Weekly Cannabis Use Was Linked to Greater Social Anxiety Severity and Suicide Risk in a National Sample

In both lifetime (N=1,255) and past-year (N=980) SAD samples, weekly+ cannabis use was significantly related to fear or avoidance of social situations interfering with relationships. Weekly+ use and CUD were associated with lifetime SAD severity, but only weekly+ use was associated with past-year severity. Weekly+ use but not CUD was related to greater odds of seeking SAD treatment and suicide attempt history.

Cross-sectional analysis of a large nationally representative sample using DSM-5 criteria. Examined lifetime (N=1,255) and past-year (N=980) social anxiety disorder subsamples.

Frequency of cannabis use may be a better clinical marker than a formal CUD diagnosis for identifying people with social anxiety who are at greater risk. The suicide risk finding is particularly important for clinicians assessing anxious patients who use cannabis.

Many people with social anxiety use cannabis to cope with social situations, but this study suggests that frequent use is associated with worse anxiety outcomes, not better. This challenges the self-medication narrative and suggests cannabis may perpetuate the avoidance cycle in SAD.

Cross-sectional design cannot determine causation. Self-reported cannabis use. People with worse anxiety may use more cannabis rather than cannabis worsening anxiety. DSM-5 criteria may classify differently than earlier versions.