A recent increase in the rate of cannabis use by American adolescents and young adults has been compounded by greater drug availability and enhanced societal acceptance. As the movement towards legalization gains momentum, some researchers and clinicians have become increasingly concerned about negative physical and mental health outcomes associated with cannabis use, particularly in young people. In a recent review of the literature, Volkow and colleagues identified major depressive disorder (MDD) as a key outcome associated with cannabis use and misuse. In addition to depression, cannabis use and misuse pose numerous risks for suicidal thoughts and behaviors (STB). Given the relatively common nature of these psychiatric outcomes, if cannabis use truly contributes to MDD and STB, the public health impact of cannabis, particularly if recreational use is legalized, could be substantial. In response to PAS-14-020, encouraging population-based research on social, behavioral, and health outcomes of marijuana involvement, this 3-year application utilizes existing data (as encouraged by the PAS) and comprehensively examines the relationship between cannabis involvement, MDD and STB using longitudinal analyses at both the state- and person- levels. Using nationally representative state-level data, Aim 1 will examine whether key aspects of medical marijuana policies that are known to influence cannabis use as well as cannabis use characteristics are associated with MDD and STB, as well as state-level data on suicide completion, after accounting for confounding factors. Utilizing an individual-level developmental perspective, Aim 2 will employ data from three large and ethnically diverse datasets of twins and siblings (baseline N=8561) that span early adolescence (age 12-15) to young adulthood (ages 17-25), to examine the longitudinal relationship between cannabis involvement, MDD and STB using between-group (e.g. cannabis users vs. non-users) and within-person across-time approaches. Finally, given robust support for heritable influences on cannabis involvement, MDD and STB, Aim 3 will use data on 13,791 adult twins to examine whether after accounting for the genetic overlap (which we have demonstrated) between cannabis involvement, MDD and STB, there is an elevated likelihood of MDD and STB in twins who report cannabis involvement (ever, early, frequent and problem use) relative to their unexposed co-twin. The use of complementary state- and person-level analyses will allow us to fully examine which aspects of cannabis involvement specifically influence MDD and STB with longitudinal data affording tests of causation and reverse-causation as well as shared liabilities. This integrative approach will inform policy discussion regarding key sources of morbidity and mortality associated with cannabis use and misuse.

Public Health Relevance

As rates of cannabis use increase in youth, there are growing concerns regarding mental health consequences associated with it. This application uses state and person level analyses to examine the relationship between cannabis involvement and depression as well as suicidal thoughts and behaviors, utilizing large-scale nationally representative data as well as longitudinal data on related individuals that allows for control of genetic background.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
1R01DA040411-01
Application #
8985951
Study Section
Risk, Prevention and Intervention for Addictions Study Section (RPIA)
Program Officer
Schulden, Jeffrey D
Project Start
2015-05-01
Project End
2018-03-31
Budget Start
2015-05-01
Budget End
2016-03-31
Support Year
1
Fiscal Year
2015
Total Cost
$381,250
Indirect Cost
$131,250
Name
Washington University
Department
Psychiatry
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Johnson, Emma C; Tillman, Rebecca; Aliev, Fazil et al. (2018) Exploring the relationship between polygenic risk for cannabis use, peer cannabis use, and the longitudinal course of cannabis involvement. Addiction :
Salloum, Naji C; Krauss, Melissa J; Agrawal, Arpana et al. (2018) A reciprocal effects analysis of cannabis use and perceptions of risk. Addiction 113:1077-1085
Luby, Joan L; Agrawal, Arpana; Belden, Andy et al. (2018) Developmental Trajectories of the Orbitofrontal Cortex and Anhedonia in Middle Childhood and Risk for Substance Use in Adolescence in a Longitudinal Sample of Depressed and Healthy Preschoolers. Am J Psychiatry 175:1010-1021
Grucza, Richard A; Vuolo, Mike; Krauss, Melissa J et al. (2018) Cannabis decriminalization: A study of recent policy change in five U.S. states. Int J Drug Policy 59:67-75
Grucza, R A; Krueger, R F; Agrawal, Arpana et al. (2018) Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: a unitary trend? Psychol Med 48:1494-1503
Agrawal, Arpana; Rogers, Cynthia E; Lessov-Schlaggar, Christina N et al. (2018) Alcohol, Cigarette, and Cannabis Use Between 2002 and 2016 in Pregnant Women From a Nationally Representative Sample. JAMA Pediatr :
Agrawal, Arpana; Nelson, Elliot C; Bucholz, Kathleen K et al. (2017) Major depressive disorder, suicidal thoughts and behaviours, and cannabis involvement in discordant twins: a retrospective cohort study. Lancet Psychiatry 4:706-714
Agrawal, Arpana; Tillman, Rebecca; Grucza, Richard A et al. (2017) Reciprocal relationships between substance use and disorders and suicidal ideation and suicide attempts in the Collaborative Study of the Genetics of Alcoholism. J Affect Disord 213:96-104
Smolkina, M; Morley, K I; Rijsdijk, F et al. (2017) Cannabis and Depression: A Twin Model Approach to Co-morbidity. Behav Genet 47:394-404
Grucza, Richard A; Agrawal, Arpana; Krauss, Melissa J et al. (2016) Declining Prevalence of Marijuana Use Disorders Among Adolescents in the United States, 2002 to 2013. J Am Acad Child Adolesc Psychiatry 55:487-494.e6

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