumption is dangerous, causes mental illnesses, and thus should be abandoned. Others present an amorphous, confused discourse, blending aspects of the alarmist discourse with those of normalization, sprinkled with myths and assertions far removed from sensibility. Only a minority master the normalization discourse and sensibly recognize both the pleasures and risks of consumption. All of them, despite recognizing potential cannabis-related harms with varying degrees of accuracy, consider themselves distant from these harms because their use is sporadic and prudent. Due to a certain perceptual bias, they tend to believe that problems affect third parties far removed from their reality. By the end of adolescence, when they begin to master the normalization discourse, they more accurately acknowledge cannabis harms. However, by this point, they are starting to transition to adult positions or directly abandon consumption. The confusion in discourse indicates that empowerment activities must be intensified.

Therapeutic Position

The therapeutic position deviates significantly from the other positions. The defining feature is that cannabis is used for therapeutic purposes to alleviate the symptoms of diseases, often serious or terminal, such as chronic pain, Crohn’s disease, epilepsy, HIV/AIDS, cancer, glaucoma, multiple sclerosis, arthritis, among others. The aim of this text is not to provide data on the efficacy and effectiveness of cannabis for treating or alleviating these diseases, but rather to present the social particularities of this position.

Before using cannabis for therapeutic purposes, consumers follow one of two trajectories. The first is that they have previous experience because they used cannabis for recreational purposes. Once diagnosed with a disease that can be addressed with cannabinoids, they adapt the variety and method of administration most suitable for alleviating their symptoms. Some may seek advice from a doctor specializing in cannabinoid treatment, while others self-medicate. The second trajectory involves individuals who have never consumed cannabis and, although they may have negative attitudes towards marijuana, they begin using it after being diagnosed and considering that the substance can relieve their symptoms. In both cases, it is common for individuals to decide to use cannabis after failing with other treatments, considering them insufficient, ineffective, counterproductive, or thinking that cannabis can complement prescribed treatments. Some, depending on the condition, may base their treatment on cannabinoids, although most continue with their prescribed treatments and use cannabis as an adjunct.

Therapeutic cannabis users can be divided into two large categories. The first are those who use cannabis under medical supervision, following the dosage, administration method, and cannabis form prescribed by the doctor specializing in cannabinoid treatment. The second group uses cannabis without professional supervision. In some cases, they may have consulted with a cannabis specialist doctor, but their sources of knowledge are readings (books, magazines, or the internet) and, most importantly, their own experience and background. They combine all the available information to draw their own conclusions, determining the dosage, administration method, and form they believe is most suitable. Self-medication creates doubts because they are unsure of the suitability and effectiveness of their actions. Decision-making regarding the most appropriate presentation is clearly affected by the overabundance of information available online, much of which is inaccurate or contradictory.

The central point of their discourse is conceptualizing cannabis as an effective medicine for their condition. Using cannabis is understood as a form of self-medication that improves their health. Marijuana does not cure them, but it allows them to improve their quality of life. Viewing cannabis as synonymous with medicine has significant symbolic, social, and even identity implications, which are notably different from those of other positions. These consumers handle cannabis in the same way that the general population takes other types of medicine. Therefore, the group of peers and the context are of little importance. They make clear distinctions between their use of cannabis and the use by recreational consumers, considering these to be almost parallel universes. Some are determined to differentiate themselves and argue that their use is legitimate, justified, and even “vital” for maintaining their fragile health, while recreational users are voluntary and peripheral, as their lives would continue without the plant. Since medicinal cannabis is also illegal in Spain, they tend to consider it an injustice that they have to interact with the black market to “get their medicine.” As a result, they strongly advocate for regulation, although some believe it should only be legalized for therapeutic purposes.

Therapeutic users exhibit great diversity in their methods of consumption, both in terms of administration routes and the forms of cannabis they use. The choice of route and format depends on the condition to be treated, the reported subjective effects, and the availability of presentations with suitable cannabinoid ratios. They apply creams, poultices, tinctures, and oils topically; take oil drops sublingually; consume edibles and capsules, and drink infusions and tinctures orally; vaporize cannabinoids through inhalation; and take suppositories rectally. However, even though smoking is the most harmful method, some still smoke, despite doctors’ recommendations to avoid it. Their perception of their consumption is extremely positive and detached from problems. If they experience any undesirable effects, they adjust the dosage and frequency. If the negative effects outweigh the positives, they stop using cannabis. In this regard, believing that cannabis is therapeutic helps achieve greater benefits due to its symbolic effectiveness. This does not mean questioning its therapeutic properties, but rather that the beneficial effects will be more easily achieved if they are anticipated, much like the placebo effect when administering any medication.

Therapeutic consumers use cannabis according to the dosage and frequency prescribed by their doctor or based on their needs. Most take it once a day, every four or eight hours, or when they feel the discomfort from their condition, and rarely exceed the prescribed doses. We emphasize that they view cannabis as a medicine, so it is uncommon to find therapeutic users who take the liberty of increasing the dose for pleasure or fun. In this way, they can continue with their daily tasks while using cannabis. Using methods other than smoking allows them to administer their doses discreetly, without arousing suspicion or prejudice. Furthermore, it should be noted that fulfilling their obligations while taking cannabis does not necessarily mean doing so under the influence of psychoactive effects, as the majority use presentations low in THC and high in CBD, meaning they consume substances with little or no psychoactive effect.

Problematic Position

In the problematic position, we find individuals who experience issues related to cannabis use. According to the EDADES survey, in 2015 there were approximately 558,549 potential problematic cannabis consumers in Spain, which represents 19.2% of people who had used cannabis in the last year. Among the school population, this was 53,700, or 13.8% of adolescents aged 14-18. The nature and intensity of the problems can vary significantly for those in this position. Some suffer mild discomforts such as tachycardia, dizziness, or anxiety, which disappear once the effects wear off. Others suffer more severe issues such as paranoia or persecutory mania, which manifest even when they are not under the influence of the psychoactive substance and intensify when they are. Others have addiction problems, with all the inherent consequences of such a condition. The genesis of these problems is almost entirely sociocultural, especially the result of deficient socializations marked by continuous conflicts within the family and school environment. By the time they reach adolescence, consuming cannabis intensely and habitually becomes a form of identity and a means of escape from a stifling reality. The mechanisms of control over their consumption are minimal and even deemed unnecessary, leading to problems arising without much delay. For some, adopting a problematic angle allows them to perform a transgressive and subversive identity, as they embrace danger and challenge as a desired lifestyle. In some, the issues are linked to mental health conditions. Those diagnosed with “Dual Pathology” tend to rely on assistance resources almost chronically, and their prognosis is extremely complex.

Within the problematic position, there are many profiles. Broadly, we can separate them into three categories: (1) consumers who had mental health issues before they started using cannabis, (2) those who develop an addiction, and (3) those who suffer from psychological ailments but can manage the problems without professional assistance. Biological theories suggest that some consumers use cannabis as a form of self-medication to control the symptoms of their mental health conditions.

Some define the negative effects simply by saying that “the joints don’t sit well with them.” Behind this generic statement, there are psychological discomforts. These usually disappear when consumption stops. Some persist in using cannabis because they maintain an identity commitment. For example, in cases where rejecting a joint implies compromising their position in the group, the consumer might prefer to experience the negative effects rather than explain their refusal. This situation is unsustainable and they must soon accept that they need to refuse cannabis. If they continue, the symptoms will worsen, and the problems will intensify.

Others, despite recognizing an addiction, continue consuming it even though it causes negative psychological effects. These individuals may begin treatment to overcome their addiction, but their low adherence results in abandoning the treatment without achieving significant results. They may also attend outpatient visits without giving up the substance, thus making little progress in their therapeutic journey.

The majority of addicts say that cannabis harms them and that they wish to quit, but find it impossible to do so because they self-categorize as addicts. As a result, they believe that because they are addicts, they cannot control their “impulses” and inevitably consume it. The addictive identity, following Goffman, is a deteriorated identity; they perceive themselves as sick and incapable of taking control of their lives. Their thoughts are filled with negative ideas, they self-stigmatize, and struggle to complete daily tasks. Therefore, viewing themselves as an addict worsens their undesirable situation and prevents them from leading a normalized life.

The vast majority of problematic consumers use cannabis intensively throughout the day, combining their responsibilities with smoking, although due to their situation, they do so reluctantly or find it impossible to fulfill them. Many do not study or work, resulting in a spiral of consumption. For these individuals, cannabis has positive effects, but the dynamics resulting from their consumption (negligence, disconnection, laziness, apathy, etc.) prevent them from living a normalized life. On the other hand, some may consume infrequently, but any contact with the substance results in discomfort, especially in the form of anxiety. They can successfully fulfill their responsibilities, as long as they avoid consuming it; once under its effects, any social activity is hindered. When explaining the reasons for their situation, they often seek scapegoats. It is common for them to blame bad influences during adolescence as the root cause of their initial and ongoing problems with cannabis.

In conclusion, we can observe that identity is a key element in understanding the relationship with cannabis and the possible negative consequences of its use. Identity, although present in many studies, has never been the central focus of analyses on consumer profiles. Therefore, we believe it should be considered a central element in preventing cannabis use. In this regard, the categorization presented here does not exhaust the topic, and we must continue analyzing the multiple factors that shape the various ways people relate to cannabis.

Consumer Positions on Cannabis: A Proposal Grounded in Identity Processes