Cannabis and binge alcohol use among older individuals with major depressive episode

Abstract

Background: Research shows significant associations of major depression with cannabis and binge alcohol use. However, despite increasing cannabis and binge alcohol use rates among the 50+ age group, research on this age group is scant. Methods: We used the 2015–2019 National Survey on Drug Use and Health data (n = 44,007 age 50+) and multinomial logistic regression models to examine associations of a major depressive episode (MDE) with cannabis and binge alcohol use and co-use and associations of binge alcohol use with nonmedical and medical cannabis use. Results: Of individuals age 50+, 89.6% had no history of MDE, 5.7% had prior-to-past-year MDE, and 4.7% had past-year MDE. The rates of past-month cannabis use were 4.3%, 7.7%, and 11.6% and binge alcohol use were 17.3%, 18.7%, and 19.9% among those with no MDE history, prior-to-past-year MDE, and past-year MDE, respectively. Compared to no MDE history, prior-to-past-year MDE (RRR = 1.70, 95% CI = 1.30–2.23) and past-year MDE (RRR = 1.80, 95% CI = 1.27–2.55) were significantly associated with past-month cannabis use (with or without binge alcohol use). However, MDE status was not associated with past-month binge alcohol use. Among cannabis users, binge alcohol use was significantly associated with nonmedical cannabis use only (RRR = 2.50, 95% CI = 1.95–3.21). Users of cannabis and/or binge alcohol also had a higher likelihood of using tobacco products and illicit drugs. Conclusions: Healthcare professionals treating individuals age 50+ with depression should screen for substance use, provide education on the potential adverse effects of polysubstance use, and help them access treatment for co-occurring depression and substance use problems.

Keywords:

• Depression
• medical cannabis use
• binge alcohol use
• antidepressants
• mental health treatments

Authors’ contributions

NGC, BYC, and DMD conceptualized the study. NGC and BYC conducted the literature review. NGC conducted the statistical analysis, and NGC and BYC jointly drafted the paper. DMD reviewed and edited the paper. CNM provided consulting for and review of statistical analyses

Disclosure statement

No potential conflict of interest was reported by the authors. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

This research was supported by a grant, [P30AG066614], awarded to the Center on Aging and Population Sciences at The University of Texas at Austin by the National Institute on Aging.