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Rapid increase in the prevalence of cannabis use among persons with depression in the U.S., 2005-2017: the role of differentially changing risk perceptions.

AIMS
To estimate trends in the prevalence of cannabis use and risk perceptions of cannabis use from 2005-2017 among United States (U.S.) persons with and without depression.


DESIGN
Linear time trends of the prevalence of any, daily, and non-daily past-30-day cannabis use and perceived great risk associated with regular cannabis use (outcome variables) among persons with and without past-year depression were assessed using logistic regression with survey year as the predictor. All analyses were adjusted for gender, age, race/ethnicity, and income; models assessing time trends of cannabis use prevalence were also adjusted for perceived risk.


SETTING
The United States: National Survey on Drug Use and Health, an annual cross-sectional survey, 2005-2017 public use data files.


PARTICIPANTS
728,691 persons age ≥12 years.


MEASUREMENTS
Self-report of any, daily, and non-daily past-30-day cannabis use and perceived great risk associated with regular cannabis use.


FINDINGS
The prevalence of any, daily, and non-daily cannabis use in the past month was higher among those with depression versus those without (e.g., 2017 for any use: 18.94% vs. 8.67%; adjusted odds ratio (aOR)=2.17 (95% confidence interval (CI)=1.92, 2.45)). Any, daily, and non-daily cannabis use increased among persons with and without depression from 2005-2017, yet the increase in any (aORs=1.06 vs. 1.05; p=0.008) and daily (aORs=1.10 vs. 1.07; p=0.021) cannabis use adjusted for sociodemographic characteristics was more rapid among those with depression. Perception of great risk associated with regular cannabis use was significantly lower among those with depression (p<0.001) and decreased significantly more rapidly over the study period among persons with depression, compared with those without (aORs=0.89 vs. 0.92; p<0.001).


CONCLUSIONS
The prevalence of cannabis use in the U.S. increased from 2005 to 2017 among persons with and without depression and was approximately twice as common among those with depression. Persons with depression experienced a more rapid decrease in perception of risk, which may be related to the more rapid increase in any and daily past-month cannabis use in this group.