Purpose: The COVID-19 pandemic likely impacted cannabis distribution, access and usage worldwide. This study aims to describe self-reported changes in cannabis use and related outcomes following COVID-19-related restrictions among an international sample of people who use drugs.

Design/methodology/approach: Using data from the Global Drug Survey COVID-19 Special Edition, the authors identified 20,417 respondents from 13 countries who reported whether the number of THC-containing cannabis usage days changed compared with February 2020 (before COVID-19 restrictions). Using descriptive statistics and a multinomial multivariable logistic regression, the authors investigated the impact of changes in cannabis use on respondents’ mental health, physical health, relationships, finances, work/study performance and cannabis-related pleasure/enjoyment.

Findings: Similar proportions of respondents reported that their cannabis use had stayed the same (38.2%) or increased (38.3%) compared with February 2020, while 21.9% of respondents reported a decrease. The most common reason for increased use was having more time (68.4%), while decreased use was associated with having less contact with people they use cannabis with (58.4%). The likelihood of reporting worse mental and physical health, finances, and work/study performance following COVID-19 restrictions was highest among those who reported increased cannabis use.