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Medical cannabis authorization associated with higher risk of depressive disorders

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Ontario findings highlight ‘the need for a careful risk-benefit assessment when authorizing cannabis’

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Medical cannabis authorization appears to be associated with an increased risk of depressive disorders, suggests a new Canadian study.

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Depression, or major depressive disorder, causes a persistent feeling of sadness and loss of interest, according to Mayo Clinic. The condition can affect how a person feels, thinks and behaves, sometimes leading to a variety of emotional and physical problems.

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  1. Patients seeking medical cannabis for either anxiety or depression saw improved outcomes over time. /

    Canadian patients using cannabis to treat anxiety and depression experienced improved outcomes: study

  2. Investigators wanted to see if there was any change in depression rating from baseline to week three and beyond. /

    Researchers report single synthetic psilocybin dose reduces depression symptoms

  3. none

    Worse mental health linked to weed use among young Canadians

With medical use of cannabis seemingly on the rise, investigators out of Quebec, Ontario and Alberta wanted to find out if users have a higher risk of emergency department (ED) visits and hospitalization for depressive disorders.

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To shed some light on the issue, they considered patients who had received medical authorization to use cannabis from 2014 to 2019 in Ontario, ultimately analyzing 54,006 cannabis-authorized patients and 161,265 controls. Of that total, 16 per cent had a history of anxiety or mood disorders, notes the study published this week in Psychiatry Research.

While the interaction between sex (or age) and exposure was not significant, study authors write, medical cannabis authorization was linked to a greater 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,” they emphasize.

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Health Canada reports the number of medical client registrations with federally licensed sellers fell four per cent from 257,059 in December 2021 to 247,548 in March 2022.

Additionally, the number of individuals registered for personal and designated cultivation of cannabis for their own medical purposes decreased 14 per cent from 41,760 to 35,754 over that same period.

It is not clear if medicinal marijuana users are turning to recreational weed for relief. A study involving respondents from both Canada and the U.S. found “a substantial proportion of the North American population self-reported cannabis use for medical purposes for a variety of medical reasons, including those living in jurisdictions without legal markets.”

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U.S. findings, published in 2019 and involving data from 169,036 participants in 2016 and 2017, showed that “compared with adults without medical conditions, adults with medical conditions had a significantly higher prevalence of current and daily marijuana use, were more likely to report using marijuana for medical reasons and were less likely to report using marijuana for recreational purposes.”

Authors of the latest study point out the safety of medicinal cannabis, particularly for mental health conditions, has not yet been clearly established.

According to the National Institute on Drug Abuse, “several studies have linked marijuana use to increased risk for psychiatric disorders, including psychosis (schizophrenia), depression, anxiety and substance use disorders,” although the agency makes clear that any causal connection “is not always easy to determine.”

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A study published in 2020 suggested that using high-potency cannabis is associated with mental health and addiction, while another one released in 2022 found immediate acquisition of a medical marijuana card led to a higher incidence and severity of cannabis use disorder, resulted in no significant improvement in pain, anxiety or depressive symptoms and improved self-rating of insomnia symptoms.

That said, results of an online survey of medicinal cannabis users show that most participants reported benefits from cannabis use for a variety of conditions where traditional treatments were ineffective or unacceptable. There were, however, concerns voiced regarding the side-effects of weed, legality, lack of information and cost.

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