Co-occurrence across time and space of drug- and cannabinoid- exposure and adverse mental health outcomes in the National Survey of Drug Use and Health: combined geotemporospatial and causal inference analysis

• Published in: BMC public health 2020-11, Vol.20 (1), p.1655-15, Article 1655
• Main Authors: Reece, Albert Stuart, Hulse, Gary Kenneth
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol abuse; Alcohol Drinking; Bipolar disorder; Cannabigerol; Cannabinoid; Cannabinoids; Cannabinoids - adverse effects; Cannabis; Cannabis - adverse effects; Cannabis - chemistry; Causality; Cigarette Smoking; Cigarettes; Cocaine; Cocaine - adverse effects; Cohort Studies; Criminal investigations; Data analysis; Demographic aspects; Depressive Disorder, Major - epidemiology; Depressive Disorder, Major - etiology; Drug abuse; Drug use; Economic factors; Exposure; Female; Generalized method of moments; Health Surveys; Humans; Hypotheses; Illnesses; Inference; Legislation, Drug; Major depressive illness; Male; Marijuana; Marijuana Smoking - adverse effects; Marijuana Smoking - epidemiology; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - etiology; Mental Health; Mental health care; Mental illness; Narcotics; Polls & surveys; Populations; Prevalence; Psychological aspects; Public health; Regression analysis; Risk factors; Robustness (mathematics); Schizophrenia; Smoking; Social factors; Sociodemographics; Spatial Analysis; Substance-Related Disorders - complications; Substance-Related Disorders - epidemiology; Suicidal Ideation; Suicides & suicide attempts; Surveys and Questionnaires; Tobacco; Trends; Young Adult; Young adults; Δ9-tetrahydrocannabinol
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-020-09748-5

Whilst many studies have linked increased drug and cannabis exposure to adverse mental health (MH) outcomes their effects on whole populations and geotemporospatial relationships are not well understood. Ecological cohort study of National Survey of Drug Use and Health (NSDUH) geographically-linked substate-shapefiles 2010-2012 and 2014-2016 supplemented by five-year US American Community Survey. Drugs: cigarettes, alcohol abuse, last-month cannabis use and last-year cocaine use. MH: any mental illness, major depressive illness, serious mental illness and suicidal thinking. two-stage, geotemporospatial, robust generalized linear regression and causal inference methods in R. 410,138 NSDUH respondents. Average response rate 76.7%. When drug and sociodemographic variables were combined in geospatial models significant terms including tobacco, alcohol, cannabis exposure and various ethnicities remained in final models for all four major mental health outcomes. Interactive terms including cannabis were related to any mental illness (β-estimate = 1.97 (95%C.I. 1.56-2.37), P