A Survey Study of Symptom Alleviation Motives for Alcohol and Cannabis Use among Students With and Without Chronic Health Conditions
Main Article Content
Abstract
The purpose of this study was to examine cannabis and alcohol use patterns and self-medication motives in college students with and without a formally diagnosed chronic mental or physical health condition who are or are not taking prescription medication for their condition. To that end, college students were surveyed about their frequency of alcohol and cannabis use, as well as their motives for using alcohol and cannabis, including a direct assessment of intentional self-medication. They were also asked if they were taking prescription medication for their health condition. Results showed that more students had used alcohol than cannabis in the past 30 days, but that among users, cannabis was used on significantly more days than alcohol. Half of our sample reported chronic health conditions and nearly 40% of those students reported that they were taking prescription medication for their condition. Those with a physical health condition used alcohol and cannabis at similar rates as those without, while those with a mental health condition used cannabis (but not alcohol) at a higher rate. Those with a mental health condition reported intentionally using both alcohol and cannabis to alleviate their symptoms, while those with a physical condition reported using only cannabis to deliberately self- medicate. Taking prescription medication was associated with a marginally higher frequency of cannabis (but not alcohol) use. All participants, regardless of formal health diagnosis, endorsed cannabis more often than alcohol as a sleep aid, to relieve pain, to increase appetite, and to relax. Alcohol was endorsed more often “to party with friends” and to “get intoxicated”. Taken together, these results show that, like the general population of American adults, college students, and especially those with a chronic mental or physical health problem, use cannabis to self-medicate. Potential implications of this behavior are discussed.
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References
2. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health. 2023 NSDUH Annual National Report. July 30, 2024. Accessed July 21, 2025. https://www.samhsa.g. ov/data/report/2023-nsduh-annual-national-report.
3. Paus T, Keshavan M, Giedd JN. Why Do Many Psychiatric Disorders Emerge During Adolescence? Nat Rev Neurosci. 2008;9(12):947-957. doi:10.1038/nrn2513
4. Qiu A, Liu C. Pathways link environmental and genetic factors with Structural Brain Networks and psychopathology in Youth. Neuropsychopharmacol. 2023;48(7):1042-1051. doi:10.1038/s41386-023-01559-7
5. Hicks TA, Bountress KE, Adkins AE, et al. A longitudinal mediational investigation of risk pathways among cannabis use, interpersonal trauma exposure, and trauma-related distress. Psychol Trauma. 2023;15(6):969-978. doi:10.1037/tra0001207
6. The Growing Burden of Chronic Diseases. NIHCM. April 3, 2025. Accessed July 21, 2025.
https://nihcm.org/publications/the-growing-burden-of-chronic-diseases.
7. Brenan M. View of U.S. Healthcare Quality Declines to 24-Year Low. Gallup.com. December 6, 2024. Accessed July 21, 2025.
https://news.gallup.com/poll/654044/view-healthcare-quality-declines-year-low.aspx.
8. Blume AW, Schmaling KB, Marlatt GA. Revisiting the self-medication hypothesis from a behavioral perspective. Cogn Behav Pract. 2000;7(4):379-384. doi:10.1016/s1077-7229(00)80048-6
9. Turner S, Mota N, Bolton J, Sareen J. Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depress Anxiety. 2018;35(9):851-860. doi:10.1002/da.22771
10. Goodhines PA, Gellis LA, Kim J, Fucito LM, Park A. Self-Medication for Sleep in College Students: Concurrent and Prospective Associations With Sleep and Alcohol Behavior. Behav Sleep Med. 2017;17(3):327-341. doi:10.1080/15402002.2017.1357119
11. Alford DP, German JS, Samet JH, Cheng DM, Lloyd-Travaglini CA, Saitz R. Primary Care Patients with Drug Use Report Chronic Pain and Self-Medicate with Alcohol and Other Drugs. J Gen Intern Med. 2016;31(5):486-491. doi:10.1007/s11606-016-3586-5
12. Leung J, Chan G, Stjepanović D, Chung JY, Hall W, Hammond D. Prevalence and self-reported reasons of cannabis use for medical purposes in USA and Canada. Psychopharmacology (Berl). 2022;239(5):1509-1519. doi:10.1007/s00213-021-06047-8
13. Tran D-MT, Silvestri-Elmore A. Healthcare-seeking behaviours in college students and Young Adults: A Review. J Res Nurs. 2020;26(4):320-338. doi:10.1177/1744987120951594
14. Chambers J, Keyhani S, Ling PM, et al. Perceptions of Safety of Daily Cannabis vs Tobacco Smoking and Secondhand Smoke Exposure. JAMA Netw Open. 2023;6(8). doi:10.1001/jamanetworkopen.2023.28691
15. Wallis D, Coatsworth JD, Mennis J, et al. Predicting Self-Medication with Cannabis in Young Adults with Hazardous Cannabis Use. Int J Environ Res Public Health. 2022;19(3):1850. doi:10.3390/ijerph19031850
16. Drazdowski TK, Kliewer WL, Marzell M. College students’ using marijuana to sleep relates to frequency, problematic use, and sleep problems. J Am Coll Health. 2019;69(1):103-112. doi:10.1080/07448481.2019.1656634
17. Millin P, Klace F, Krieg D. A Comparative Analysis of the Frequency and Motivations for Cannabis Use in College Students With & Without an Autoimmune Disease. Med Res Arch. 2023;11(11). doi:10.18103/mra.v11i11.4674
18. Simons J, Correia CJ, Carey KB, Borsari BE. Validating a five-factor marijuana motives measure: Relations with use, problems, and alcohol motives. J Couns Psychol. 1998;45(3):265-273. doi:10.1037//0022-0167.45.3.265
19. Cooper ML. Motivations for Alcohol Use Among Adolescents: Development and Validation of a Four-Factor Model. Psychol Assess. 1994;6(2):117-128. doi:10.1037/1040-3590.6.2.117
20. Lee CM, Neighbors C, Woods BA. Marijuana motives: Young adults’ reasons for using marijuana. Addict Behav. 2007;32(7):1384-1394. doi:10.1016/j.addbeh.2006.09.010
21. Lee CM, Neighbors C, Hendershot CS, Grossbard JR. Development and preliminary validation of a comprehensive marijuana motives questionnaire. J Stud Alcohol Drugs. 2009;70(2):279-287. doi:10.15288/jsad.2009.70.279
22. Han B, Shi Y. Associations of recreational cannabis dispensaries' availability, storefront signage and health benefit signs with cannabis use: findings from a representative adult sample in California, United States. Addiction. 2023;118(7):1270-1279. doi:10.1111/add.16132
23. Cohn AM, Alexander AC, Ehlke SJ, et al. Seeing is believing: How cannabis marketing exposure is associated with cannabis use attitudes and behavior in a permissive medical cannabis policy environment. Am J Addict. 2023;32(4):333-342. doi:10.1111/ajad.13390
24. Moitra E, Christopher PP, Anderson BJ, Stein MD. Coping-motivated marijuana use correlates with DSM-5 cannabis use disorder and psychological distress among emerging adults. Psychol Addict Behav. 2015;29(3):627-632. doi:10.1037/adb0000083
25. Schoeler T, Ferris J, Winstock AR. Rates and correlates of cannabis-associated psychotic symptoms in over 230,000 people who use cannabis. Transl Psychiatry. 2022;12(1). doi:10.1038/s41398-022-02112-8
26. Hall W, Degenhardt L. Cannabis use and the risk of developing a psychiatric disorder. World Psychiatry. 2008;7(2)68-71. doi: 10.1002/j.2051-5545.2008.tb00158.x
27. Blyth LG, Seal C, Sorkhou M, Lowe DJ, George TP. A Systematic Review of Cannabis and Anxiety: Chicken or Egg? Curr Addict Rep. 2025;12(1). doi:10.1007/s40429-025-00650-x
28. Lowe DJ, Sasiadek JD, Coles AS, George TP. Cannabis and Mental Illness: A Review. Eur Arch of Psychiatry Clin Neurosci. 2018;269(1):107-120. doi:10.1007/s00406-018-0970-7
29. Kennedy S, Millin P, Kennedy GJ. A Preliminary Study Examining Self-Reported Invincibility, Alcohol Problems, and the Nonmedical Use of Prescription Stimulants in College Students. J Drug Issues. 2021;52(1):3-14. doi:10.1177/00220426211037267
30. Ravert RD, Schwartz SJ, Zamboanga BL, Kim SY, Weisskirch RS, Bersamin M. Sensation seeking and danger invulnerability: Paths to college student risk-taking. Pers Individ Dif. 2009 Nov;47(7):763-768. doi: 10.1016/j.paid.2009.06.017.
31. Brammer WA, Conn BM, Iverson E, Lankenau SE, Dodson C, Wong CF. Coping Motives Mediate the Association of Trauma History with Problematic Cannabis Use in Young Adult Medical Cannabis Patients and Non-Patient Cannabis Users. Subst Use Misuse. 2022;57(5):684-697. doi: 10.1080/10826084.2022.2026970