[Skip to Content]
[Skip to Content Landing]

Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young AdulthoodA Systematic Review and Meta-analysis

Educational Objective To review if adolescent cannabis consumption is associated with risk of depression, anxiety, and suicidality in young adulthood.
1 Credit CME
Key Points

Question  Is adolescent cannabis consumption associated with risk of depression, anxiety, and suicidality in young adulthood?

Findings  In this systematic review and meta-analysis of 11 studies and 23 317 individuals, adolescent cannabis consumption was associated with increased risk of developing depression and suicidal behavior later in life, even in the absence of a premorbid condition. There was no association with anxiety.

Meaning  Preadolescents and adolescents should avoid using cannabis as use is associated with a significant increased risk of developing depression or suicidality in young adulthood; these findings should inform public health policy and governments to apply preventive strategies to reduce the use of cannabis among youth.

Abstract

Importance  Cannabis is the most commonly used drug of abuse by adolescents in the world. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood.

Objective  To provide a summary estimate of the extent to which cannabis use during adolescence is associated with the risk of developing subsequent major depression, anxiety, and suicidal behavior.

Data Sources  Medline, Embase, CINAHL, PsycInfo, and Proquest Dissertations and Theses were searched from inception to January 2017.

Study Selection  Longitudinal and prospective studies, assessing cannabis use in adolescents younger than 18 years (at least 1 assessment point) and then ascertaining development of depression in young adulthood (age 18 to 32 years) were selected, and odds ratios (OR) adjusted for the presence of baseline depression and/or anxiety and/or suicidality were extracted.

Data Extraction and Synthesis  Study quality was assessed using the Research Triangle Institute item bank on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis.

Main Outcomes and Measures  The studies assessing cannabis use and depression at different points from adolescence to young adulthood and reporting the corresponding OR were included. In the studies selected, depression was diagnosed according to the third or fourth editions of Diagnostic and Statistical Manual of Mental Disorders or by using scales with predetermined cutoff points.

Results  After screening 3142 articles, 269 articles were selected for full-text review, 35 were selected for further review, and 11 studies comprising 23 317 individuals were included in the quantitative analysis. The OR of developing depression for cannabis users in young adulthood compared with nonusers was 1.37 (95% CI, 1.16-1.62; I2 = 0%). The pooled OR for anxiety was not statistically significant: 1.18 (95% CI, 0.84-1.67; I2 = 42%). The pooled OR for suicidal ideation was 1.50 (95% CI, 1.11-2.03; I2 = 0%), and for suicidal attempt was 3.46 (95% CI, 1.53-7.84, I2 = 61.3%).

Conclusions and Relevance  Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming cannabis generates a large number of young people who could develop depression and suicidality attributable to cannabis. This is an important public health problem and concern, which should be properly addressed by health care policy.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

Article Information

Corresponding Author: Gabriella Gobbi, MD, PhD, Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, 1033 Pine Ave W, Ludmer Research and Training Building, Ste 220, Montreal, QC H3A 1A1, Canada (gabriella.gobbi@mcgill.ca).

Published Online: February 13, 2019. doi:10.1001/jamapsychiatry.2018.4500

Correction: This article was corrected on March 13, 2019, for incorrect information in the Discussion section.

Accepted for Publication: November 26, 2018.

Author Contributions: Dr Gobbi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Gobbi, Atkin, Boruff, Ware, Mayo.

Acquisition, analysis, or interpretation of data: Gobbi, Atkin, Zytynski, Wang, Askari, Boruff, Cipriani, Marmorstein, Dendukuri, Mayo.

Drafting of the manuscript: Gobbi, Atkin, Zytynski, Askari, Boruff, Ware, Cipriani, Dendukuri.

Critical revision of the manuscript for important intellectual content: Gobbi, Atkin, Wang, Askari, Cipriani, Marmorstein, Dendukuri, Mayo.

Statistical analysis: Wang, Askari, Cipriani, Marmorstein, Dendukuri, Mayo.

Obtained funding: Gobbi, Mayo.

Administrative, technical, or material support: Gobbi, Atkin, Zytynski, Ware.

Supervision: Gobbi, Atkin, Cipriani, Mayo.

Conflict of Interest Disclosures: Dr Gobbi received a grant (which was not related to this meta-analysis) for the study of cannabidiol in neuropathic pain by the Quebec Ministry of Economy, Science and Innovation with the participation of Aurora Cannabis Inc. As of July 1, 2018, Dr Ware has been employed by Canopy Growth Corporation, a Canadian-licensed cannabis producer; this affiliation was disclosed at the time of the appointment, and his involvement in the study was prior to all discussions about this appointment. No other conflicts were reported.

Funding/Support: This research was funded by the Canadian Institutes of Health Research (knowledge synthesis grant 147991) and the Quebec Network on Suicide, Mood Disorders and Related Disorders. Dr Cipriani’s work in this article was supported by the National Institute for Health Research (NIHR) Oxford Cognitive Health Clinical Research Facility, by an NIHR Research Professorship (grant RP-2017-08-ST2-006) and by the NIHR Oxford Health Biomedical Research Centre (grant BRC-1215-20005).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The views expressed are those of the authors and not necessarily those of the UK National Health Service, the National Institute for Health Research, or the UK Department of Health.

Additional Contributions: We thank Nazi Torabi, MLIS (St Michael’s Hospital, Toronto), for the peer review of the Medline search strategy. No compensation was received.

References
1.
 World Drug Report. Vienna, Austria: United National Office on Drugs and Crime; 2017.
2.
Hasin  DS, Saha  TD, Kerridge  BT,  et al.  Prevalence of marijuana use disorders in the United States between 2001-2002 and 2012-2013.  JAMA Psychiatry. 2015;72(12):1235-1242. doi:10.1001/jamapsychiatry.2015.1858PubMedGoogle ScholarCrossref
3.
Choo  EK, Benz  M, Zaller  N, Warren  O, Rising  KL, McConnell  KJ.  The impact of state medical marijuana legislation on adolescent marijuana use.  J Adolesc Health. 2014;55(2):160-166. doi:10.1016/j.jadohealth.2014.02.018PubMedGoogle ScholarCrossref
4.
Johnston  LD.  OMP, Bachman J, Schulenberg J. Monitoring the Future National Results on Drug Use: 2012 Overview. Ann Arbor, Michigan: Institute for Social Research, University of Michigan; 2013.
5.
Canadian Tobacco Alcohol and Drugs (CTADS): 2015 summary. https://www.canada.ca/en/health-canada/services/canadian-tobacco-alcohol-drugs-survey/2015-summary.html. Accessed December 28, 2018.
6.
Australian Institute of Health and Welfare (AIHW).  2010 National Drug Strategy Household Survey Report. Canberra, Australia: Australian Institute of Health and Welfare; 2011.
7.
Fuller  E, Hawkins  V.  Smoking, drinking and drug use among young people in England in 2011. London, UK: Health and Social Care Information Centre; 2012.
8.
 European Drug Report 2018: Trends and Developments. Luxembourg: European Monitoring Centre for Drugs and Drug Addiction; 2018.
9.
Volkow  ND, Baler  RD, Compton  WM, Weiss  SR.  Adverse health effects of marijuana use.  N Engl J Med. 2014;370(23):2219-2227. doi:10.1056/NEJMra1402309PubMedGoogle ScholarCrossref
10.
Silins  E, Horwood  LJ, Patton  GC,  et al; Cannabis Cohorts Research Consortium.  Young adult sequelae of adolescent cannabis use: an integrative analysis.  Lancet Psychiatry. 2014;1(4):286-293. doi:10.1016/S2215-0366(14)70307-4PubMedGoogle ScholarCrossref
11.
Di Forti  M, Sallis  H, Allegri  F,  et al.  Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.  Schizophr Bull. 2014;40(6):1509-1517. doi:10.1093/schbul/sbt181PubMedGoogle ScholarCrossref
12.
Meier  MH, Caspi  A, Ambler  A,  et al.  Persistent cannabis users show neuropsychological decline from childhood to midlife.  Proc Natl Acad Sci U S A. 2012;109(40):E2657-E2664. doi:10.1073/pnas.1206820109PubMedGoogle ScholarCrossref
13.
National Academies of Sciences.  The Health Effects of Cannabis and Cannabinoids: the Current State of Evidence and Recommendations for Research. Washington, DC: National Academies Press; 2017.
14.
Paton  S, Kessler  R, Kandel  D.  Depressive mood and adolescent illicit drug use: a longitudinal analysis.  J Genet Psychol. 1977;131(2d Half):267-289.PubMedGoogle ScholarCrossref
15.
Patton  GC, Coffey  C, Carlin  JB, Degenhardt  L, Lynskey  M, Hall  W.  Cannabis use and mental health in young people: cohort study.  BMJ. 2002;325(7374):1195-1198. doi:10.1136/bmj.325.7374.1195PubMedGoogle ScholarCrossref
16.
Brook  JS, Lee  JY, Brown  EN, Finch  SJ, Brook  DW.  Developmental trajectories of marijuana use from adolescence to adulthood: personality and social role outcomes.  Psychol Rep. 2011;108(2):339-357. doi:10.2466/10.18.PR0.108.2.339-357PubMedGoogle ScholarCrossref
17.
Bambico  FR, Nguyen  N-T, Katz  N, Gobbi  G.  Chronic exposure to cannabinoids during adolescence but not during adulthood impairs emotional behaviour and monoaminergic neurotransmission.  Neurobiol Dis. 2010;37(3):641-655. doi:10.1016/j.nbd.2009.11.020PubMedGoogle ScholarCrossref
18.
Pistis  M, Perra  S, Pillolla  G, Melis  M, Muntoni  AL, Gessa  GL.  Adolescent exposure to cannabinoids induces long-lasting changes in the response to drugs of abuse of rat midbrain dopamine neurons.  Biol Psychiatry. 2004;56(2):86-94. doi:10.1016/j.biopsych.2004.05.006PubMedGoogle ScholarCrossref
19.
Rubino  T, Parolaro  D.  The impact of exposure to cannabinoids in adolescence: insights from animal models.  Biol Psychiatry. 2016;79(7):578-585. doi:10.1016/j.biopsych.2015.07.024PubMedGoogle ScholarCrossref
20.
Giedd  JN, Blumenthal  J, Jeffries  NO,  et al.  Brain development during childhood and adolescence: a longitudinal MRI study.  Nat Neurosci. 1999;2(10):861-863. doi:10.1038/13158PubMedGoogle ScholarCrossref
21.
Fuhrmann  D, Knoll  LJ, Blakemore  SJ.  Adolescence as a sensitive period of brain development.  Trends Cogn Sci. 2015;19(10):558-566. doi:10.1016/j.tics.2015.07.008PubMedGoogle ScholarCrossref
22.
Lev-Ran  S, Roerecke  M, Le Foll  B, George  TP, McKenzie  K, Rehm  J.  The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies.  Psychol Med. 2014;44(4):797-810. doi:10.1017/S0033291713001438PubMedGoogle ScholarCrossref
23.
Moore  TH, Zammit  S, Lingford-Hughes  A,  et al.  Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.  Lancet. 2007;370(9584):319-328. doi:10.1016/S0140-6736(07)61162-3PubMedGoogle ScholarCrossref
24.
Degenhardt  L, Hall  W, Lynskey  M.  Exploring the association between cannabis use and depression.  Addiction. 2003;98(11):1493-1504. doi:10.1046/j.1360-0443.2003.00437.xPubMedGoogle ScholarCrossref
25.
Eden  J, Levit  L, Berg  A, Morton  S. Finding What Works in Health Care: Standards for Systematic Reviews. Washington, DC: National Academies Press; 2011.
26.
Lowe  HJ, Barnett  GO.  Understanding and using the medical subject headings (MeSH) vocabulary to perform literature searches.  JAMA. 1994;271(14):1103-1108. doi:10.1001/jama.1994.03510380059038PubMedGoogle ScholarCrossref
27.
McGowan  J, Sampson  M, Lefebvre  C.  An evidence based checklist for the peer review of electronic search strategies (PRESS EBC).  Evid Based Libr Inf Pract. 2010;5(1):149-154. doi:10.18438/B8SG8RGoogle ScholarCrossref
28.
Canadian Agency for Drugs and Technologies in Health.  Grey Matters: a Practical Search Tool for Evidence-Based Medicine. Ottawa, Canada: Canadian Agency for Drugs and Technologies in Health; 2013.
29.
Moher  D, Liberati  A, Tetzlaff  J, Altman  DG, PRISMA Group.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.  PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097PubMedGoogle ScholarCrossref
30.
Arria  AM, Caldeira  KM, Bugbee  BA, Vincent  KB, O’Grady  KE.  Marijuana use trajectories during college predict health outcomes nine years post-matriculation.  Drug Alcohol Depend. 2016;159:158-165. doi:10.1016/j.drugalcdep.2015.12.009PubMedGoogle ScholarCrossref
31.
Arseneault  L, Cannon  M, Poulton  R, Murray  R, Caspi  A, Moffitt  TE.  Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study.  BMJ. 2002;325(7374):1212-1213. doi:10.1136/bmj.325.7374.1212PubMedGoogle ScholarCrossref
32.
Baggio  S, N’Goran  AA, Deline  S,  et al.  Patterns of cannabis use and prospective associations with health issues among young males.  Addiction. 2014;109(6):937-945. doi:10.1111/add.12490PubMedGoogle ScholarCrossref
33.
Brook  JS, Cohen  P, Brook  DW.  Longitudinal study of co-occurring psychiatric disorders and substance use.  J Am Acad Child Adolesc Psychiatry. 1998;37(3):322-330. doi:10.1097/00004583-199803000-00018PubMedGoogle ScholarCrossref
34.
Brook  DW, Brook  JS, Zhang  C, Cohen  P, Whiteman  M.  Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders.  Arch Gen Psychiatry. 2002;59(11):1039-1044. doi:10.1001/archpsyc.59.11.1039PubMedGoogle ScholarCrossref
35.
Caldeira  KM, O’Grady  KE, Vincent  KB, Arria  AM.  Marijuana use trajectories during the post-college transition: health outcomes in young adulthood.  Drug Alcohol Depend. 2012;125(3):267-275. doi:10.1016/j.drugalcdep.2012.02.022PubMedGoogle ScholarCrossref
36.
D’Amico  EJ, Tucker  JS, Miles  JN, Ewing  BA, Shih  RA, Pedersen  ER.  Alcohol and marijuana use trajectories in a diverse longitudinal sample of adolescents: examining use patterns from age 11 to 17 years.  Addiction. 2016;111(10):1825-1835. doi:10.1111/add.13442PubMedGoogle ScholarCrossref
37.
Degenhardt  L, Coffey  C, Carlin  JB, Swift  W, Moore  E, Patton  GC.  Outcomes of occasional cannabis use in adolescence: 10-year follow-up study in Victoria, Australia.  Br J Psychiatry. 2010;196(4):290-295. doi:10.1192/bjp.bp.108.056952PubMedGoogle ScholarCrossref
38.
Degenhardt  L, Coffey  C, Romaniuk  H,  et al.  The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood.  Addiction. 2013;108(1):124-133. doi:10.1111/j.1360-0443.2012.04015.xPubMedGoogle ScholarCrossref
39.
Epstein  M, Hill  KG, Nevell  AM,  et al.  Trajectories of marijuana use from adolescence into adulthood: environmental and individual correlates.  Dev Psychol. 2015;51(11):1650-1663. doi:10.1037/dev0000054PubMedGoogle ScholarCrossref
40.
Fergusson  DM, Horwood  LJ.  Early onset cannabis use and psychosocial adjustment in young adults.  Addiction. 1997;92(3):279-296. doi:10.1111/j.1360-0443.1997.tb03198.xPubMedGoogle ScholarCrossref
41.
Fergusson  DM, Lynskey  MT, Horwood  LJ.  The short-term consequences of early onset cannabis use.  J Abnorm Child Psychol. 1996;24(4):499-512. doi:10.1007/BF01441571PubMedGoogle ScholarCrossref
42.
Fergusson  DM, Horwood  LJ, Swain-Campbell  N.  Cannabis use and psychosocial adjustment in adolescence and young adulthood.  Addiction. 2002;97(9):1123-1135. doi:10.1046/j.1360-0443.2002.00103.xPubMedGoogle ScholarCrossref
43.
Fleming  CB, Mason  WA, Mazza  JJ, Abbott  RD, Catalano  RF.  Latent growth modeling of the relationship between depressive symptoms and substance use during adolescence.  Psychol Addict Behav. 2008;22(2):186-197. doi:10.1037/0893-164X.22.2.186PubMedGoogle ScholarCrossref
44.
Gage  SH, Hickman  M, Heron  J,  et al.  Associations of cannabis and cigarette use with depression and anxiety at age 18: findings from the Avon Longitudinal Study of Parents and Children.  PLoS One. 2015;10(4):e0122896. doi:10.1371/journal.pone.0122896PubMedGoogle ScholarCrossref
45.
Georgiades  K, Boyle  MH.  Adolescent tobacco and cannabis use: young adult outcomes from the Ontario Child Health Study.  J Child Psychol Psychiatry. 2007;48(7):724-731. doi:10.1111/j.1469-7610.2007.01740.xPubMedGoogle ScholarCrossref
46.
Marmorstein  NR, Iacono  WG.  Explaining associations between cannabis use disorders in adolescence and later major depression: a test of the psychosocial failure model.  Addict Behav. 2011;36(7):773-776. doi:10.1016/j.addbeh.2011.02.006PubMedGoogle ScholarCrossref
47.
McGee  R, Williams  S, Nada-Raja  S.  Is cigarette smoking associated with suicidal ideation among young people?  Am J Psychiatry. 2005;162(3):619-620. doi:10.1176/appi.ajp.162.3.619PubMedGoogle ScholarCrossref
48.
Meier  MH, Hill  ML, Small  PJ, Luthar  SS.  Associations of adolescent cannabis use with academic performance and mental health: a longitudinal study of upper middle class youth.  Drug Alcohol Depend. 2015;156:207-212. doi:10.1016/j.drugalcdep.2015.09.010PubMedGoogle ScholarCrossref
49.
Briere  FN. Association Entre Consommation de Drogues Illicites et Symptomatologie Dépressive à l’Adolescence. Une Étude Longitudinale Auprès de Jeunes Québécois Fréquentant l’École Secondaire en Milieu Défavorisé [PhD thesis]. Montreal, Canada: Université de Montréal; 2011.
50.
Newcomb  AF, Bukowski  WM, Pattee  L.  Children’s peer relations: a meta-analytic review of popular, rejected, neglected, controversial, and average sociometric status.  Psychol Bull. 1993;113(1):99-128. doi:10.1037/0033-2909.113.1.99PubMedGoogle ScholarCrossref
51.
Pahl  K, Brook  JS, Koppel  J.  Trajectories of marijuana use and psychological adjustment among urban African American and Puerto Rican women.  Psychol Med. 2011;41(8):1775-1783. doi:10.1017/S0033291710002345PubMedGoogle ScholarCrossref
52.
Pedersen  W.  Does cannabis use lead to depression and suicidal behaviours? a population-based longitudinal study.  Acta Psychiatr Scand. 2008;118(5):395-403. doi:10.1111/j.1600-0447.2008.01259.xPubMedGoogle ScholarCrossref
53.
Repetto  PB, Caldwell  CH, Zimmerman  MA.  A longitudinal study of the relationship between depressive symptoms and cigarette use among African American adolescents.  Health Psychol. 2005;24(2):209-219. doi:10.1037/0278-6133.24.2.209PubMedGoogle ScholarCrossref
54.
Roberts  RE, Roberts  CR, Xing  Y.  One-year incidence of suicide attempts and associated risk and protective factors among adolescents.  Arch Suicide Res. 2010;14(1):66-78. doi:10.1080/13811110903479078PubMedGoogle ScholarCrossref
55.
Scholes-Balog  KE, Hemphill  SA, Evans-Whipp  TJ, Toumbourou  JW, Patton  GC.  Developmental trajectories of adolescent cannabis use and their relationship to young adult social and behavioural adjustment: a longitudinal study of Australian youth.  Addict Behav. 2016;53:11-18. doi:10.1016/j.addbeh.2015.09.008PubMedGoogle ScholarCrossref
56.
van Gastel  WA, Vreeker  A, Schubart  CD, MacCabe  JH, Kahn  RS, Boks  MPM.  Change in cannabis use in the general population: a longitudinal study on the impact on psychotic experiences.  Schizophr Res. 2014;157(1-3):266-270. doi:10.1016/j.schres.2014.04.023PubMedGoogle ScholarCrossref
57.
Weeks  M, Colman  I.  Predictors of suicidal behaviors in Canadian adolescents with no recent history of depression.  Arch Suicide Res. 2017;21(2):354-364. doi:10.1080/13811118.2016.1193076PubMedGoogle ScholarCrossref
58.
Wilcox  HC, Anthony  JC.  The development of suicide ideation and attempts: an epidemiologic study of first graders followed into young adulthood.  Drug Alcohol Depend. 2004;76(suppl):S53-S67. doi:10.1016/j.drugalcdep.2004.08.007PubMedGoogle ScholarCrossref
59.
Wilkinson  AL, Halpern  CT, Herring  AH.  Directions of the relationship between substance use and depressive symptoms from adolescence to young adulthood.  Addict Behav. 2016;60:64-70. doi:10.1016/j.addbeh.2016.03.036PubMedGoogle ScholarCrossref
60.
Windle  M, Wiesner  M.  Trajectories of marijuana use from adolescence to young adulthood: predictors and outcomes.  Dev Psychopathol. 2004;16(4):1007-1027. doi:10.1017/S0954579404040118PubMedGoogle ScholarCrossref
61.
Womack  SR, Shaw  DS, Weaver  CM, Forbes  EE.  Bidirectional associations between cannabis use and depressive symptoms from adolescence through early adulthood among at-risk young men.  J Stud Alcohol Drugs. 2016;77(2):287-297. doi:10.15288/jsad.2016.77.287PubMedGoogle ScholarCrossref
62.
American Psychiatric Association.  Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.
63.
Viswanathan  M, Berkman  ND.  Development of the RTI item bank on risk of bias and precision of observational studies.  J Clin Epidemiol. 2012;65(2):163-178. doi:10.1016/j.jclinepi.2011.05.008PubMedGoogle ScholarCrossref
64.
Nikolakopoulou  A, Mavridis  D, Salanti  G.  How to interpret meta-analysis models: fixed effect and random effects meta-analyses.  Evid Based Ment Health. 2014;17(2):64. doi:10.1136/eb-2014-101794PubMedGoogle ScholarCrossref
65.
Lipsey  MW, Wilson  DB.  Practical Meta-analysis. Thousand Oaks, CA: Sage Publications; 2001.
66.
Viechtbauer  W.  Conducting meta-analyses in R with the metafor package.  J Stat Softw. 2010;36(3):1-48. doi:10.18637/jss.v036.i03Google ScholarCrossref
67.
Schneeweiss  S, Rassen  JA, Glynn  RJ, Avorn  J, Mogun  H, Brookhart  MA.  High-dimensional propensity score adjustment in studies of treatment effects using health care claims data.  Epidemiology. 2009;20(4):512-522. doi:10.1097/EDE.0b013e3181a663ccPubMedGoogle ScholarCrossref
68.
Harder  VS, Stuart  EA, Anthony  JC.  Adolescent cannabis problems and young adult depression: male-female stratified propensity score analyses.  Am J Epidemiol. 2008;168(6):592-601. doi:10.1093/aje/kwn184PubMedGoogle ScholarCrossref
69.
Otten  R, Engels  RC.  Testing bidirectional effects between cannabis use and depressive symptoms: moderation by the serotonin transporter gene.  Addict Biol. 2013;18(5):826-835. doi:10.1111/j.1369-1600.2011.00380.xPubMedGoogle ScholarCrossref
70.
Borges  G, Bagge  CL, Orozco  R.  A literature review and meta-analyses of cannabis use and suicidality.  J Affect Disord. 2016;195:63-74. doi:10.1016/j.jad.2016.02.007PubMedGoogle ScholarCrossref
71.
Brody  DJ, Pratt  LA.  J H. Prevalence of depression among adults aged 20 and over: United States, 2013–2016. Hyattsville, MD: National Center for Health Statistics; 2018.
72.
Vespa  J.  The Changing Economics and Demographics of Young Adulthood: 1975-2016. Suitland, MD: US Department of Commerce Economics and Statistics Administration, US Census Bureau; 2017.
73.
Lorenzetti  V, Solowij  N, Yücel  M.  The Role of cannabinoids in neuroanatomic alterations in cannabis users.  Biol Psychiatry. 2016;79(7):e17-e31. doi:10.1016/j.biopsych.2015.11.013PubMedGoogle ScholarCrossref
74.
Gilman  JM, Kuster  JK, Lee  S,  et al.  Cannabis use is quantitatively associated with nucleus accumbens and amygdala abnormalities in young adult recreational users.  J Neurosci. 2014;34(16):5529-5538. doi:10.1523/JNEUROSCI.4745-13.2014PubMedGoogle ScholarCrossref
75.
Rubino  T, Realini  N, Braida  D,  et al.  Changes in hippocampal morphology and neuroplasticity induced by adolescent THC treatment are associated with cognitive impairment in adulthood.  Hippocampus. 2009;19(8):763-772. doi:10.1002/hipo.20554PubMedGoogle ScholarCrossref
76.
ElSohly  MA, Mehmedic  Z, Foster  S, Gon  C, Chandra  S, Church  JC.  Changes in cannabis potency over the last 2 decades (1995-2014): analysis of current data in the United States.  Biol Psychiatry. 2016;79(7):613-619. doi:10.1016/j.biopsych.2016.01.004PubMedGoogle ScholarCrossref
77.
Faggiano  F, Vigna-Taglianti  FD, Versino  E, Zambon  A, Borraccino  A, Lemma  P.  School-based prevention for illicit drugs’ use.  Cochrane Database Syst Rev. 2005;(2):CD003020.PubMedGoogle Scholar
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close