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BACKGROUND: With the legalization of recreational marijuana in Colorado in January 2014, Tri-County Health Department (TCHD) in metro Denver wanted to understand marijuana use among women during and after pregnancy. There is a paucity of data on marijuana use during pregnancy, and the impact of legalization on adult marijuana use in the two states currently permitting recreational use is also unknown. To enhance knowledge on this issue, we assessed marijuana use and educational needs among WIC clients in order to tailor public health messaging on the maternal and pediatric health effects of marijuana exposure during pregnancy and breastfeeding.
METHODS: TCHD has the highest WIC caseload of any local health department in Colorado. During the summer and fall of 2014, we conducted a voluntary, anonymous, self-administered survey to learn about the questions and concerns that WIC clients have regarding the health effects of marijuana and to measure prevalence of marijuana use.
RESULTS: During the ten week administration of the survey, 1,749 of 2,903 eligible clients (60%) completed surveys in 12 WIC clinics. A total of 1,616 (92%) respondents were pregnant mothers and/or mothers receiving WIC services for a child. Overall, 470 (29%) of participating WIC mothers reported ever using marijuana, 95 (6%) of whom were current users (marijuana use at least once within the past 30 days) and 375 (23%) of whom were past users. Among current users, 36% used during their most recent pregnancy, 41% used since the baby was born, and 14% used while breastfeeding, while past users reported lower rates of use during pregnancy (5%), since the baby was born (2%) and while breastfeeding (<1%). The most common reasons cited by current users for using marijuana included depression/anxiety/stress (63%), pain (60%), and to help nausea/vomiting (48%). A high proportion of WIC clients reported wanting information about the health effects of marijuana, with topics of greatest interest including the health effect of marijuana on children and learning the difference between medical versus recreational marijuana.
CONCLUSIONS: Survey results show that nearly 30% of WIC mothers in our jurisdiction had a history of marijuana use. Current users are often using marijuana during pregnancy and after their baby is born (including while breastfeeding), most commonly to relieve symptoms. Education needs of WIC clients regarding health effects of marijuana were prominent, and strategies are being developed to disseminate this information.