Among over 323,000 US college students surveyed from 2009 to 2019, the association between cannabis use and depression, anxiety, and suicidal ideation strengthened substantially over the decade.
College health professionals, substance use counselors, public health researchers, and university administrators
323,896 students surveyed over a decade
What the researchers found
Cannabis use was associated with greater odds of depression, anxiety, and suicidal ideation among US post-secondary students. Critically, the strength of this association increased substantially over the 2009-2019 period, more so than for heavy drinking or cigarette smoking.
Why it matters
The strengthening association between cannabis and mental health problems among college students coincides with increasing cannabis potency and legalization, raising questions about whether changing cannabis products or patterns are contributing to worse mental health outcomes.
The numbers in context
323,896 students from 2009-2019; cannabis association with mental health concerns strengthened substantially over time; heavy drinking association strengthened modestly; smoking association remained stable
How the study worked
Weighted two-level logistic regression models with time-by-substance interaction terms applied to data from 323,896 students participating in the Healthy Minds Study, a national cross-sectional survey of US post-secondary students, collected annually from 2009 to 2019.
What this study cannot tell us
Cross-sectional design at each time point cannot determine causation; self-reported substance use and mental health; cannot distinguish whether cannabis contributes to mental health problems or vice versa; survey methodology changes over time could influence trends
How to read the evidence
Very large national dataset with appropriate statistical modeling, though cross-sectional design at each time point limits causal inference.
When this study was published
2024 publication analyzing 2009-2019 data
The bigger picture
While cannabis legalization and use have expanded among young adults, this study suggests the relationship between cannabis and mental health problems is intensifying rather than remaining stable, warranting attention from college health systems.
Questions still open
- Is the strengthening association driven by increasing cannabis potency, more frequent use, or changes in the population of cannabis users? Would harm reduction interventions on college campuses reduce the co-occurrence of cannabis use and mental health problems?
Common questions
How did the cannabis-mental health link change over time?
What does this mean for college students?
Read the original research
Trends in the co-occurrence of substance use and mental health symptomatology in a national sample of US post-secondary students from 2009 to 2019.
Journal of American college health : J of ACH, 72(6), 1911-1924
Citation
Halladay, Jillian; Freibott, Christina E; Lipson, Sarah K; Zhou, Sasha; Eisenberg, Daniel. (2024). Trends in the co-occurrence of substance use and mental health symptomatology in a national sample of US post-secondary students from 2009 to 2019.. Journal of American college health : J of ACH, 72(6), 1911-1924. https://doi.org/10.1080/07448481.2022.2098030
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