Associations Of Cannabis Use Research Articles

Cannabis Use and Brain Volume in Adolescent and Young Adult Cannabis Users: Effects Moderated by Sex and Aerobic Fitness.

Studies examining the impact of adolescent and young adult cannabis use on structural outcomes have been heterogeneous. One already-identified moderator is sex, while a novel potential moderator is extent of aerobic fitness. Here, we sought to investigate the associations of cannabis use, sex, and aerobic fitness levels on brain volume. Second, we explored brain-behavior relationships to interpret these findings. Seventy-four adolescents and young adults (36 cannabis users and 38 controls) underwent 3 weeks of monitored cannabis abstinence, aerobic fitness testing, structural neuroimaging, and neuropsychological testing. Linear regressions examined cannabis use and its interaction with sex and aerobic fitness on whole-brain cortical volume and subcortical regions of interests. No main-effect differences between cannabis users and nonusers were observed; however, cannabis-by-sex interactions identified differences in frontal, temporal, and paracentral volumes. Female cannabis users generally exhibited greater volume while male users exhibited less volume compared to same-sex controls. Positive associations between aerobic fitness and frontal, parietal, cerebellum, and caudate volumes were observed. Cannabis-by-fitness interaction was linked with left superior temporal volume. Preliminary brain-behavior correlations revealed that abnormal volumes were not advantageous in either male or female cannabis users. Aerobic fitness was linked with greater brain volume and sex moderated the effect of cannabis use on volume; preliminary brain-behavior correlations revealed that differences in cannabis users were not linked with advantageous cognitive performance. Implications of sex-specific subtleties and mechanisms of aerobic fitness require large-scale investigation. Furthermore, present findings and prior literature on aerobic exercise warrant examinations of aerobic fitness interventions that aimed at improving neurocognitive health in substance-using youth.

Associations of cannabis use, opioid use, and their combination with serious psychological distress among Ontario adults.

Considering the widespread use of cannabis and opioids, examining the use of cannabis, opioids and their combination with serious psychological distress (SPD) is important. A total of N=12,358 adults participating in the Monitor surveillance study between 2014 and 2019 were included. Cannabis and opioid use reflected any use of the substances in the past 12 months. SPD was defined as having a score of 13 or more on the Kessler-6 questionnaire, a 6-item scale that includes feeling nervous, hopeless, restless or fidgety, sad or depressed. Odds ratios (ORs) were estimated from logistic regression models accounting for complex survey design and sociodemographic factors. Overall, 12.8% of the sample reported cannabis use only, 18% reported opioid use only, and 4.9% reported both cannabis and opioid use. Use of both cannabis and opioids was significantly associated with SPD in both women (OR=4.24; 95% CI, 2.34 to 7.69), and in men (OR=2.99; 95% CI, 1.56 to 5.73) compared to use of neither. The joint association of cannabis and opioids with SPD was additive. Addressing those who use both cannabis and opioids may help reduce the burden of SPD among adults in Ontario.

The Medico-economic Impacts of Marijuana Use on the Outcomes and In-hospital Mortality in Patients with Atrial Fibrillation – Nationwide Database study

Introduction Cannabinoid users are at high risk of developing atrial arrhythmias. We sought to investigate the outcomes and the economic impact of marijuana use on patients with atrial fibrillation utilizing the National Inpatient Sample. Materials and Methods Patients with atrial fibrillation were identified in the National Inpatient Sample (NIS) database between 2012 and 2014 using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), who subsequently were divided into two groups, those with and without marijuana smoking. The primary outcome was all-cause in-hospital mortality in the two groups. Secondary outcomes were in-hospital morbidities, required procedures and complications. We also evaluated the length of hospital stay and the cost of hospitalization. Logistic regression model was performed to address potential confounding factors. Results: The marijuana-users group had no significant increase of in-hospital mortality (OR: 1.24; 95% CI: 0.51 - 3.01, p = 0.632). However, marijuana users were predominantly younger males and less likely to undergo cardiac surgery (OR: 0.54, 95% CI 0.37 - 0.78, p = 0.001). Moreover, marijuana users are more likely to have a lower cost of hospitalization when compared to non-users ($28,916 vs $32,303, p = 0.001). Conclusion: Cannabinoid use was not associated with an increase in mortality among patients admitted with atrial fibrillation. However, marijuana users were younger, had fewer comorbidities, and cardiac surgeries with associated lower hospitalization costs. Admittedly, given the growing popularity of these products, further large prospective studies are needed to investigate the safety and evaluate different integral associations of cannabis use with worse cardiac outcomes in atrial arrhythmias patients, particularly those with atrial fibrillation.

Associations of cannabis use disorder with cognition, brain structure, and brain function in African Americans.

Although previous studies have highlighted associations of cannabis use with cognition and brain morphometry, critical questions remain with regard to the association between cannabis use and brain structural and functional connectivity. In a cross‐sectional community sample of 205 African Americans (age 18–70) we tested for associations of cannabis use disorder (CUD, n = 57) with multi‐domain cognitive measures and structural, diffusion, and resting state brain‐imaging phenotypes. Post hoc model evidence was computed with Bayes factors (BF) and posterior probabilities of association (PPA) to account for multiple testing. General cognitive functioning, verbal intelligence, verbal memory, working memory, and motor speed were lower in the CUD group compared with non‐users (p < .011; 1.9 < BF < 3,217). CUD was associated with altered functional connectivity in a network comprising the motor‐hand region in the superior parietal gyri and the anterior insula (p < .04). These differences were not explained by alcohol, other drug use, or education. No associations with CUD were observed in cortical thickness, cortical surface area, subcortical or cerebellar volumes (0.12 < BF < 1.5), or graph‐theoretical metrics of resting state connectivity (PPA < 0.01). In a large sample collected irrespective of cannabis used to minimize recruitment bias, we confirm the literature on poorer cognitive functioning in CUD, and an absence of volumetric brain differences between CUD and non‐CUD. We did not find evidence for or against a disruption of structural connectivity, whereas we did find localized resting state functional dysconnectivity in CUD. There was sufficient proof, however, that organization of functional connectivity as determined via graph metrics does not differ between CUD and non‐user group.

Cannabis use among Canadian adults with cancer (2007–2016): results from a national survey

ABSTRACT Background: The current study aims to evaluate the rates and associations of cannabis use among Canadian adults with cancer (2007-2016). Methods: Canadian Community Health Survey (CCHS) (2007-2016) was accessed and adult participants who answered yes to the question “Do you have cancer?” and who have complete information about cannabis use were included. Multivariable logistic regression was used to identify factors associated with cannabis use. Results: A total of 4667 participants who currently have cancer were included in the current analysis. The rate of cannabis use increased throughout the study (34.4% in 2015-2016 versus 27.7% in 2007-2008). The following factors were associated with cannabis use: younger age (OR: 3.64; 95% CI: 2.27-5.86; P<0.01); male sex (OR: 2.11; 95% CI: 1.80-2.48; P<0.01); white race (OR: 2.02; 95% CI: 1.46-2.78; P<0.01); single status (OR for married versus single: 0.38; 95% CI: 0.29-0.50; P<0.01) and higher income (OR for income < 20,000 versus income ≥ 80,000: 00.74; 95% CI: 0.56-0.99; P=0.04). Conclusions: Within this study cohort of Canadian adults with current cancer diagnosis, cannabis use is not uncommon. A history of cannabis use is associated with younger age, male sex, white race, non-married status, and higher income.

Association of Cannabis Use With All-Cause and Cause-Specific Mortality Among Younger- and Middle-Aged U.S. Adults

Cannabis is frequently used and increasingly legalized in the U.S., and 27.7 million Americans aged ≥12 years are currently using cannabis. However, the public health effects of cannabis use in the general population remain unclear. This study examines the associations of cannabis use with all-cause and cause-specific mortality in U.S. adults. The study included 14,818 adults (aged 20-59 years) who participated in the National Health and Nutrition Examination Survey from 2005 to 2014 and were free of cardiovascular disease or cancer at baseline. Survey participants were linked to mortality records through December 31, 2015. The outcomes included all-cause mortality, cardiovascular disease mortality, and cancer mortality. All statistical analyses were conducted in 2019. During 86,453 person-years of observation, 304 deaths occurred, including 39 deaths from cardiovascular disease and 79 deaths from cancer. After adjustment for a variety of potential confounders, the hazard ratios for all-cause mortality, cardiovascular disease mortality, and cancer mortality among cannabis ever users, compared with the ratios among nonusers, were 1.14 (95% CI=0.81, 1.59), 2.29 (95% CI=1.10, 4.78), and 0.67 (95% CI=0.40, 1.14), respectively. The hazard ratios for cardiovascular disease mortality among cannabis users, compared with those among nonusers, were 1.65 (95% CI=0.57, 4.89) if the use was first initiated at age ≥18 years and 3.00 (95% CI=1.41, 6.38) if the use was first initiated before age 18 years. Cannabis use was significantly associated with an increased risk of cardiovascular disease mortality among U.S. adults, especially among those who started using cannabis before age 18 years. The reasons and mechanisms underlying this association will require future research.

Women’s Use of and Access to Illicit Cannabis: An Investigation of Gendered Norms among College Students in Canada

In the present study, I investigate how often unacknowledged gendered norms shape young women’s use of and access to illicit cannabis. I apply a “doing gender” approach to analyse 58 interviews conducted with cannabis using and non-using female and male college students in Canada in 2012, a time when nonmedical cannabis possession and supply were illegal. I identify prominent gendered norms and stereotypes that are critical of women’s use and that create barriers to women’s participation as either buyers or dealers in the illicit cannabis market. I show how these norms reinforce associations of cannabis use with masculinity and how they may direct social pressure against women’s use. I engage with Deutsch's (2007) concept of “undoing” gender to provide a novel contribution to research on cannabis by illustrating women’s strategies for resisting derogatory stereotypes. I highlight how women resist stigmatization of their use in the university context by drawing on presentations of social belonging, particularly scholastic success. However, I show that women may reinforce other stereotypes when appealing to such strategies. Legalization of nonmedical cannabis will create regulated commercial access alternatives to the highly gendered barriers that characterize illicit cannabis markets. My analysis suggests some increase in women’s cannabis use may be expected as a result, although deeply embedded gender norms are likely to maintain downward social pressure on women’s rates of use.

Current cannabis use and smoking cessation among treatment seeking combustible smokers

IntroductionCombustible tobacco smoking and cannabis use frequently occur together, and the use of both substances is associated with overall greater severity of tobacco and cannabis related problems. Observational work has found that cannabis use is associated with tobacco cessation failure, but research directly testing the longitudinal associations of cannabis use on tobacco cessation during smoking cessation treatment is lacking. The current study examined the impact of current cannabis use on combustible tobacco cessation outcomes. Methods207 daily combustible tobacco smokers (Mage = 38.24 years, SD = 14.84, 48.1 % male) were enrolled in a randomized controlled smoking cessation trial. Survival analyses and multi-level modeling were used to assess lapse and relapse behavior through 12-week follow up. The current study is a secondary data analysis. ResultsResults of the current study suggest that cannabis use is associated with faster time to lapse (OR = 0.644, se = .188, p = .019), but not relapse (OR = −0.218, se = .403, p = .525), compared to combustible tobacco-only smokers. Additionally, cannabis use was associated with lower likelihood of achieving any 7-day point prevalence abstinence during the 12 week follow up (b = 0.93, se = 0 0.24, p = 0.0001). ConclusionsThe current study provides novel evidence that cannabis use may be related to combustible tobacco use in terms of faster time to lapse and lower likelihood of any 7-day point prevalence abstinence following smoking cessation treatment. Developing integrated cannabis-tobacco cessation treatments is an important next step in research focused on tobacco-cannabis use.

Recent cannabis use is associated with smaller hippocampus volume: High-resolution segmentation of structural subfields in a large non-clinical sample.

There is mixed evidence that individuals who use cannabis have reduced hippocampal and amygdalar gray matter volume, potentially because of small sample sizes and imprecise morphological characterization. New automated segmentation procedures have improved the measurement of these structures and allow better examination of their subfields, which have been linked to distinct aspects of memory and emotion. The current study applies this new segmentation procedure to the Human Connectome Project Young Adult dataset (N = 1080) to investigate associations of cannabis use with gray matter volume in the hippocampus and amygdala. Results revealed significant bilateral inverse associations of hippocampal volume with recent cannabis use (THC+ urine drug screen; P < .005). Hippocampal subfield analyses indicated these associations were primarily driven by the head of the hippocampus, the first section of the cornu amonis (CA1), the subicular complex, and the molecular layer of the hippocampus. No associations were detected for age of cannabis initiation, the frequency of cannabis use across the lifespan, or the lifetime presence of cannabis use disorder. In one of the largest studies to date, these results support the hypothesis that recent cannabis use is linked to reduced hippocampal volume, but that this effect may dissipate following prolonged abstinence. Furthermore, these results clarify the specific subfields which may be most associated with recent cannabis use.

Diving, cannabis use, and techniques of neutralisation: exploring how divers rationalise cannabis use.

Diving medicine literature often regards the use of cannabis as a potential contra-indicator for fitness to dive. With that said, there has been no empirical research done with cannabis-using divers to examine how they subjectively understand and construct the risks that their cannabis use may have on their diving. This study explored how cannabis-using divers rationalise the pejorative associations of cannabis use through rhetorical techniques of neutralisation (TON) that function to deny the risks that cannabis use may have on their diving. Ten medically-fit professional divers from South Africa were individually intervie- wed. The interviews focussed on each diver's reported recreational use of cannabis. The interviews were transcribed and analysed through a framework for TON originally formulated by Sykes and Matza (1957). Analysis revealed six primary TON employed to refute the pejorative associations of cannabis use on dive work, namely: 1. Denial of responsibility: which denies a diver's direct culpability for their cannabis use; 2. Denial of injury: which asserts that no (serious) harm results from a diver's cannabis use; 3. Denial of victim: which repudiates the potentially deleterious effects that cannabis use may have on a diver; 4. Condemnation of condemners: which minimises cannabis use in relation to other divers' unsafe diving practices; 5. Appeal to loyalties: which situates cannabis use within interpersonal networks to whom a diver has a "higher" allegiance; 6. Denial of penalty: which justifies cannabis use by virtue of a perceived lack of punitive action by a Diving Medical Examiner. The findings of this research highlight the TON which potentially inform a diver's cannabis use, particularly in relation to their diving. Identifying such TON carry important implications for the ways in which fitness to dive is assessed.

Associations between probable anxiety and mood disorder and measures of alcohol and cannabis use in young, middle-aged and older adults.

This study examined the associations of cannabis use, alcohol use and alcohol problems with probable anxiety and mood disorders (AMD) in young, middle-aged and older adults. Method: Data are based on the CAMH Monitor, an ongoing cross-sectional telephone survey of Ontario adults aged 18 years and older. For the purposes of the current study, a merged dataset from the years 2001 through 2009 inclusive was separated into three individual datasets: 18-34 year olds (n=4,211), 35-54 year olds (n=7,874), and 55 years of age and older (n=6,778). The survey included the 12-item version of the General Health Questionnaire, which provides a measure of probable AMD for the general population. Logistic regression analyses examined the odds of probable AMD in three age groups associated with alcohol measures (number of drinks per day and alcohol problems (AUDIT 8+)) and cannabis use, while controlling for self-reported physical health, religious service attendance, and demographic factors. Due to listwise deletion, the logistic regression models were based on reduced samples. Results: Lifetime cannabis use and past year cannabis use predicted probable AMD in young and middle-aged adults, but only lifetime cannabis use predicted probable AMD among older adults. Alcohol problems predicted probable AMD among middle aged and older adults, but not among younger adults. No consistent link between recent alcohol consumption and probable AMD was observed. Conclusion: These analyses suggest that the impact of alcohol and cannabis use and problems on probable AMD may differ across age groups.

Age-varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults.

AimsWe tested the age‐varying associations of cannabis use (CU) frequency and disorder (CUD) with psychotic, depressive and anxiety symptoms in adolescent and adult samples. Moderating effects of early onset (≤ 15 years) and sex were tested.DesignTime‐varying effect models were used to assess the significance of concurrent associations between CU and CUD and symptoms of psychosis, depression and anxiety at each age.Setting and ParticipantsAdolescent data (V‐HYS; n = 662) were collected from a randomly recruited sample of adolescents in Victoria, British Columbia, Canada during a 10‐year period (2003–13). Adult cross‐sectional data (NESARC‐III; n = 36 309) were collected from a representative sample from the United States (2012–13).MeasurementsMental health symptoms were assessed using self‐report measures of diagnostic symptoms. CU was based on frequency of past‐year use. Past‐year CUD was based on DSM‐5 criteria.FindingsFor youth in the V‐HYS, CU was associated with psychotic symptoms following age 22 [b = 0.13, 95% confidence interval (CI) = 0.002, 0.25], with depressive symptoms from ages 16–19 and following age 25 (b = 0.17, 95% CI = 0.003, 0.34), but not with anxiety symptoms. CUD was associated with psychotic symptoms following age 23 (b = 0.51, 95% CI = 0.01, 1.01), depressive symptoms at ages 19–20 and following age 25 (b = 0.71, 95% CI = 0.001, 1.42) and anxiety symptoms ages 26–27 only. For adults in the NESARC‐III, CU was associated with mental health symptoms at most ages [e.g. psychotic symptoms; age 18 (b = 0.22, 95% CI = 0.10, 0.33) to age 65 (b = 0.36, 95% CI = 0.16, 0.56)]. CUD was associated with all mental health symptoms across most ages [e.g. depressive symptoms; age 18 (b = 0.96, 95% CI = 0.19, 1.73) to age 61 (b = 1.11, 95% CI = 0.01, 2.21)]. Interactions with sex show stronger associations for females than males in young adulthood [e.g. V‐HYS: CUD × sex interaction on psychotic symptoms significant after age 26 (b = 1.12, 95% CI = 0.02, 2.21)]. Findings were not moderated by early‐onset CU.ConclusionsSignificant associations between cannabis use (CU) frequency and disorder (CUD) and psychotic and depressive symptoms in late adolescence and young adulthood extend across adulthood, and include anxiety.

Cannabis use among two national samples of Aboriginal and Torres Strait Islander tobacco smokers.

There is a concern that cannabis use is an important barrier to reducing Aboriginal and Torres Strait Islander smoking. We investigate the associations of cannabis use and tobacco smoking and quitting in two large national samples. The 2012-2013 National Aboriginal and Torres Strait Islander Health Survey was a national stratified random household survey conducted between April 2012 and February 2013, and included 2580 adult Aboriginal and Torres Strait Islander smokers. The Talking About The Smokes Project interviewed a national quota sample of 1301 Aboriginal and Torres Strait Islander adult smokers between August 2013 and August 2014. Both surveys asked about tobacco smoking and quitting, cannabis use and socio-demographic factors. Both surveys estimated that cannabis use is common among Aboriginal and Torres Strait Islander smokers (National Aboriginal and Torres Strait Islander Health Survey: 32%, Talking About The Smokes: 24%). Both surveys found a higher prevalence of cannabis use among smokers who were male, younger, unemployed or who more frequently consumed five or more alcoholic drinks in a day. However, the two surveys provided inconsistent evidence about whether cannabis use is associated with not quitting smoking tobacco. We did not find consistent evidence in this setting that cannabis use is an obstacle to quitting tobacco smoking. Nevertheless, we would still recommend that clinicians counselling Aboriginal and Torres Strait Islander tobacco smokers about quitting talk about cannabis use because its use is common and almost all mix it with tobacco.

Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study.

With rising rates of marijuana use in the general population and an increasing number of states legalizing recreational marijuana use and authorizing medical marijuana programs, there are renewed clinical and policy concerns regarding the mental health effects of cannabis use. To examine prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population. A nationally representative sample of US adults aged 18 years or older was interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 34 653 respondents who were interviewed in both waves. Data analysis was conducted from March 15 to November 30, 2015. We used multiple regression and propensity score matching to estimate the strength of independent associations between cannabis use at wave 1 and incident and prevalent psychiatric disorders at wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). In both analyses, the same set of wave 1 confounders was used, including sociodemographic characteristics, family history of substance use disorder, disturbed family environment, childhood parental loss, low self-esteem, social deviance, education, recent trauma, past and present psychiatric disorders, and respondent's history of divorce. In the multiple regression analysis of 34 653 respondents (14 564 male [47.9% weighted]; mean [SD] age, 45.1 [17.3] years), cannabis use in wave 1 (2001-2002), which was reported by 1279 respondents, was significantly associated with substance use disorders in wave 2 (2004-2005) (any substance use disorder: odds ratio [OR], 6.2; 95% CI, 4.1-9.4; any alcohol use disorder: OR, 2.7; 95% CI, 1.9-3.8; any cannabis use disorder: OR, 9.5; 95% CI, 6.4-14.1; any other drug use disorder: OR, 2.6; 95% CI, 1.6-4.4; and nicotine dependence: OR, 1.7; 95% CI, 1.2-2.4), but not any mood disorder (OR, 1.1; 95% CI, 0.8-1.4) or anxiety disorder (OR, 0.9; 95% CI, 0.7-1.1). The same general pattern of results was observed in the multiple regression analyses of wave 2 prevalent psychiatric disorders and in the propensity score-matched analysis of incident and prevalent psychiatric disorders. Within the general population, cannabis use is associated with an increased risk for several substance use disorders. Physicians and policy makers should take these associations of cannabis use under careful consideration.

Mental health symptom severity in cannabis using and non-using Veterans with probable PTSD

BackgroundPosttraumatic Stress Disorder (PTSD) is a disabling illness suffered by many Veterans returning from war. Some Veterans believe that cannabis may be therapeutic for PTSD. The purpose of this study was to better understand the association between cannabis use and PTSD symptoms. MethodsThe study was a matched case-control cross-sectional evaluation of the psychiatric and sociocultural associations of cannabis use in Veterans with probable PTSD. Patient self-report measures were examined comparing cannabis users (cases) to non-users (controls) who were case-matched on age and gender. ResultsResults indicated that there were no significant differences between cases and controls in mean PTSD Checklist-Civilian version (PCL-C) scores (59.2 and 59.1, respectively). There was also no association between PTSD scores and frequency of cannabis use. It was also observed that cases were more likely to be non-Caucasian, financially challenged, and unmarried. LimitationsThe sample is a convenience sample of Veterans being referred for a clinical assessment and therefore, sampling biases may limit the generalizability of the results to other populations including Veterans not seeking health care in the Veterans Affairs (VA) system. ConclusionsThe results do not support the theory that cannabis use would be associated with less severe PTSD symptoms. Results do suggest important sociocultural differences in cannabis users compared to controls.

Characteristics of pregnant illicit drug users and associations between cannabis use and perinatal outcome in a population-based study

Background According to the 2004 National Survey on Drug Use and Health, 4.6% of American women reported use of an illicit drug during pregnancy. Previous studies on illicit drug use during pregnancy and perinatal outcomes showed inconsistent results. Methods This population-based study included mothers who delivered live-born infants without birth defects between 1997 and 2004 and completed interviews for the National Birth Defects Prevention Study (response rate 69%; n = 5871). Prevalence of self-reported illicit drug use (specifically cannabis, cocaine, and stimulants) during pregnancy and its associations with demographic and social factors were assessed. We used multivariable linear and logistic regression analyses to study the associations of cannabis use with birth weight and gestational age. Results The prevalence of reported illicit drug use during pregnancy was 3.6% (standard error 0.24). Pregnant users of cannabis, cocaine, and stimulants were younger, had a lower level of education and lower household income, and were less likely to have used folic acid in the periconceptional period than nonusers. Illicit drug users were also more likely to have used alcohol and tobacco. After adjustment for confounding, cannabis use was not associated with mean birth weight or gestational age or with low birth weight or preterm delivery. Conclusion Women who report use of illicit drugs during pregnancy differ in demographic and socioeconomic background from nonusers. Reported cannabis use does not seem to be associated with low birth weight or preterm birth.

Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents

Background Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use (CU) or cannabis use disorder (CUD), the status of anxiety and mood disorders in predicting CU and CUD remains controversial. Objective (1) To examine cross-sectional and prospective associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders. Methods N = 1395 community subjects aged 14–17 at baseline were followed-up at three waves prospectively over 10 years. Substance use, substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI. Results (1) The baseline prevalence rates where 19.3% at t 0 for CU and 2.6% for CUD. Cumulative incidence rates at t 3 were 54.3% for CU and 13.7% for CUD. (2) In cross-sectional and prospective analyses other substance use disorders, mood and anxiety disorders were associated with CU and CUD. (3) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders. Conclusion A range of psychopathological conditions, including depressive, bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD, even when controlling for externalising disorders. A better understanding of this complex interplay may result in better aetiological models and intervention strategies.