TOPLINE

Poor mental health (MH) in US adults was associated with nearly twice the odds of having a drug use disorder (DUD) and more frequent use of cannabis for escaping problems or managing stress, with findings mediated by attention-deficit/hyperactivity disorder (ADHD) status, a new study showed.

METHODOLOGY

• Cross-sectional data from the 2023 National Wellbeing Survey were assessed for 2400 US adults aged 18-64 years who reported cannabis use in the past 12 months. 
• Participants reported lifetime diagnoses of depression, anxiety, and ADHD and rated their MH on a 5-point scale. Six reasons for cannabis use were examined: medicinal use, escaping problems, managing daily stressors, reducing the effects of other drugs, getting some sleep, and getting high.
• The primary outcome was a diagnosis of a DUD, and the secondary outcome was the frequency of cannabis use. Researchers also assessed whether the outcomes differed by ADHD diagnosis status.
• Covariates included sex, age, race/ethnicity, household income, alcohol use disorder diagnosis, and alcohol consumption.

TAKEAWAY

• Depression was linked to increased odds of having a DUD (adjusted odds ratio [aOR], 1.84; P < .01), but the association was no longer significant after accounting for ADHD status. Anxiety was not significantly associated with increased odds of having a DUD. 
• Each 1-point improvement in self-rated MH was linked to lower odds of using cannabis to escape problems (aOR, 0.67; P < .001), cope with daily stressors (aOR, 0.79; P < .001), and get some sleep (aOR, 0.90; P < .05).
• Depression was associated with higher odds of using cannabis to escape problems (aOR, 1.38) and to reduce the effects of other drugs (aOR, 2.23), whereas anxiety was linked to higher odds of using cannabis to get some sleep (aOR, 1.36; all P < .05). 
• Men had higher rates of daily cannabis use than women (44.8% vs 42.1%); they also had higher rates of recreational motives for this, whereas women had higher rates of medicinal and sleep-related motives.

IN PRACTICE

The findings showed that cannabis use was “intricately related” to MH symptoms in the US, the investigators wrote.

“There are important implications for public health surveillance, harm reduction programs, and clinical interventions related to the use patterns indicated by MH diagnoses,” they added.

SOURCE

The study was led by Luis E. Espinoza, PhD, Texas A&M University-Corpus Christi, College of Nursing & Health Sciences. It was published online on July 27 in the Journal of Psychiatric Research.

LIMITATIONS

The study was limited by its reliance on self-reporting; a low overall response rate; lack of clinical assessments; lack of data on cannabis potency, dose, and route of administration; and unmeasured confounders, such as the use of other substances and chronic pain.

DISCLOSURES

The study received no funding. The investigators reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.