More Cannabis Stores Near Teens' Homes Linked to Higher Rates of Psychotic and Mood Disorders | Research

The takeaway

Among nearly 96,000 Northern California adolescents, greater cannabis retail density and proximity to home were associated with higher rates of psychotic, anxiety, and depressive disorders.

local policymakers, cannabis regulators, adolescent mental health researchers, public health officials

What the researchers found

Banning storefront cannabis retail was associated with 48% lower prevalence of psychotic disorders (aPR 0.52). Having 6+ retailers within a 15-minute drive was associated with 11% higher anxiety disorder prevalence (aPR 1.11), 10% higher depressive disorder prevalence (aPR 1.10), and 8% higher depression symptom prevalence (aPR 1.08). A 20+ minute drive to the nearest retailer was associated with 47% lower psychotic disorder prevalence (aPR 0.53).

Why it matters

This is one of the largest studies to date examining whether local cannabis retail policies affect adolescent mental health outcomes, not just cannabis use rates. The findings suggest that retail availability may influence mental health beyond just facilitating access.

The numbers in context

95,645 adolescents aged 13-17. Storefront ban only: aPR 0.52 for psychotic disorders. Both bans: aPR 0.67. 6+ retailers within 15-min drive: aPR 1.11 anxiety, 1.10 depression, 1.08 depression symptoms. 20+ min to nearest retailer: aPR 0.53 psychotic, 0.89 anxiety, 0.89 depressive, 0.91 depression symptoms.

How the study worked

Cross-sectional study of 95,645 Northern California adolescents aged 13-17 who completed a well-check questionnaire in 2021. Exposures included local cannabis retail bans, retailer proximity, and density relative to geocoded home addresses. Outcomes included ICD-coded psychotic, depressive, and anxiety disorders plus self-reported depression symptoms.

What this study cannot tell us

Cross-sectional design cannot establish causation. Cannabis use itself was not measured, only retail availability and mental health outcomes. Residual confounding by neighborhood socioeconomic factors is possible. ICD diagnoses may undercount actual conditions.

How to read the evidence

Very large sample with geocoded exposure assessment and clinical outcomes, but cross-sectional design and inability to measure actual cannabis use limit evidence to moderate.

When this study was published

Data from 2021 well-check visits in Northern California.

The bigger picture

While this study cannot establish that cannabis retail causes adolescent mental health problems, it adds to evidence that retail density and availability correlate with adverse outcomes. Policymakers face the challenge of balancing legal adult access with adolescent protection.

Questions still open

Does retail proximity affect adolescent cannabis use, which then affects mental health?
Would limiting retail density improve adolescent mental health outcomes?

Common questions

Does having a cannabis store nearby make teens mentally ill?

This study found an association but cannot prove causation. Areas with more cannabis retail had higher rates of adolescent mental health diagnoses, but many factors could contribute to this pattern.

Do cannabis retail bans help adolescent mental health?

Areas with storefront bans had significantly lower rates of psychotic disorders among adolescents. The study suggests limiting retail availability may be associated with better mental health outcomes, but more research is needed.

Read the original research

Associations of Local Cannabis Policy and Retail Availability in Northern California with Adverse Adolescent Mental Health Outcomes.

Substance use & misuse, 60(10), 1571-1576

View on PubMed ↗Publisher’s paper ↗

Citation

Silver, Lynn D; Slama, Natalie E; Dong, Huyun; Padon, Alisa A; Pacula, Rosalie Liccardo; Alexeeff, Stacey E; Sterling, Stacy A; Dyer, Wendy T; Campbell, Cynthia I; Satre, Derek D; Lu, Yun; Does, Monique B; Annam, Jay; Young-Wolff, Kelly C. (2025). Associations of Local Cannabis Policy and Retail Availability in Northern California with Adverse Adolescent Mental Health Outcomes.. Substance use & misuse, 60(10), 1571-1576. https://doi.org/10.1080/10826084.2025.2505145