Frequent Cannabis Users Had More Anxiety but Were Not More Likely to Take Prescription Medications | Research

The takeaway

Among 195 Colorado cannabis users, frequent use (15+ days/month) was associated with higher anxiety odds, yet use of FDA-approved anxiolytics did not differ between use groups.

primary care clinicians, anxiety researchers, medical cannabis clinicians

What the researchers found

Frequent cannabis use was associated with higher anxiety likelihood (AOR 1.06, 95% CI 1.01-1.12) but not depression on validated scales. Use of FDA-approved anxiolytic or antidepressant medications did not differ significantly across non-use, infrequent, and frequent cannabis groups (20% vs. 18.2% vs. 21.1% for anxiolytics). Urinary cannabinoid levels were not associated with symptom severity.

Why it matters

The finding that frequent cannabis users have elevated anxiety but similar rates of medication use suggests some may be substituting cannabis for evidence-based treatments, which has implications for clinical screening and referral.

The numbers in context

195 participants. Frequent use (15+ days/month): AOR 1.06 for anxiety. No association with depression. Anxiolytic use: 20% non-users, 18.2% infrequent, 21.1% frequent (NS). Antidepressant: 14%, 9.1%, 11.4% (NS). Urinary cannabinoids not associated with symptom severity.

How the study worked

Secondary analysis of a cross-sectional sleep and cannabis study. 195 participants completed HADS, BAI, BDI-II, and self-reported cannabis use. Urinary THC metabolites validated exposure. Regression models adjusted for demographics and clinical variables.

What this study cannot tell us

Cross-sectional design. Secondary analysis. Small sample (195). Cannabis users from Colorado may differ from other populations. Self-reported frequency and medication use. Cannot determine directionality.

How to read the evidence

Validated measures with urinary biomarker confirmation, but small cross-sectional secondary analysis limits to moderate.

When this study was published

Secondary analysis of a Colorado cannabis cohort study.

The bigger picture

This study adds to a complex picture where cannabis users report using for anxiety yet show more anxiety symptoms, and the lack of correlation between urinary THC levels and symptom severity suggests the relationship is not straightforward.

Questions still open

Are frequent cannabis users self-medicating anxiety or is cannabis contributing to it?
Would systematic screening for untreated anxiety among cannabis users improve outcomes?

Common questions

Does frequent cannabis use increase anxiety?

Frequent users in this study had higher odds of anxiety on validated scales, but the cross-sectional design cannot determine if cannabis causes anxiety or if anxious people use more cannabis.

Are cannabis users avoiding prescription medications?

Rates of anxiolytic and antidepressant use were similar regardless of cannabis use frequency, suggesting frequent cannabis users are not systematically avoiding prescription treatments.

Read the original research

Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort.

Journal of cannabis research, 7(1), 78

View on PubMed ↗Publisher’s paper ↗

Citation

Steeger, Christine M; Tandukar, Poojashree; Hoth, Karin F; Aloia, Mark; Wamboldt, Fred; Castaldi, Peter; Sharma, Sunita; Lorenzon, Nancy; Crotty Alexander, Laura E; Klawitter, Jost; Sempio, Cristina; Kinney, Gregory L; Althoff, Meghan D; Kruse, Gina R; Bowler, Russell P. (2025). Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort.. Journal of cannabis research, 7(1), 78. https://doi.org/10.1186/s42238-025-00327-2