Marijuana Use Patterns and Consequences Among Primary Care Patients With Anxiety, Depression, and Pain

Marijuana use is common among patients with anxiety, depression, and pain, and patients may use it believing that it can address these symptoms. Heavy, habitual marijuana use is associated with negative consequences, including worsening psychiatric symptoms. The authors of this secondary data analysis sought to determine the association between anxiety, depression, and pain symptoms—and changes in marijuana use and drug use consequences (such as interpersonal, intrapersonal, physical and social problems related to drug use)—among primary care patients (n=331) who had reported marijuana use exclusively.

• At baseline, 67% of patients reported no/minimal anxiety/depression symptoms, 16% anxiety or depression symptoms, and 17% both. Fourteen percent reported no pain, 16% low, 23% medium, and 47% high pain levels. Mean (SD) number of marijuana use days was 16.4 (11.6).No association was found between anxiety/depression and marijuana use changes. Patients with baseline anxiety and depression had greater increases in drug use consequences, measured by the Short Inventory of Problems-Drugs (SIP-D) and drug use risk, measured by the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) score for drugs.
• No association was found between pain and marijuana use changes or drug use consequences, but there was an increase in drug use risk.

Comments: With the shifting landscape of marijuana legislation in the US, it is vital for the medical community to accurately educate patients on the consequences and health risks of marijuana use. This study suggests that although primary care patients with anxiety and depression may not increase self-reported marijuana use over time, they may experience increases in drug use consequences and risk. The results of this study add to our growing understanding of marijuana-use consequences, especially among certain populations, and should help craft counseling-based interventions for patients who use marijuana to control symptoms.

Jeanette M. Tetrault, MD

Reference: Bertholet N, Cheng DM, Palfai TP, et al. Anxiety, depression, and pain symptoms: associations with the course of marijuana use and drug use consequences among urban primary care patients. J Addict Med. 2018;12:45–52.