The link between cannabis use and mental health problems in college students grew substantially from 2009 to 2019

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.

Halladay, Jillian et al.·Journal of American college health : J of ACH·2024·Strong EvidenceObservational
RTHC-05366ObservationalStrong Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Strong Evidence
Sample
N=323,896

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
323,896 students surveyed over a decade
Evidence Grade:
Very large national dataset with appropriate statistical modeling, though cross-sectional design at each time point limits causal inference.
Study Age:
2024 publication analyzing 2009-2019 data
Original Title:
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.
Published In:
Journal of American college health : J of ACH, 72(6), 1911-1924 (2024)
Database ID:
RTHC-05366

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

How did the cannabis-mental health link change over time?

While cannabis use was associated with higher odds of depression, anxiety, and suicidal ideation throughout the study period, this association grew substantially stronger from 2009 to 2019. The strengthening was more pronounced for cannabis than for heavy drinking or cigarette smoking.

What does this mean for college students?

The findings suggest that co-occurring cannabis use and mental health problems are becoming more common among college students. The study authors recommend colleges prioritize early identification, psychoeducation, harm reduction, and brief interventions for students at risk.

Read More on RethinkTHC

Cite This Study

RTHC-05366·https://rethinkthc.com/research/RTHC-05366

APA

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

MLA

Halladay, Jillian, et al. "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, 2024. https://doi.org/10.1080/07448481.2022.2098030

RethinkTHC

RethinkTHC Research Database. "Trends in the co-occurrence of substance use and mental heal..." RTHC-05366. Retrieved from https://rethinkthc.com/research/halladay-2024-trends-in-the-cooccurrence

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.