Associations Between Major Depressive Episodes, Sociodemographic Factors, and Past-Year Marijuana Use Among U.S. Adolescents: A Cross-Sectional Study.

Background: The decriminalization of cannabis in multiple states within the United States and the increasing societal approval of its non-medical consumption has notable implications for public health, particularly among the youth population. This study aimed to examine the relationship between previous major depressive episodes (MDE) and sociodemographic factors with marijuana consumption in the past year among adolescents in the United States. Methodology: Retrospective, cross-sectional design utilizing data from the 2021 US NSDUH report. The sample consisted of 10,315 adolescents aged 12-17. The primary outcome measure was past-year daily/near-daily marijuana use (≥300 days). Chi-square test explored relationships between exposure variables and marijuana use. Logistic regression identified predictors of marijuana use. Level of significance was p<0.05. Results: About half were male (51.6%), middle schoolers (54.3%), and White (50.5%). Prevalence of marijuana use and MDE was 10.4% and 19.9%, respectively. Independent associations for marijuana use include MDE (adjusted OR = 2.05; CI: 1.54-2.73; p < 0.001), increasing age (adjusted OR = 3.19 – 6.52; p = 0.001), high school education (adjusted OR=1.70; 95% CI: 1.14-2.53; p = 0.010), worsening general health (adjusted OR = 1.58 – 2.11; p < 0.001) and income levels greater than two times below the poverty threshold (aOR = 2.30; 95% CI: 1.22 - 4.32; p=0.011). Conclusion: The findings from this study are fundamental for health promotion efforts and intervention programs to reduce the occurrence of depression and marijuana use in adolescents. However, although the findings of the study may be generalized to the US population, the primary outcome measure of ≥300-day past-year daily/near-daily marijuana use may exclude occasional users with heavy cannabis consumption on a less frequent basis who are also at risk of developing adverse cannabis effects, including cognitive deficits and cannabis use disorder.