A systematic review of 50 studies found that people who fear their own anxiety symptoms are more likely to use cannabis to cope, but not more likely to use cannabis overall.
clinical psychologists, addiction researchers, mental health clinicians treating co-occurring anxiety and cannabis use
What the researchers found
Elevated anxiety sensitivity was directly associated with greater coping-oriented and potentially problematic cannabis use, but not with lifetime cannabis use or overall use frequency. The review proposes a model where high anxiety sensitivity leads to coping-motivated use, which in the presence of psychopathology and positive cannabis expectancies progresses to problematic use.
Why it matters
Understanding why some people develop problematic cannabis use while others do not is key for prevention. This review identifies a specific psychological trait that predicts not whether someone uses cannabis, but why they use it and whether that use becomes problematic.
The numbers in context
50 studies reviewed. Two independent coders assessed risk of bias. Anxiety sensitivity associated with coping-oriented use but not lifetime use or frequency. Proposed conceptual model links AS to coping use to problematic use through psychopathology and positive expectancies.
How the study worked
Systematic review of 50 empirical studies from PubMed and PsycInfo through Spring 2024 examining associations between anxiety sensitivity and cannabis use. Two independent coders evaluated study characteristics and risk of bias. Results were qualitatively synthesized.
What this study cannot tell us
Qualitative synthesis only, no meta-analytic effect sizes. Most included studies were cross-sectional. Publication bias not formally assessed. Heterogeneity in how anxiety sensitivity and cannabis use were measured across studies.
How to read the evidence
Comprehensive search with independent coding, but qualitative synthesis and predominantly cross-sectional source studies limit evidence to moderate.
When this study was published
Literature search through Spring 2024.
The bigger picture
This review bridges the conflicting findings on anxiety sensitivity and cannabis: some people with high AS may use cannabis to manage distressing sensations, while others avoid it because it worsens anxiety. The distinction may depend on coping motives and existing mental health conditions.
Questions still open
- Would interventions targeting anxiety sensitivity reduce problematic cannabis use?
- Does the proposed conceptual model hold up in prospective studies?
Common questions
What is anxiety sensitivity?
Does anxiety sensitivity make cannabis use more dangerous?
Read the original research
Anxiety sensitivity and cannabis use: A systematic review and conceptualization of research findings.
Behaviour research and therapy, 188, 104733
Citation
Short, Nicole A; Weese, Rachel; Pezza, Mattea; Bedard-Gilligan, Michele A. (2025). Anxiety sensitivity and cannabis use: A systematic review and conceptualization of research findings.. Behaviour research and therapy, 188, 104733. https://doi.org/10.1016/j.brat.2025.104733
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