Impact of cannabis use disorder on teens and young adults with mood disorders

Just as in the general adolescent and young adult population, cannabis use as well as cannabis use disorder can be common in those who have mood disorders. Cannabis use disorder has been linked to suicide, self-harm, and overall mortality risk in previous research, but it has not been extensively reviewed in teenagers with mood disorders. An investigation in JAMA Pediatrics provides some much needed information.¹

The researchers ran a population-base retrospective cohort study that used Ohio Medicaid claims data that was linked to death certificate data. The review included people aged 10 to 24 years who had a diagnosis of mood disorders between July 2020 and December 2017. Each participant was followed up to 365 days from the index diagnostic claim until either the end of enrollment, a self-harm event, or death.

A total of 204,780 people with an average age of 17.2 years were included in the research. The investigators found that cannabis use disorder occurred in 10.3% of the participants and was significantly linked to a number of characteristics including:

• Older age: (14-18 years vs 10-13 years: adjusted risk ratio [ARR], 9.35; 95% CI, 8.57-10.19; and 19-24 years vs 10-13 years: ARR, 11.22; 95% CI, 10.27-12.26)
• Black race: (ARR, 1.39; 95% CI, 1.35-1.44)
• Prior history of self-harm: (ARR, 1.66; 95% CI, 1.52-1.82)
• Male sex: (ARR, 1.79; 95% CI, 1.74-1.84)
• Psychiatric hospitalizations: (ARR, 1.66; 95% CI, 1.57-1.76)
• Mental health emergency department visits: (ARR, 1.54; 95% CI, 1.47-1.61)
• Bipolar or other mood disorders: (bipolar disorders: ARR, 1.24; 95% CI, 1.21-1.29; other mood disorders: ARR, 1.20; 95% CI, 1.15-1.25)

Additionally, cannabis use disorder had significant links to both nonfatal self-harm (adjusted hazard ratio [AHR], 3.28; 95% CI, 2.55-4.22) as well as an all-cause mortality (AHR, 1.59; 95% CI, 1.13-2.24), which includes homicide (AHR, 3.23; 95% CI, 1.22-8.59) and death by unintentional overdose (AHR, 2.40; 95% CI, 1.39-4.16).

The researchers concluded that in adolescents and young adults with mood disorders, cannabis use disorder was a risk marker for self-harm, all-cause mortality, and death. They also believe that their research should be considered by any state considering the legalization of either medical or recreational marijuana.

Reference

1. Fontanella C, Steelesmith D, Brock G, Bridge J, Campo J, Fristad M. Association of cannabis use with self-harm and mortality risk among youths with mood disorders. JAMA Pediatr. January 19, 2021. Epub ahead of print. doi:10.1001/jamapediatrics.2020.5494