Cannabis use disorder linked to greater apathy in people living with HIV | Research

The takeaway

Among 311 adults with HIV, current cannabis use disorder was associated with higher apathy scores compared to cannabis users without CUD, though the association was no longer significant after accounting for depression.

People interested in cannabis use disorder, motivation, and the intersection of substance use and mental health.

CUD-apathy link disappeared after controlling for depression

What the researchers found

Current CUD was associated with greater apathy (beta = 2.13, p = 0.018) compared to cannabis users without CUD history. The association became nonsignificant after adjusting for depressive symptoms, suggesting overlap between apathy and depression. Adolescent-onset CUD was not linked to greater apathy than adult-onset.

Why it matters

Apathy is common in people with HIV and is associated with poor adherence to treatment. Identifying modifiable risk factors like substance use disorders could help clinicians address apathy and improve HIV outcomes.

The numbers in context

311 adults with HIV studied. CUD-apathy association: beta = 2.13 (95% CI: 0.37-3.90, p = 0.018). Alcohol use correlated with apathy: r = 0.19 (p = 0.001). Association became nonsignificant after depression adjustment.

How the study worked

Cross-sectional analysis of 311 adult people with HIV. Apathy was measured using the Apathy Evaluation Scale-Self (AES-S). CUD history was categorized as current, past, none, or no cannabis use. Analyses tested robustness to adjustment for depression and alcohol use.

What this study cannot tell us

Cross-sectional design cannot determine whether CUD causes apathy or vice versa. The association disappeared when controlling for depression, raising questions about whether apathy and depression are being measured as overlapping constructs. Only people with HIV were studied.

How to read the evidence

Moderate-sized cross-sectional study with validated measures, but the design cannot establish causation and the sample is specific to people with HIV.

When this study was published

Published in 2024 in Drug and Alcohol Dependence.

The bigger picture

The stereotype that cannabis makes people apathetic is common but poorly supported by rigorous data. This study finds the link exists specifically with cannabis use disorder (not casual use) and appears intertwined with depression, complicating simple narratives about cannabis and motivation.

Questions still open

Is CUD-related apathy a manifestation of depression rather than a direct cannabis effect? Would treating CUD improve apathy in people with HIV? Do these findings extend to HIV-negative populations?

Common questions

Does cannabis make people apathetic?

This study found that cannabis use disorder (not casual use) was associated with greater apathy in people with HIV. However, the association was no longer significant after accounting for depressive symptoms, suggesting the picture is more nuanced than simple cause and effect.

Did it matter when cannabis use started?

No. Adolescent-onset cannabis use disorder was not associated with greater apathy compared to adult-onset, contrary to what some might expect.

Read the original research

Association between cannabis use disorder and greater apathy in adults with HIV.

Drug and alcohol dependence, 261, 111354

View on PubMed ↗Publisher’s paper ↗

Citation

Britton, Mark K; DeFelice, Jason; Porges, Eric C; Cohen, Ronald; Li, Yancheng; Wang, Yan; Ibañez, Gladys E; Somboonwit, Charurut; Cook, Robert L. (2024). Association between cannabis use disorder and greater apathy in adults with HIV.. Drug and alcohol dependence, 261, 111354. https://doi.org/10.1016/j.drugalcdep.2024.111354