Abstract Background Regulatory changes are increasing access to both medical cannabis and cannabis in general. As such, understanding patterns of recreational and medical cannabis use is a high public health priority. Objectives Patterns of cannabis use (recreational and medical), other substance use, and psychiatric symptoms were characterized in a large sample of community adult cannabis users in Canada, prior to federal cannabis legalization. Methods This was a self-report assessment of 709 cannabis users (Mean age = 30.19 (11.82) years; 55.01% female). Patterns of overall substance use and psychiatric symptomatology were compared based on recreational/medical cannabis status. Results Overall, 61.4% of participants endorsed exclusively recreational use, while 38.6% reported some level of medical use. Of all medical...