Predicting Self-Medication with Cannabis in Young Adults with Hazardous Cannabis Use

Abstract

Using cannabis to reduce psychological and physical distress, referred to as self-medication, is a significant risk factor for cannabis use disorder. To better understand this high-risk behavior, a sample of 290 young adults (ages 18–25; 45.6% female) were recruited from two U.S. universities in January and February of 2020 to complete a survey about their cannabis use and self-medication. Results: seventy-six percent endorsed using cannabis to reduce problems such as anxiety, sleep, depression, pain, loneliness, social discomfort, and concentration. When predicting reasons for self-medication with cannabis, logistic regression models showed that lower CUDIT-R scores, experiencing withdrawal, living in a state where cannabis was illegal, and being female were all associated with higher rates of self-medication. Withdrawal symptoms were tested to predict self-medication with cannabis, and only insomnia and loss of appetite were significant predictors. To further explore why young adults self-medicate, each of the original predictors were regressed on seven specified reasons for self-medication. Young adults experiencing withdrawal were more likely to self-medicate for pain. Participants living where cannabis is legal were less likely to self-medicate for anxiety and depression. Living where cannabis is illegal also significantly predicted self-medicating for social discomfort—though the overall model predicting social discomfort was statistically non-significant. Finally, female participants were more likely to self-medicate for anxiety. These results suggest widespread self-medication among young adults with likely CUD and underscore the complexity of their cannabis use. The findings have implications for understanding why young adults use cannabis in relation to psychological and physical distress and for accurately treating young adults with cannabis use disorder.

A description of self-medication with cannabis among adults with legal access to cannabis in Quebec, Canada

“…This preference for CBD-dominant products was previously observed by Turna et al (35% of exclusive medical users versus 10% of mixed users reported using products with low THC/high CBD concentration (Turna et al 2020 ). In most of the previous studies of self-medication with cannabis, information regarding the doses or ratios of THC and CBD was not provided to allow further comparisons with our data (Wallis et al 2022 ; Greenwald et al 2021 ; Osborn et al 2015 ; Sinclair et al 2020 ; Hansen et al 2020 ).…”

“…A survey conducted before the legalization of recreational cannabis in Canada showed a similar portrait (mean age was 31.1 years for recreational + medical users versus 40.7 years for exclusive medical users) (Turna et al 2020 ). In a recent study that included young US participants (aged 18–25 years) with hazardous cannabis use, older individuals were more likely to self-medicate their pain with cannabis (Wallis et al 2022 ). In our survey, the observed similar proportion of men and women is not consistent with previous surveys of cannabis users (Turna et al 2020 ; Lucas and Walsh 2017 ).…”

“…For example, Turna et al observed a higher proportion of women (59%) among cannabis users (exclusive medical and mixed users) who were surveyed before cannabis legalization in Canada (Turna et al 2020 ). In the US sample of young adults, females were more likely to report self-medication of anxiety with cannabis than males (Wallis et al 2022 ). Another US study of HIV patients also observed that women were more likely to use cannabis for self-medication (Greenwald et al 2021 ).…”

Association between cannabis use and physical health problems in Norwegian adolescents: a cross-sectional study from the youth survey Ungdata

“…This suggests a real connection between cannabis use and physical health problems. What is more, young adults (18–25 years) may use cannabis as self-medication to reduce physical and mental distress [ 40 ], and further, it has been shown, that pain relief is the primary motivation for cannabis users with chronic pain [ 41 ]. The causal relationship has, however, not sufficiently been studied among adolescents as cannabis use may increase the risk of physical health problems, and physical health problems may be a risk factor for cannabis use.…”

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study

“…Studies conducted in the United States involving healthy populations have shown that Black youth are more likely than White youth to report self-medicating with cannabis to relieve physiological symptoms associated with anxiety [ 65 ]. However, many studies suggest that youth use cannabis because they believe it will alleviate anxiety symptoms regardless of race, but no studies to date indicate that youth self-medicate to ease psychosis symptoms [ 66 , 67 ]. This study is unique because it will explore the intersections of race, ethnicity, and cannabis use among young people experiencing their first episode of psychosis.…”