Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence

Hines, Lindsey A; Freeman, Tom P.; Gage, Suzanne H.; Zammit, Stanley; Hickman, Matthew; Cannon, Mary; Munafò, Marcus R; Macleod, John; Heron, Jon

doi:10.1001/jamapsychiatry.2020.1035

Cited by 139 publications

(83 citation statements)

References 24 publications

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“…A small number of studies reported OR s of developing specific anxiety disorders: GAD ( n = 4), SAD ( n = 3), and PD ( n = 3). 29- 31,39,47 Cannabis use was nonsignificantly associated with increased odds of developing GAD ( OR = 1.44; 95% CI, 0.94 to 2.22; I 2 = 35%), SAD ( OR = 1.12; 95% CI, 0.61 to 2.05; I 2 = 38%), and PD ( OR = 1.52; 95% CI, 0.96 to 2.40; I 2 = 0%) at follow-up (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…9 This review included 24 cohort studies and involved participants from 8 countries and 3 continents, and who were followed for a period of up to 20 years. 24- 47 Furthermore, this is the first review that evaluated the association between cannabis use and development of specific anxiety disorders such as GAD, SAD, and PD.…”

Section: Discussionmentioning

confidence: 99%

“…Seven studies supported an association between cannabis use and increased risk of developing an anxiety disorder and/or increased severity of the condition. 35,38,40,41,43,45,47 Another study suggested reduction of cannabis use to be associated with decreased severity of anxiety on follow-up. 42…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

et al. 2020

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Objectives: Cannabis use is proposed as a risk factor for psychosis and is associated with depressive disorders. However, the relationship between recreational cannabis use and its longitudinal implications on anxiety conditions is less studied. The aim of this investigation is to systematically evaluate published literature and perform a meta-analysis of the data. Methods: A systematic search was performed of MEDLINE, Embase, and PsychINFO from inception to May 31, 2020, in addition to a hand search. Longitudinal studies that evaluated the relationship of cannabis use and development of anxiety were included. Where applicable, adjusted odds ratios ( ORs) were extracted, pooled, and evaluated using random-effects meta-analysis. Results: After screening of unique abstracts ( n = 6835), the final evaluation included 24 studies, of which 10 reported ORs that were analyzed quantitatively. Cannabis use was significantly associated with increased odds of developing any anxiety conditions ( OR = 1.25; 95% CI, 1.01 to 1.54). Cannabis use was not significantly associated with developing generalized anxiety disorder, panic disorder, or social anxiety disorder. Review of studies not reporting OR revealed mixed results but are suggestive of a link between cannabis use and increased rates/severity of anxiety. Conclusions: Published evidence suggests that cannabis use is likely associated with increased risk of anxiety in the long term but variability of study designs precludes declaration of a causal relationship. Awareness of this association is of relevance for both clinical practice and mental health policy implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

et al. 2020

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“…Notably, perceptions of health benefits of cannabis use for mental health showed the largest increase. The literature suggests potential anxiolytic effects of CBD [ 7 ], but also points to the association of mental health harms with high-potency cannabis use [ 28 ]. Though our sample had an overall positive perception of cannabis use in benefiting physical health and wellbeing, there was no significant association between cannabis use with pain or cancer, common conditions for which cannabis has been used to treat.…”

Section: Discussionmentioning

confidence: 99%

Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study

Gali

Winter

Ahuja

et al. 2021

Subst Abuse Treat Prev Policy

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Background Most U.S. states have legalized cannabis for medical and/or recreational use. In a 6-month prospective observational study, we examined changes in adult cannabis use patterns and health perceptions following broadened legalization of cannabis use from medical to recreational purposes in California. Methods Respondents were part of Stanford University’s WELL for Life registry, an online adult cohort concentrated in Northern California. Surveys were administered online in the 10 days prior to state legalization of recreational use (1/1/18) and 1-month (2/1/18–2/15/18) and 6-months (7/1/2018–7/15/18) following the change in state policy. Online surveys assessed self-reported past 30-day cannabis use, exposure to others’ cannabis use, and health perceptions of cannabis use. Logistic regression models and generalized estimating equations (GEE) examined associations between participant characteristics and cannabis use pre- to 1-month and 6-months post-legalization. Results The sample (N = 429, 51% female, 55% non-Hispanic White, age mean = 56 ± 14.6) voted 58% in favor of state legalization of recreational cannabis use, with 26% opposed, and 16% abstained. Cannabis use in the past 30-days significantly increased from pre-legalization (17%) to 1-month post-legalization (21%; odds ratio (OR) = 1.28, p-value (p) = .01) and stayed elevated over pre-legalization levels at 6-months post-legalization (20%; OR = 1.28, p = .01). Exposure to others’ cannabis use in the past 30 days did not change significantly over time: 41% pre-legalization, 44% 1-month post-legalization (OR = 1.18, p = .11), and 42% 6-months post-legalization (OR = 1.08, p = .61). Perceptions of health benefits of cannabis use increased from pre-legalization to 6-months post-legalization (OR = 1.19, p = .02). Younger adults, those with fewer years of education, and those reporting histories of depression were more likely to report recent cannabis use pre- and post-legalization. Other mental illness was associated with cannabis use at post-legalization only. In a multivariate GEE adjusted for sociodemographic characteristics and diagnoses, favoring legalization and the interaction of time and positive health perceptions were associated with a greater likelihood of using cannabis. Conclusions Legalized recreational cannabis use was associated with greater self-reported past 30-day use post-legalization, and with more-positive health perceptions of cannabis use. Future research is needed to examine longer-term perceptions and behavioral patterns following legalization of recreational cannabis use, especially among those with mental illness.

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“…Regular cannabis use is typically the strongest predictor of later psychosocial impairment (13), next to potency (17,18) and age of onset (10). Despite this, not all regular users, hereby defined as at least weekly consumption, report poor psychosocial functioning (19)(20)(21), with evidence suggesting the proportion is only one third of regular users (22).…”

Section: Introductionmentioning

confidence: 99%

Young Adults With Higher Motives and Expectancies of Regular Cannabis Use Show Poorer Psychosocial Functioning

et al. 2020

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Background: Young adults regularly using cannabis represent a uniquely vulnerable yet heterogeneous cohort. Few studies have examined user profiles using cannabis use motives and expectations. The association between user profiles and psychosocial functioning among only regular users remains unexplored. This exploration is important to improve public education efforts and design tailor treatment approaches.Methods: Regular cannabis users (at least weekly; n = 329) completed an online survey via Amazon Mechanical Turk. The survey measured levels of cannabis use, other substance use, motives and expectations of cannabis use, symptoms of psychosis, depression, anxiety and stress, and reckless behavior such as getting high before work or driving under the influence of cannabis. Latent class analysis was performed using motives and expectations to identify data driven patterns of regular cannabis use. Classes were then used to investigate mental health and behavioral correlates of differences in motives and expectations.Results: A 2-class solution provided the best fit to the data; Class 1: Low Motives and Expectancies (n = 158) characterized by lower endorsement across all motivation and expectation variables, and Class 2: High Motives and Expectancies (n = 171) characterized by endorsing multiple motivations, and higher positive and negative expectations of cannabis use. Classes differed in a range of cannabis use variables; e.g., greater proportion of peer use in Class 2. The High Motives and Expectancies users reported higher symptoms of psychosis (positive and negative symptoms), depression, anxiety, and stress. A higher proportion met the criteria for a cannabis use disorder compared with Low Motives and Expectancies users. High Motives and Expectancies users reported higher mean problems with nicotine dependence and illicit drug use other than cannabis and were more likely to get high before work and drive under the influence of cannabis.Conclusions: There is heterogeneity among young regular cannabis users in their motivations and expectancies of use and associated psychosocial functioning. Understanding motives and expectancies can help segregate which users are at higher risk of worse functioning. These findings are timely when designing targeted assessment and treatment strategies, particularly as cannabis is further decriminalized and accessibility increases.

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Association of High-Potency Cannabis Use With Mental Health and Substance Use in Adolescence

Cited by 139 publications

References 24 publications

Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

Cannabis Use and Prospective Long-Term Association with Anxiety: A Systematic Review and Meta-Analysis of Longitudinal Studies: Usage du cannabis et association prospective à long terme avec l’anxiété: une revue systématique et une méta-analyse d’études longitudinales

Changes in cannabis use, exposure, and health perceptions following legalization of adult recreational cannabis use in California: a prospective observational study

Young Adults With Higher Motives and Expectancies of Regular Cannabis Use Show Poorer Psychosocial Functioning

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