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Cannabis abuse in early adulthood linked to anxiety disorders

Sherika Hill

Problematic cannabis use during early adulthood may increase risk for anxiety disorders, according to recent findings.

“Among active users, 18% to 30% report problematic cannabis use, characterized by cannabis use disorder or daily use. Such problematic use peaks at ages 19 to 21 years and subsequently decreases or plateaus, and is associated with long-term health and social consequences, including higher risk for altered brain development, psychosis and exacerbated symptoms of schizophrenia, escalation to harsher drug use, and lower educational attainment and employment,” Sherika Hill, PhD, of Duke University, and colleagues wrote.

To determine risk profiles associated with problematic cannabis use in early adulthood, researchers analyzed data for 1,229 participants in the Great Smoky Mountains Study, a prospective 20-year cohort from 1993 to 2015. Yearly assessments were conducted from ages 9 to 16 years and at ages 19, 21, 26 and 30 years.

Researchers categorized patterns of problematic cannabis use as nonproblematic use in late adolescence (from ages 19 to 21 years) or early adulthood (from ages 20 to 30 years); limited problematic use in late adolescence only; persistent problematic use in late adolescence and early adulthood; and delayed problematic use in early adulthood only.

Overall, 6.7% of the cohort exhibited persistent problematic cannabis use. This pattern was associated with more anxiety disorders across development and more DSM-5 cannabis use disorder symptoms during late adolescence, compared with the limited pattern (13.3%), which was associated with more childhood family instability and dysfunction.

Study participants with delayed patterns of problematic cannabis use were more likely to have externalizing disorders, and to have experienced maltreatment and/or peer bullying in childhood, compared with nonproblematic users.

Associations with sex or race/ethnicity were not significant, according to researchers.

“Given that more states may be moving towards legalization of cannabis for medicinal and recreational purposes, this study raises attention about what we anticipate will be the fastest growing demographic of users — adults,” Hill said in a press release. “A lot of current interventions and policies in the U.S. are aimed at early adolescent users. We have to start thinking about how we are going to address problematic use that may arise in a growing population of older users.” – by Amanda Oldt

Disclosures: Hill reports receiving research support from the National Institute on Drug Abuse and National Institute of Child Health and Development. Please see the study for all other authors’ relevant financial disclosures.