Cannabis Use and Social Anxiety Disorder Often Co-Occur in Young Adults | Research

The takeaway

Among a nationally representative sample of 5,194 young adults, co-occurring cannabis use and social anxiety disorder was associated with being White, not being a full-time student, and having multiple psychiatric disorders.

Psychiatrists, college counselors, and clinicians treating young adults with anxiety or substance use

Panic disorder increased odds of co-occurrence up to 19-fold

What the researchers found

The prevalence of co-occurring cannabis use and social anxiety disorder was 1.10%. Being White, a part-time student, or not a student increased odds of having both conditions (OR: 2.26-3.09). Multiple psychiatric disorders were strongly associated with the co-occurrence, including panic disorder (AOR up to 19.05), major depressive disorder, bipolar I, generalized anxiety, specific phobia, and agoraphobia (AOR range: 3.03-19.05).

Why it matters

Social anxiety is one of the most commonly cited reasons for cannabis use among young adults. Understanding who is at risk for both conditions simultaneously helps target screening and intervention efforts in a population where both are highly prevalent.

The numbers in context

5,194 young adults. Co-occurrence prevalence: 1.10%. Being White: OR 2.26-3.09 for co-occurrence. Panic disorder: AOR up to 19.05 for co-occurrence. Major depression, bipolar I, GAD, specific phobia, and agoraphobia also significantly associated.

How the study worked

Cross-sectional analysis of 5,194 emerging adults (ages 18-25) from the NESARC-III, a nationally representative US survey. Weighted cross-tabulations and multinomial logistic regressions examined four groups: no cannabis/no SAD, cannabis only, SAD only, and cannabis plus SAD.

What this study cannot tell us

Cross-sectional design cannot determine whether cannabis use leads to social anxiety, vice versa, or both arise from shared risk factors. The 1.10% co-occurrence rate may underestimate true prevalence due to stigma in reporting. NESARC-III data is from 2012-2013.

How to read the evidence

Nationally representative sample with validated measures, but cross-sectional design and older data (2012-2013) limit conclusions.

When this study was published

2024 study using NESARC-III (2012-2013) data

The bigger picture

The strong associations with other psychiatric disorders suggest that co-occurring cannabis use and social anxiety may be a marker of broader mental health vulnerability rather than a simple two-condition overlap. Screening for one should prompt assessment for the other, and for additional psychiatric conditions.

Questions still open

Does cannabis use worsen social anxiety symptoms or provide temporary relief? Would treating social anxiety reduce cannabis use in this group? How has the prevalence changed since cannabis legalization expanded?

Common questions

Is cannabis use connected to social anxiety?

In this nationally representative sample, 1.1% of young adults had both cannabis use and social anxiety disorder. The co-occurrence was strongly linked to having other psychiatric conditions, suggesting shared vulnerability.

Who is most at risk for both cannabis use and social anxiety?

White young adults, part-time students or non-students, and those with other psychiatric disorders (especially panic disorder, which increased odds up to 19-fold) had the highest risk of co-occurrence.

Read the original research

Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample.

Journal of anxiety disorders, 101, 102808

View on PubMed ↗Publisher’s paper ↗

Citation

Single, Alanna; Alcolado, Gillian; Keough, Matthew T; Mota, Natalie. (2024). Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample.. Journal of anxiety disorders, 101, 102808. https://doi.org/10.1016/j.janxdis.2023.102808