Association between Non-Medical Cannabis Use and Anxiety Disorders in Women

Research Article

J Community Med Health Care. 2021; 6(2): 1050.

Association between Non-Medical Cannabis Use and Anxiety Disorders in Women

Ordean A1,2*, Pollieri E1 and Giby K1

1Department of Family and Community Medicine, St. Joseph’s Health Centre, Unity Health Toronto, Canada

2Department of Family and Community Medicine, University of Toronto, Canada

*Corresponding author: Ordean A, Department of Family Medicine, St. Joseph’s Health Centre, Unity Health Toronto, 30 The Queensway, Toronto, ON M6R 1B5, Canada

Received: July 08, 2021; Accepted: August 10, 2021; Published: August 17, 2021


Introduction: Non-medical cannabis use and anxiety disorders are highly prevalent among Canadian women; however, the direction of this assocation remains controversial. The objective of this article is to provide an evidencebased update regarding the effect of non-medical cannabis on anxiety symptoms in women.

Methods: A literature search was conducted using PsychINFO and MEDLINE for articles related to cannabis and marijuana use among women with anxiety or anxiety disorders. Only English language literature from 2010 to 2020 was reviewed. Studies including patients under the age of 18 and studies addressing medical cannabis were excluded. Four studies met our inclusion criteria for this review.

Results: Cannabis use and anxiety disorders are both highly prevalent among young women. Other substance use in addition to cannabis is frequently reported by women. Reasons for cannabis use by women with anxiety differed from those of men. Findings did not show a direct association between cannabis use and anxiety symptoms. Women who used cannabis did not report higher rates of anxiety nor did anxiety predict the onset of cannabis use.

Conclusion: There is no evidence to indicate that non-medical cannabis use worsens anxiety symptoms among women. Further studies should focus on reducing potential confounding factors and developing a reliable method of quantifying cannabis use in order to determine the direction of the interaction between cannabis and anxiety disorders among women.

Keywords: Cannabis; Anxiety; Women’s health


NSDUH: National Survey on Drug Use and Health; THC: Delta- 9-Tetrahydrocannabinol


Cannabis is the most commonly used psychoactive substance in North America. Key findings from the 2019 NSDUH show that past month cannabis use significantly increased to 7.6% from 5.1% in 2016 among adult women aged 26 and older [1]. However, cannabis use disorder increased to 2.8% among women aged 12 to 17 years and 4.8% of those aged 18 to 25 years. In Canada, approximately 11% of women reported past year cannabis use in 2017 with highest rates among those aged 18 to 24 years [2]. While motives to use cannabis differ, reducing anxiety is a common reason especially among female cannabis users [3,4]. THC, is the main psychoactive ingredient in cannabis and has been associated with the acute effects of cannabis specifically anxiety secondary to its effect on serotonin and noradrenaline [5]. The average concentration of THC in cannabis has increased significantly since 2010 and therefore, more pronounced acute and chronic effects may be seen among current users [6]. Data addressing the sex differences in cannabis use found that more women reported increased anxiety as an acute effect of cannabis use and more women experienced anxiety during withdrawal [7,8]. Although cannabis use is more prevalent among women with anxiety disorders, the evidence about its association with anxiety is not as robust. The debate continues whether cannabis use is associated with the development of anxiety disorders and whether cannabis has an anxiogenic response in patients with anxiety disorders [9]. Recent meta-analyses have found mixed results regarding the directionality of the association of cannabis use with anxiety symptoms in the general population which makes it difficult to decide whether anxiety is a precursor to cannabis use or whether cannabis is used for its stress-relieving properties [10,11]. Furthermore, meta-analyses have not addressed sex-specific differences in the association between nonmedical cannabis use and anxiety. The objective of this review article is to determine if there is an association between non-medical cannabis use and anxiety symptoms among women.


We conducted a literature search in PsychINFO and MEDLINE using the following MESH headings and key words: cannabis or marijuana AND anxiety or anxiety disorders or mental health AND female. For the purpose of this review, anxiety was used as an umbrella term to include any type of anxiety disorder. References of articles were also reviewed for additional studies. Only English language literature from 2010 to 2020 was reviewed. Studies were included if they provided results for women specifically. We decided to exclude studies prior to 2010 due to evidence showing that the potency of THC has increased significantly from 2010 onwards. Studies that enrolled persons under the age 18 and studies focused on medical cannabis were excluded.


Only four articles met our inclusion criteria [12-15]. All four studies attempted to control for the presence of confounding factors such as other drug use, and psychiatric co-morbidities by excluding participants with psychosis, high risk suicidal behaviors and severe psychopathology. Summary demographics for each study is presented in Table 1. One study recruited only women participants while in the other three studies, women represented at least 40% of the study population. The mean age of participants ranged from 18 to 34 years.

Citation: Ordean A, Pollieri E and Giby K. Association between Non-Medical Cannabis Use and Anxiety Disorders in Women. J Community Med Health Care. 2021; 6(2): 1050.