Association of Marijuana Use With Psychological Distress Among Adults in United States

Purpose: Determine the association of marijuana use with serious psychological distress (SPD) among adults aged 18 years or older using a large, nationally representative sample of US households. Design: Cross-sectional analysis. Setting: Data from the National Survey on Drug Use and Health, 2021. Subjects: 47,247 respondents representing 253.7 million adults (age>18 years) in the US. Measures: Marijuana use was categorized as (1) None, (2) within the past month, (3) within 1 year, and (4) more than a year ago from the interview time. SPD was measured with the Kessler-6 distress scale. Analysis: Bivariable and multivariable logistic regression analyses accounting for complex survey designs were conducted. Results: Among adults in the US, 50.9% never used marijuana, 13.7%, 6.0%, and 29.4% reported marijuana use in the past month, in the past year, and more than a year ago, respectively. Individuals using marijuana within the past month, within a year, and more than a year ago reported higher past month SPD (15.3%, 13.5%, and 6.8%, respectively) than never-users (4.9%). Adjusted logistic regression analysis revealed that marijuana use in the past month, past year (1-12 months), and over a year ago is associated with higher SPD (AOR [95% CI] = 2.06 [1.72, 2.45]; 1.82 [1.50, 2.21]; 1.53 [1.26, 1.87], respectively) compared to no marijuana use. Conclusion: Adults who used marijuana more recently were more likely to report SPD.