Cannabis Use and Anxiety: Is Stress the Missing Piece of the Puzzle? (original) (raw)
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European Neuropsychopharmacology, 2016
The cross-sectional association between cannabis use and anxiety disorders is well documented, yet less is known about the longitudinal association between the two. This study explored the association between cannabis use, cannabis use disorders (CUDs) and anxiety disorders in a 3year prospective study. Data was drawn from waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Anxiety disorders, including generalized anxiety disorder, social anxiety, panic disorder and specific phobias, were controlled for at baseline. Initiation of cannabis use was defined as any cannabis use by former lifetime abstainers in the time period between baseline and follow-up, CUDs were defined as a diagnosis of cannabis abuse or dependence. Results indicate that cannabis use was not associated with increased incidence of any anxiety disorder (Adjusted Odds Ratio (AOR) =1.12(0.63-0.98)). Though heavy cannabis use was associated with increased incidence of social anxiety in most models, this was not fully retained in the final adjusted model (AOR =1.98(0.99-1.98)). Investigation of the association between baseline CUDs and anxiety disorders at follow-up revealed similar results. Any baseline anxiety disorder was not associated with future initiation of cannabis use (AOR =1.03(0.62-1.69)) or onset of a CUD (AOR =0.68(0.41-1.14)), yet
Cannabis and anxiety: a critical review of the evidence
Human Psychopharmacology: Clinical and Experimental, 2009
Background Anxiety reactions and panic attacks are the acute symptoms most frequently associated with cannabis use. Understanding the relationship between cannabis and anxiety may clarify the mechanism of action of cannabis and the pathophysiology of anxiety. Aims of the present study were to review the nature of the relationship between cannabis use and anxiety, as well as the possible clinical, diagnostic and causal implications. Method Systematic review of the Medline, PsycLIT and EMBASE literature. Results Frequent cannabis users consistently have a high prevalence of anxiety disorders and patients with anxiety disorders have relatively high rates of cannabis use. However, it is unclear if cannabis use increases the risk of developing long-lasting anxiety disorders. Many hypotheses have been proposed in an attempt to explain these relationships, including neurobiological, environmental and social influences. Conclusions The precise relationship between cannabis use and anxiety has yet to be established. Research is needed to fully clarify the mechanisms of such the association.
Does cannabis use increase anxiety disorders? A literature review
Current Opinion in Psychiatry, 2019
Purpose of review Cannabis is widely used worldwide and cannabis use disorders are highly comorbid with anxiety disorders. In this review, we consider the recent literature on the effects of cannabis on the incidence, course, and treatment outcomes of anxiety disorders. Recent findings Although cannabis use is mostly found to be associated with increased incidence of anxiety disorders, these findings are generally not sustained in adjusted analyses controlling for multiple confounders. There are some equivocal data suggesting higher risk for anxiety disorders among heavy cannabis users. The scarce data available indicates no clear effect of cannabis use on the course and treatment outcomes of anxiety disorders. Summary Further research is needed focusing on trajectories of cannabis-induced acute anxiety, effects of cannabis use on treatment outcomes in anxiety disorders, and common genetic factors. Future epidemiological studies should utilize more precise measures of cannabis use and address several confounding factors which may affect the association between cannabis use and anxiety disorders.
A Scoping Review of Associations Between Cannabis Use and Anxiety in Adolescents and Young Adults
Child Psychiatry & Human Development, 2021
Cannabis and anxiety are both rising issues that impact young people. This review seeks to explore the association between anxiety and cannabis in adolescents and young adults (AYA). A database search was run retrospectively from July 2020 through calendar year 2013. Articles had to present outcomes examining cannabis use and symptoms of anxiety, be written in English, contain samples with ≥ 50% who are age 25 or younger, and be published in a peer-reviewed journal. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use. Twenty-three studies found a positive association that greater anxiety among AYA was associated with greater cannabis use. In contrast, seven studies found a negative association that greater anxiety was related to less cannabis use. And finally, 17 studies found no clear association between anxiety and cannabis use. Further research is needed to better understand the relationship between anxiety and cannabis use.
Depression and Anxiety, 2018
Background: Cannabis use has been reported to negatively affect the course and outcome of various psychiatric disorders, yet little is known on its effect on rates of remission from anxiety disorders and associated clinical and functional outcomes. Methods: In this study, data were drawn from Waves 1 and 2 of the National Epidemiologic survey on Alcohol and Related Conditions, focusing on individuals who qualified for a diagnosis of any anxiety disorder (social anxiety, panic disorder, generalized anxiety disorder, and specific phobias) at Wave 1 (N = 3,723). Cannabis users and individuals with cannabis use disorders (CUDs) throughout a 4-year period were compared to nonusers in rates of remission, suicidality, general functioning, and quality of life at Wave 2, while controlling for baseline confounders. Results: Although rates of remission decreased with level of cannabis use, this was not maintained in adjusted models. Aside from specific outcomes (individuals with CUDs were significantly more prone to report breaking up from a romantic relationship; adjusted odds ratio [AOR] = 3.85, 95% confidence interval [CI] = 1.66-8.97) and repeatedly quitting school (AOR = 6.02, 95% CI = 2.65-13.66)), following adjustment no additional differences were found in outcome measures. Conclusions: These findings add to previous reports suggesting that poorer outcome of anxiety disorders among cannabis users may be attributed mainly to differences in baseline factors and not cannabis use. K E Y W O R D S anxiety disorders, cannabis, course of illness, marijuana 1 INTRODUCTION Cannabis is one of the most widely used drugs in the world (United Nations Office on Drugs and Crime, 2016). Neurobiological research points to the contribution of the human endo-cannabinoid system to the onset and course of various psychiatric disorders (Carvalho & Van Bockstaele, 2012). Epidemiological studies have shown an association between cannabis use and increased risk for developing psychotic dis
Cannabis use, depression and anxiety: A 3-year prospective population-based study
Journal of Affective Disorders, 2016
Background: Whether or not cannabis use may increase the risk for depression and/or anxiety is not clear. For one thing, it has not been possible to draw a definitive conclusion regarding the direction of causality, i.e. whether cannabis use increases the risk for depression/anxiety or vice versa. This study aimed at examining possible associations between cannabis use, depression and anxiety, using all three measures as both exposure and outcome. Methods: Data were obtained from a longitudinal cohort study comprising 8598 Swedish men and women, aged 20-64, with a three-year-follow-up. Results: Adjusted for sex and age, cannabis use at baseline was associated with an increased relative risk (RR) for depression and anxiety at follow-up, with RR¼ 1.22 [1.06-1.42 Cl 95%] for depression and RR¼ 1.38 [1.26-1.50 Cl 95%] for anxiety. Adjusted for all confounders (alcohol and illicit drug use, education, family tension, place of upbringing), the associations were no longer statistically significant; RR¼ 0.99 [0.82-1.17 Cl 95%] for depression and RR ¼1.09 [0.98-1.20 Cl 95%] for anxiety. Age-adjusted, reporting depression or anxiety at baseline increased the risk of cannabis onset at follow-up three years later; RR ¼1.62 [1.28-2.03 CI 95%] and RR¼ 1.63 [1.28-2.08 CI 95%] respectively. However, adjusted for other illicit drug use the associations were no longer statistically significant. Limitations: Lack of information on frequency of cannabis use and of age of initiation of use. Conclusions: We found no longitudinal associations between cannabis use and incidence of depression/ anxiety, or between depression/anxiety and later cannabis use onset.
Anxiety, Expectancies for Cannabis-Induced Anxiolytic Effects, and Frequency of Cannabis Consumption
Abstracts from the 2020 Virtual Scientific Meeting of the Research Society on Marijuana July 24th, 2020, 2021
This study explored relations among anxiety, expectancies for cannabis’s anxiolytic effects, and frequency of use. Undergraduate users (N=242, Mage = 19.1, 64.5% male, 46.6% White, 18.6% African American, 13% Hispanic/Latino, 12.7% Asian, 9.1% Mixed) rated their anxiety on the TSC-40. They reported expectancies for cannabis’s anxiolytic effects using the same TSC items with a rating from -2 (making the symptom worse) to +2 (making the symptom better). Average expectancies were 2.41, suggesting that users expected some impact of cannabis on anxiety symptoms. These expectancies showed a dramatic skew that required transformation. We regressed anxiety and expectancies and their centered interaction term on days of use per month. Expectancies (B=.917) served as a significant predictor, however anxiety did not (B=.215). The interaction term was not significant, (B=.155). These results suggest that users choose the number of days they use based on their expectations of cannabis-induced im...
Problems Associated with Using Cannabis to Cope with Stress
Cannabis
Previous research has uncovered a link between stress and cannabis. The overall goal of the present study was to further elucidate the nature of this link by examining whether cannabis use motives (e.g., using cannabis to cope with negative affect) mediate the putative associations between stress (early life stress, chronic stress) and cannabis (frequency of cannabis use, problematic cannabis use). A sample of 578 cannabis-using college students completed an anonymous online survey designed to measure early life stress, chronic stress, frequency of cannabis use, and problematic cannabis use. The results indicated that early life stress was significantly associated with more frequent cannabis use and that both early life stress and chronic stress were significantly associated with more problematic cannabis use. The results of a series of parallel multiple mediation models further revealed that cannabis coping motives (i.e., using cannabis to cope with negative affect and other problems) was a significant mediator of all three of these relationships. These findings suggest that both early life stress and chronic stress may lead to the use of cannabis to cope with stress, and that the use of cannabis for this purpose may, in turn, increase problematic cannabis use. We propose that enhancing cannabis users' coping skills, so that they are not reliant on cannabis for coping, may help sever the connection between stress and problematic cannabis use.