(Crippa et al., 2009). Studies continue into the relationship between marijuana and anxiety. One study found that social anxiety is positively associated with marijuana-related problems. Although no significant direct effect of social anxiety resulting from marijuana use frequency was observed, a significant indirect effect on solitary marijuana use was found. This research suggests that social anxiety exerts its influence on marijuana use frequency indirectly via more frequent solitary use. Solitary marijuana use was related to more marijuana-related problems. This finding was congruent with the investigators’ previous work, which found that socially anxious marijuana users tended to avoid social situations when marijuana was unavailable. Socially anxious persons used marijuana before social events to manage anticipatory anxiety about the event and/or used marijuana following the social event to manage their anxiety associated with review of negative aspects of their behavior during the social event (Buckner et al., 2016). A study of 149 male and female participants, aged 18 to 36, used various statistics to investigate the factors, such as social anxiety, norms, and expectancies that might be related to craving marijuana. The craving was greatest when marijuana use was viewed as acceptable and expected to reduce tension. Cravings resulting from social anxiety were low when expectations were low. The study found that non-Caucasian participants reported greater tension-reduction expectancies than Caucasian participants. This study suggests the importance of considering social norms, expectancies, and social anxiety in understanding marijuana-related behaviors, given that craving is robustly related to marijuana use problems, such as relapse during an attempt to quit (Foster et al., 2015). A meta-analysis included a total of 267 studies on marijuana use in anxiety. The results of 31 of those studies were re- analyzed using a random- effects meta-analysis with inverse variance weights. Analysis of the epidemiological data from this cohort representing 112,000 non- institutionalized members of the general population of 10 countries (the United States, Trauma and stressor-related disorders Rates of marijuana use have increased in the wake of major disasters. High rates of posttraumatic stress disorder (PTSD) exist in the United States, particularly in combat-exposed veterans, and marijuana use disorder is associated with PTSD (OR = 4.3). While some researchers hypothesize that individuals with PTSD might benefit from marijuana use, one review of the literature found that the known risks of marijuana use outweigh the unknown benefits for PTSD (Steenkamp et al., 2017). Posttraumatic stress disorder symptom severity is: Positively associated with (a) use of cannabis to cope, (b) cannabis use problems, (c) severity of cannabis withdrawal, and (d) experiences of craving related to compulsivity and emotionality, with findings regarding withdrawal and Depressive and bipolar disorders A recent survey measured the statistical association between the age at which people first used marijuana and depression in two ways (Gorfinkel et al., 2020). First, two statistics (linear regressions) used scores from three assessments – the 12-Item Short-Form Health Survey, the Mental Component Summary, and the Major Depression Inventory – as the dependent variables, with the age at first use of marijuana as the independent variable. Second, two regression analyses used age at marijuana first use as the independent variable (with lifetime nonusers as a reference) and poor mental health and major depression as the dependent variables. The results confirmed that marijuana first use at a young age is an important risk factor in the progression to other drug use. Mental health and depression were significantly predicted by age at marijuana first use. However, after controlling for the frequency of marijuana use and for the misuse of alcohol, cigarettes, and other drugs, the association with depression did not persist and the association with poor
Canada, Switzerland, Australia, France, Colombia, New Zealand, Netherlands, Germany, and the United Kingdom) found a small positive association between anxiety and either marijuana use (odds ratio [OR] = 1.24, 95% confidence interval [CI], p = 0.006; n = 15 studies) or marijuana use disorders (OR = 1.68, 95% CI, p = 0.001; n = 13 studies) and between comorbid anxiety and depression and marijuana use (OR = 1.68, 95% CI, p = 0.004; n = 5 studies; Kedzior & Laeber, 2014). A study conducted with 232 participants between the ages of 18 and 70 years who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV ), criteria for panic disorder tested an intervention that included cognitive- behavioral therapy (CBT; six sessions in three months followed by six follow-up 15- to 30-minute phone sessions) and marijuana use. Core panic symptoms were assessed using the Anxiety Sensitivity Index, social phobia by the social phobia subscale of the Fear Questionnaire, and depression by the 20-item Center for Epidemiological Studies Depression Scale. Recent marijuana use (smoking) was also recorded. Findings of the study suggested that monthly marijuana use combined with CBT did not significantly reduce anxiety, panic, or social phobia, but was effective in persons with depression. The investigators noted significant comorbidity between anxiety and depression and suggested that the anxiety arm of the study may not have had sufficient power to detect the effect. The symptoms of persons with depression who smoked marijuana monthly showed no more improvement than the symptoms of persons who smoked less than monthly (Bricker et al., 2007). Most recently a retrospective study of patients utilizing medical cannabis who received their medical cannabis documentation and allotment from a clinic in Canada to determine the impact of medical cannabis on anxiety and depression outcomes was concluded. The findings provide some evidence to support the effectiveness of medical cannabis as a treatment for anxiety and depression (Sachedina et al., 2022). emotion-related craving remaining significant after adjusting for covariates (Boden, Babson, Vujanovic, Short, & Bonn- Miller, 2013, p. 277). Although a range of psychotherapies have been employed with varying degrees of effectiveness, persons who suffer with PTSD may not seek care, and a recent meta-analysis of pharmacotherapy for PTSD found only small effects (Steenkamp et al., 2017). O’Neil and colleagues (2017) found “virtually no conclusive evidence” concerning whether cannabis is of help to patients with PTSD. As of 2022, a scoping review of the use of cannabidiol in psychiatric disorders found no published studies demonstrating the effectiveness of marijuana in treating PTSD (Kirkland et al., 2022). mental health was reduced. These results underscore the importance of preventing early marijuana users from progressing to other drugs. Among individuals whose first use of marijuana is early in life, these results suggest that the risks of mental health problems and depression are subsequently mediated by abusive consumption of marijuana or other substances. Early onset does not appear to be an indicator of later mental health problems per se, as long as it is not followed by harmful patterns of substance use. Major depressive disorder is known to be more common in women. Conflicting reports exist concerning the relationship between gender and the prevalence of the use of marijuana to cope with emotional distress. Researchers conducted a secondary analysis of the results of a marijuana intervention trial involving 332 young adult women. Changes in depression symptoms (categorized as minimal, mild, and moderate or more severe depression) were assessed using Beck’s Depression
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