Cannabis. Marijuana. Pot. Weed. Mary Jane. Whatever you call it, there's no denying that its use is not only prevalent, but also increasing. Results of a recent Gallup poll indicated that in the United States alone, rates of cannabis use jumped from 7 to 13 percent between 2013 and 2016, with 43 percent of U.S. adults indicating that they have tried it.1

While its use has been shown to have a positive effect on a variety of medical problems, frequent use can result in a cannabis use disorder, the rates of which are also on the rise. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 25 percent of cannabis users were daily users, and over 20 percent met criteria for a cannabis use disorder (CUD).2 Such statistics may be particularly relevant for individuals with anxiety because cannabis use disorders are also highly related to anxiety disorders: 43.5 to 50 percent of individuals with CUD also met criteria for an anxiety disorder, particularly social anxiety disorder (SAD) or generalized anxiety disorder (GAD).3

The Link: CUD and Anxiety Disorders

One feature of the high association with cannabis use is a state of increased relaxation, happiness, and detachment from reality. One of the most commonly cited reasons people give for using cannabis is increased relaxation and the ability to cope with negative emotions while under its influence.4 When considering this, it makes sense that individuals, particularly those experiencing high levels of anxiety, might use cannabis to experience some relief from their anxiety.

While cannabis temporarily decreases anxiety, it may also maintain or exacerbate symptoms in the long run; perhaps creating a way to avoid experiencing the anxiety fully. The result? Individuals may not learn that they can cope with and manage their anxiety without cannabis.

Cannabis use may function as a false safety behavior. Anxiety disorders and CUD may be linked because using safety behaviors is associated with greater levels of anxiety, as well as serving to further increase the severity of anxiety disorders.

False Safety Behavior

To examine false safety behaviors as the link between CUD and anxiety disorders, researchers led by Dr. Julia Buckner at Louisiana State University examined such behaviors in 77 adults seeking treatment for cannabis use and anxiety.5 The majority of the participants presented symptoms of SAD, GAD, or panic disorder, and all reported using cannabis to manage their anxiety. The results indicated that individuals with greater anxiety tended to utilize more safety behaviors, which resulted in more severe CUD.

This study was cross-sectional (the data was collected at a specific time), which prevents drawing conclusions about cause and effect. The results do point to a strong relationship between anxiety disorders, CUD, and false safety behaviors. We can't be certain if anxiety disorders lead to CUD through false safety behaviors, or if CUD leads to anxiety disorders through false safety behaviors. Given their strong association, though, the evidence clearly points to the importance of being particularly mindful of cannabis use if a person experiences clinically significant anxiety.

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Sources

1. McCarthy, J. (2016, August). One in eight U.S. adults say they smoke marijuana. Retrieved from: http://www.gallup.com/poll/194195/adults-say-smoke-marijuana.aspx.

2. Substance Abuse and Mental Health Services Administration (2014,). Results from the 2013 National Survey on Drug Use and Health: Summary of national findings: NSDUH series H-48, HHS publication no. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration.

3. Stinson, F. S., Ruan, W. J., Pickering, R., & Grant, B. F. (2006). Cannabis use disorders in the USA: Prevalence, correlates and co-morbidity. Psychological Medicine, 36, 1447-1460.

4. Buckner, J. D., Zvolensky, M. J., Crosby, R. D., Wonderlich, S. A., Ecker, A. H., & Richter, A. A. (2015). Antecedents and consequences of cannabis use among racially diverse cannabis users: An analysis from ecological momentary assessment. Drug and Alcohol Dependence, 147, 20-25.

5. Buckner, J., Zvolensky, M. J., Ecker, A. H., Jeffries, E. R., Lemke, A. W., Dean, K. E., … Gallagher, M. W. (2017). Anxiety and cannabis-related problem severity among dually diagnosed outpatients: The impact of false safety behaviors. Addictive Behaviors, 70, 49-53.

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