Differences in Cannabis and Cannabidiol Attitudes, Perceptions, and Behaviors Between US Adolescents Receiving Mood Disorder Treatment and Their Parents Across Legal Contexts

Dramatic shifts in state-level cannabis laws (CLs) and federal hemp regulations have resulted in increased availability and use of cannabis and cannabidiol (CBD) products throughout the US, with unknown implications for the youth. Youth with mood disorders represent a vulnerable population that is more likely to use cannabis and CBD and is at elevated risk for experiencing cannabis-related adverse health outcomes. This multisite study characterized attitudes, health perceptions, and behaviors related to cannabis and CBD use among US youth receiving mood disorder treatment and their parents, and assessed whether attitudinal differences varied as a function of respondent group and state-level CL status. Anonymous surveys were completed by 84 youths and 66 parents recruited from six child mood clinics providing care to patients living in eleven US states with variable CLs. Covariate-adjusted regressions were run using respondent group and state-level CL status as between-subject factors. Most youths (76% and 74%) and parents (65% and 68%) endorsed believing that cannabis and CBD, respectively, are safe and effective treatments for mental health conditions, and that regular use of these products reduces depression, anxiety, and suicidal behaviors. Intergenerational differences in cannabis-related attitudes and health perceptions were observed, with some associations varying as a function of state-level CL. Among the youth, male sex and positive cannabis expectancies and attitudes were associated with higher cannabis use intentions. Findings can inform prevention and public health messaging efforts.