Depressive and Anxiety Symptoms Moderate Cannabis Use Disorder Treatment Effects: A Randomized Clinical Trial with Young Adults

Compared to other US age groups, young adults (ages 18–25) have the highest past-year prevalence of cannabis use disorder (CUD, 14.4%), major depressive disorder (MDD, 18.6%), and general anxiety disorder (GAD, 19.5%). Research is needed to determine whether affective disorders moderate CUD treatment. We tested whether the effects of a CUD treatment were dependent on MDD and GAD with 1078 US young adults using a clinical trial design. Participants were randomized to peer network counseling text, a text message delivered, motivational interviewing-informed treatment, or a wait-list control condition. Moderation analyses revealed that treatment participants with subthreshold MDD or GAD significantly reduced cannabis use compared to those meeting the criteria for MDD or GAD. For those meeting MDD or GAD criteria, the intervention had no significant effects. The results of this trial support the value of assessing and addressing depression and anxiety when treating young adults for CUD. Clinical Trial Registration NCT04567394.