National Epidemiologic Survey Analyzes Cannabis Use and Social Anxiety

A team of experts analyzed the data from the 2001-2002 National Epidemiologic Survey on Alcohol and Drug Related Conditions (NESARC) and found that many individuals with cannabis use disorder (CUD) have social anxiety disorder (SAD) as well. The study also concluded that comorbid SAD is related to a greater severity of cannabis-related issues. The team consisted of Dr. Julia D. Buckner from Louisiana State University, Dr. Richard G. Heimberg at Temple University, Dr. Franklin Schneier at Columbia University, and a team from the New York State Psychiatric Institute led by Dr. Carlos Blanco. 

According to NIDA, “Of the 43,093 respondents to the survey, 3,297 (7.6 percent) reported having had drug problems consistent with CUD at some time in their lives” (2013). Of the respondents with CUD, 340 (10.3 percent) reported having had social anxiety severe enough to warrant a diagnosis of SAD. Eighty percent of the respondents with comorbid CUD-SAD stated that their social anxiety preceded their cannabis use, and 15 percent reported cannabis use preceding social anxiety. 

Dr. Bruckner and her colleagues identified two “pathways”—which uphold and aggravate each other—that could potentially lead to comorbidity of CUD and SAD. In the first pathway, individuals develop CUD as a result of self-medicating to ease social anxiety. In the second, uncontrolled cannabis use leads to social difficulties and SAD (NIDA, 2013). According to the researchers, it is of paramount concern to identify whether these pathways really do exist in order to effectively treat people suffering from CUD and SAD. 

The following are additional findings from the survey: 

• Twenty-one percent of the respondents who met the criteria for cannabis dependence also had SAD.
• Of those respondents who met the criteria for cannabis abuse, 8.5 percent also had SAD. 
• Individuals with cannabis dependence had a 1.6 percent higher chance of having SAD than an individual with cannabis abuse issues. 
• More than 99 percent of respondents with comorbid CUD and SAD reported symptoms that met the criteria for at “at least one other psychiatric disorder,” according to NIDA (2013). 

Dr. Bruckner stated that successfully treating an individual with CAD has to involve screenings for comorbid SAD, because ignoring any issues aside from a substance use disorder can present problems for treatment. “Research suggests that socially anxious people may be less likely to participate in group therapy or seek a sponsor,” she states, adding that “higher levels of anxiety at the end of CUD treatment have been shown to lead to higher rate of relapse” (NIDA, 2013). 

National Institute on Drug Abuse (NIDA). (2013). Study parses comorbidity of cannabis use and social anxiety. NIDA Notes. Retrieved from http://www.drugabuse.gov/news-events/nidanotes/2013/10/study-parses-comorbidity-cannabis-use-social-anxiety?utm_source=Updates&utm_medium=MailChimp&utm_content=12.17.2013&utm_campaign=NIDANotes