Journal article
Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort
Journal of cannabis research, Vol.7(1), 78
10/17/2025
DOI: 10.1186/s42238-025-00327-2
PMCID: PMC12535088
PMID: 41107903
Abstract
Background
Cannabis is commonly used as a self-prescribed treatment for anxiety and depression, but few studies have evaluated these associations using both validated mental health scales and biological cannabinoid markers. This study aimed to test associations between cannabis use frequency and symptoms of anxiety and depression, and to examine whether frequent cannabis users with high symptom scores were less likely to use FDA-approved medications.
Methods
This is a secondary analysis of a cross-sectional study on sleep and cannabis use, including 195 participants who completed the Hospital Anxiety and Depression Scale (HADS), Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), and self-reported cannabis use. Urinary tetrahydrocannabinol (THC) metabolites validated recent cannabis exposure. Regression models adjusted for demographic and clinical variables.
Results
Frequent cannabis use (≥ 15 uses in the past 30 days) vs. infrequent use (14 or fewer uses in the past 30 days) was associated with higher likelihood of anxiety, AOR = 1.06 (95% CI 1.01, 1.12), p < 0.01 for the BAI and AOR = 1.05 (95% CI 1.01, 1.09), p < 0.05 for the HADS-A. However, frequency of cannabis use was not associated with depression for either the HADS-D, AOR = 0.98 (95% CI 0.94, 1.05) or BDI-II, AOR = 0.98 (95% CI 0.92, 1.04), ps > 0.05. Use of FDA-approved anxiolytic or antidepressant medications did not significantly differ by non-use, infrequent, and frequent cannabis use groups (20% vs. 18.2% vs. 21.1% for anxiolytic-hypnotics and 14% vs. 9.1% vs. 11.4% for antidepressants), and urinary cannabinoid levels were not associated with symptom severity, all ps > 0.05.
Conclusions
Elevated anxiety was common among frequent cannabis users, yet use of FDA-approved medications was infrequent in this group despite increased symptom burden. These results suggest that some individuals may turn to cannabis to manage their symptoms instead of using evidence-based treatments. Clinicians should consider the possibility that patients might substitute cannabis for prescription medications, and routinely screen cannabis users for untreated anxiety. Randomized studies are needed to determine causal associations between anxiety symptoms and cannabis use, including potential interactions with FDA-approved pharmacotherapies. Such evidence will inform clinical recommendations and policy on cannabis use and mental health.
Details
- Title: Subtitle
- Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort
- Creators
- Christine M Steeger - University of Colorado BoulderPoojashree Tandukar - Colorado State University PuebloKarin F Hoth - University of IowaMark Aloia - National Jewish HealthFred Wamboldt - National Jewish HealthPeter Castaldi - Harvard UniversitySunita Sharma - Colorado State University PuebloNancy Lorenzon - University of DenverLaura E Crotty Alexander - University of California San DiegoJost Klawitter - University of Colorado DenverCristina Sempio - Colorado State University PuebloGregory L Kinney - Colorado State University PuebloMeghan D Althoff - Colorado State University PuebloGina R Kruse - Colorado State University PuebloRussell P Bowler - Cleveland Clinic
- Resource Type
- Journal article
- Publication Details
- Journal of cannabis research, Vol.7(1), 78
- DOI
- 10.1186/s42238-025-00327-2
- PMID
- 41107903
- PMCID
- PMC12535088
- NLM abbreviation
- J Cannabis Res
- ISSN
- 2522-5782
- eISSN
- 2522-5782
- Publisher
- BMC
- Grant note
- Colorado Department of Public Health and Environment Research Grant
This work was supported by a Colorado Department of Public Health and Environment Research Grant.
- Language
- English
- Date published
- 10/17/2025
- Academic Unit
- Psychiatry; Iowa Neuroscience Institute
- Record Identifier
- 9985014800702771
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