People with depression twice as likely to use cannabis
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Individuals with depression were more than twice as likely to use cannabis than those without depression, according to study findings published in Addiction. Researchers noted that the prevalence of cannabis use in the United States has increased among individuals with and without depression.
“Screening for cannabis use among people seeking treatment for depression, especially among young adults among whom nearly 40% reported past-month cannabis use, may be increasingly important as the risks of cannabis use for persons with depression are not known,” Renee D. Goodwin, PhD, of Columbia University Mailman School of Public Health, told Healio Psychiatry. “If depression is treated with either medicine or therapy, cannabis use is generally likely not to be indicated or helpful toward recovery. Medicinal cannabis is not approved to treat depression.”
According to Goodwin and colleagues, epidemiologic and clinical studies have found that cannabis use is often more prevalent among individuals with depression than those without, and evidence from meta-analyses suggests a causal relationship between cannabis use and the onset of affective disorders, including depression. The researchers estimated trends in the prevalence of cannabis use and risk perceptions of cannabis use from 2005 to 2017 among individuals in the U.S. with and without depression. They analyzed data from the annual cross-sectional National Survey on Drug Use and Health to assess linear time trends of the prevalence of any, daily and nondaily past 30-day use and perceived great risk associated with regular cannabis use. Data were available for 728,691 individuals aged 12 years or older.
The researchers found that 18.94% of those with depression reported any use in the past month, vs. 8.67% among those without depression (adjusted OR = 2.17; 95% CI, 1.92-2.45). Those with depression also had a higher prevalence of daily and nondaily use in the past month. All forms of use increased among individuals with and without depression from 2005 to 2017, but the increase in any (aORs = 1.06 vs. 1.05; P = .008) and daily (aORs = 1.10 vs. 1.07; P = .021) cannabis use adjusted for sociodemographic characteristics was more rapid among those with depression, the researchers wrote. Those with depression had a significantly lower perception of great risk associated with regular cannabis use, and this perception decreased at a significantly more rapid rate over the study period for those with depression compared with those without.
“We were surprised that the increase in cannabis use was so much more rapid among those with depression, and that perception of risk associated with use was so much lower,” Goodwin said. “The prevalence of cannabis use among young adults whose brains are still developing (and cannabis use can affect brain development) was notable.” – by Joe Gramigna
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Adam Bisaga, MD
Lessening legal restrictions on access to cannabis over the past decade coincided with decreasing perception of its risks and increased cannabis use. It is less known whether there are individuals disproportionately affected by these changes. The present cross-sectional analysis of almost 730,000 individuals shows that people with depressive disorder were twice as likely to use cannabis as people with no depression and that rate of increase in cannabis use between 2005 and 2017 was greater among persons with depression than in those without depression. Authors also observed that depressed individuals worry less about the risks involved in cannabis use, which could be responsible for the rapid increase in cannabis use in this population.
This is a worrisome trend considering that cannabis use may be particularly harmful for individuals with mental health vulnerabilities. Heavy cannabis use can precipitate the onset of psychiatric symptoms and worsen the course of the depressive disorder. A segment of the population that is most vulnerable are young men who have the highest rate of cannabis use and may suffer consequences such as depression and suicide.
Findings of this study underscore the importance of closely monitoring the impact of easing legal restrictions around drug use on the most vulnerable members of the society, adolescents and young adults. The general public needs to be informed about the public health consequences of regulatory changes. Closely tracking the impact of regulations on population mental health should be used in developing strategies to counteract the negative impact of such changes. This may include measures to protect vulnerable individuals and the development of interventions to offset the negative impact. Training medical providers on screening for cannabis-related disorders and psychiatric complications and training on prevention and treatment strategies should also be a part of the public health response.
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