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Changes in Mental Health as a Predictor of Marijuana Coping Motives and Consequences: Examining the Impact of COVID-19 on College Students

Background: The spread of COVID-19 has increased anxiety and depression (Khan et al., 2020), especially among college students (Wang et al., 2020). Several theoretical models focus on the impact of poor mental health on marijuana outcomes, largely via coping motives (Cooper et al., 2016). College students may be turning to marijuana to cope with the mental health problems that COVID-19 has exacerbated. The present study compared students who reported increases in anxiety and depression since COVID-19 stay-at-home orders to those who reported no change in anxiety and depression on marijuana coping motives, use frequency, and negative consequences. Specifically, we examined whether self-reported changes (i.e., group that indicated increases) in poor mental health during COVID-19 were associated with problematic marijuana use via higher marijuana coping motives. Method: Students were recruited to participate in an online study examining the effects of COVID-19 on mental health and substance use between Fall 2020 - Spring 2021. Given aims of the present study, our analytic sample was limited to 300 students that reported past-month marijuana use and completed measures of changes in mental health due to COVID-19 (single item each for depression and anxiety), measure of general depression/anxiety, and measures of marijuana use, motives, and negative consequences. Among our analytic sample, a majority of participants identified as being White (61.0%), female (71.3%), college freshman (46.8%), and reported a mean age of 20.36 (Median = 19.00; SD = 3.78) years. To test study aims, we conducted two mediation models (changes in depression [Model 1] or anxiety [Model 2] due to COVID-19→marijuana coping motives→ marijuana consequences) using the PROCESS Macro (Hayes, 2013) in SPSS. Results: Within our analytic sample, we found that 58% of students reported increases in depression since COVID-19 stay-at-home orders, with the remainder (42%) reporting no change. For anxiety, trends were similar, with 63.6% indicating increases in anxiety due to COVID-19, with the remainder (36.4%) reporting no change. Within both of our mediational models, we found support for coping motives mediating the effects of changes in mental health on marijuana problems (depression model: indirect effect = 0.65, 95% CIs = 0.29, 1.08; anxiety model: indirect effect = 0.57, 95% CIs = 0.22, 0.98). Specifically, we found that students reporting an increase in anxiety/depression (compared to those that indicated their mental health remained the same) reported more marijuana problems via higher marijuana use coping motives. It is important to note that we found these effects even when controlling for past month marijuana use frequency and past 2-week depression/anxiety levels (assessed via DASS-21). Conclusions: We found that in young adults, increases in levels of anxiety and depression due to COVID-19 were associated with higher problematic marijuana use through higher motivation to use marijuana to cope. Future prevention/interventions efforts targeting problematic marijuana use may benefit from considering changes to mental health before or during major events like COVID-19.