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. 2023 Feb:320:115047.
doi: 10.1016/j.psychres.2022.115047. Epub 2023 Jan 2.

Risk of depressive disorders associated with medical cannabis authorization: A propensity score matched cohort study

Jerry Liwono Yana  1 , Cerina Lee  2 , Dean T Eurich  2 , Jason R B Dyck  3 , John G Hanlon  4 , Arsène Zongo  5
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Risk of depressive disorders associated with medical cannabis authorization: A propensity score matched cohort study

Jerry Liwono Yana et al. Psychiatry Res. 2023 Feb.

Abstract

There is an increase in the medical use of cannabis. However, the safety of medical cannabis, particularly for mental health conditions, has not yet been clearly established. Thus, this study assessed the risk of emergency department (ED) visits and hospitalization for depressive disorders among medical cannabis users. We conducted a retrospective longitudinal cohort study of patients who received medical authorization to use cannabis from 2014 to 2019 in Ontario, matched (1:3 ratio) to population-based controls using propensity scores. Conditional Cox regressions were used to assess the association between cannabis authorization and the outcome. A total of 54,006 cannabis-authorized patients and 161,265 controls were analyzed. Approximately 39% were aged under 50 years, 54% were female, and 16% had a history of anxiety or mood disorders. The adjusted hazard ratio (aHR) for depressive disorders was 2.02 (95%CI: 1.83-2.22). The aHR was 2.23 (1.95-2.55) among subjects without prior mental health disorders. The interaction between sex (or age) and exposure was not significant. In conclusion, medical cannabis authorization was associated with an increased risk of depressive disorders. This finding highlights the need for a careful risk-benefit assessment when authorizing cannabis, particularly for patients who seek cannabis to treat a depressive condition.

Keywords: Depression; Depressive disorders; Emergency department visit; Hospitalization; Longitudinal cohort study; Medical cannabis.

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Conflict of interest statement

Declaration of Competing Interest JRBD was a former member on the board of directors of Aurora Cannabis Inc., which is a for-profit, company licensed for the cultivation and sale of medical cannabis. JRBD has a financial interest in Aurora Cannabis Inc. DTE, JRBD and AZ (as post-doctoral fellow) held a Mitacs Grant with Aurora as a partner. Mitacs is a national, not-for-profit organization that works with universities, private companies, and both federal and provincial governments, to build partnerships and administer research funding that supports industrial and social innovation in Canada. JLY, CL, AZ, DTE do not have any past or present financial interest in the companies involved; and have no conflicts of interest to declare. Moreover, the above-mentioned entities, research funders and companies listed were not involved in any aspect of the design or write-up of the study and all analysis was performed independent from the funders and companies.

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