Adolescent Cannabis Use is Associated With Subsequent Anxiety Symptoms and Disorders

Cannabis use, anxiety symptoms, and anxiety disorders are common among adolescents, yet how they interact is not well understood. Adolescents are particularly vulnerable to the harmful effects of cannabis because of ongoing neurodevelopment, while its use is increasing among US adolescents due to legalization in many states. Researchers conducted a systematic review and meta-analysis of prospective studies of adolescents aged 13–19 to elucidate the temporal relationship between cannabis use, anxiety symptoms, and anxiety disorders.

• A meta-analysis of six studies found that adolescents with cannabis use were more likely to be diagnosed with a subsequent anxiety disorder (odds ratio [OR], 2.14), compared with those without cannabis use.
• In a systematic qualitative review of 12 additional studies, eight studies confirmed a prospective association between cannabis use and subsequent anxiety symptoms and one found an association with subsequent anxiety disorder diagnosis. Three studies detected no significant association.
• None of the studies detected an association between anxiety symptoms and subsequent cannabis use.

Comments: Adolescents and their parents should be educated that cannabis use is associated with increased risk of anxiety symptoms and disorders. More research is needed to better understand cannabis dose effects, the role of individual components of cannabis, and the differential impact among gender, racial, and ethnic identities that face intersectional stress and stigma.

Safina Adatia, MD, MSc* & Alexander Y. Walley, MD, MSc

* Contributing editorial intern and addiction medicine fellow, Boston Medical Center

Reference: Lowe DJE, Sorkhou M, George TP. Cannabis use in adolescents and anxiety symptoms and disorders: a systematic review and meta-analysis. Am J Drug Alcohol Abuse. 2024;50(2):150–161.