First population-level evidence shows synthetic cannabinoids and CBD use, not just cannabis, are associated with probable depression, anxiety, conduct disorder, and auditory hallucinations in adolescents.
Adolescent psychiatrists, school health professionals, and substance use policy researchers.
3 substance typescannabis, synthetic cannabinoids, and CBD all associated with probable mental health disorders in 6,672 UK adolescents
What the researchers found
All three substance types were significantly associated with mental health disorders after correction for multiple testing. CBD use appeared to weaken the cannabis-anxiety and cannabis-depression associations, suggesting a potential moderating role.
Why it matters
As CBD products become widely available and synthetic cannabinoids persist as a street drug, this first general population study shows both are associated with teen mental health problems.
The numbers in context
6,672 adolescents aged 13-14 in England and Wales (2019-2020). 5.2% used cannabis, 1.9% used CBD, 0.6% used synthetic cannabinoids. Weekly tobacco use markedly attenuated associations.
How the study worked
Cross-sectional analysis of 13-14 year old adolescents with multilevel logistic regression examining lifetime substance use and self-reported mental health symptoms.
Who was studied
6,672 adolescents aged 13-14 across England and Wales (2019-2020).
What this study cannot tell us
Cross-sectional design cannot determine causation. Self-reported substance use and mental health symptoms. Low prevalence of synthetic cannabinoid and CBD use limits statistical power. Tobacco use confounding.
How to read the evidence
Large population-based cross-sectional study; first of its kind but cannot establish causation.
When this study was published
Data from 2019-2020 UK adolescent survey.
The bigger picture
This study extends cannabis-mental health research to synthetic cannabinoids and CBD in the general adolescent population, challenging the assumption that CBD is benign for teens while raising new concerns about emerging substance types.
Replication
First general population evidence; needs replication with prospective designs.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Is CBD truly protective or is the interaction an artifact of polysubstance use patterns?
- Should CBD products be age-restricted like cannabis?
Read the original research
Association of cannabis, cannabidiol and synthetic cannabinoid use with mental health in UK adolescents.
The British journal of psychiatry : the journal of mental science, 223(4), 478-484
Citation
Hotham, James; Cannings-John, Rebecca; Moore, Laurence; Hawkins, Jemma; Bonell, Chris; Hickman, Matthew; Zammit, Stanley; Hines, Lindsey A; Adara, Linda; Townson, Julia; White, James. (2023). Association of cannabis, cannabidiol and synthetic cannabinoid use with mental health in UK adolescents.. The British journal of psychiatry : the journal of mental science, 223(4), 478-484. https://doi.org/10.1192/bjp.2023.91