ArticleDrug and alcohol dependence2026
Relations between depression and cannabis use among college students in evolving state cannabis policy environments.
Article in Drug and alcohol dependence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesDepression is a risk factor for cannabis use, an association that may change as state cannabis policies evolve. The present study uses individual-level data on college students and a continuous measure of state cannabis policy restrictiveness to examine this question.
methodsUndergraduates (n = 902,486) ages 18-24 years from 591 four-year institutions in 47 states completed a cross-sectional survey between 2008 and 2019, including items assessing significant 30-day depressive symptoms, 12-month depression diagnosis or treatment, and 30-day cannabis use and frequent (20 + days) use. Time-varying, state-level cannabis policy restrictiveness was measured with the Cannabis Policy Scale (CPS).
resultsFrom 2008-2019 prevalence increased for 30-day depressive symptoms (15.3-26.7%) and frequent cannabis use (3.3-5.2%). Depression measures were associated with cannabis use outcomes [odds ratios (OR) ranged from 1.54 to 2.13, p < 0.0001]. Effects were modestly but significantly weaker in less restrictive than in more restrictive state cannabis policy environments. For example, depressive symptoms were less associated with increased odds of 30-day cannabis use in the least restrictive states [OR (95% CI) = 1.47 (1.42-1.52), p < 0.0001] than in the most restrictive states [OR (95% CI) = 1.57 (1.54-1.59), p < 0.0001; interaction p = 0.0017]. There was no evidence that depression prevalence was higher among students exposed to less restrictive cannabis policies.
conclusionsDepression and frequent cannabis use co-occurred across restrictive and liberal state cannabis policy environments, and both conditions increased in prevalence across the study period. Depression was a somewhat weaker risk factor for cannabis use when and where cannabis was more legal and accessible.
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