Introduction: The substance abuse by people and their mental health are found to be directly correlated as people with substance addition are found to develop the addiction as result of mental illness or the substance abuse leads individuals to develop mental illness such as anxiety and depression.
Aim: The aim of the study is to identify the relationship between cannabis used for substance abuse habit on mental health (anxiety and depression) of the youths.
Methodology: The systematic review as secondary research is to be performed in which information is to be gathered from existing articles gathered from search in the platforms such as Medline, PubMed, CINHAL and others.
Substance abuse is the use of alcohol, unprescribed drugs and other illegal or legal substances in increased amount in a wrong way by the individuals which is harmful to their health and well-being. The substance abuse by people and their mental health are found to be directly correlated as people with substance addition are found to develop the addiction as result of mental illness or the substance abuse leads individuals to develop mental illness such as anxiety and depression. Thus, the current study is developed to determine the extent of relationship the substance abuse of cannabis has on the mental health of youth in the UK. This is because it is one of the key drugs used for abusive purpose mostly by the youth in the UK.
During the early 1990s, the increased use of Cannabis for reactional purpose was initially reported. Since the year, it was seen that it is the most frequently used substance by many youths in the United Kingdom, NewZealand, United States and other developed as well as underdeveloped countries (WHO, 2022). In the current condition, it is reported that Cannabis is the most cultivated, trafficked and abused illegal drug in the world. Nearly half of the drug seizures made globally in the world is found to be Cannabis. As of 2021, it is reported that nearly 147 million people in the world which is 2.5% of the world population are involved in consumption of Cannabis for substance abuse habits (WHO, 2022a). This indicates that large number of people in the UK as well as all over the world are involved in the use of cannabis.
The relation of cannabis use with the development of acute health effects on individuals is common. This is evident as cannabis use is found to impair the cognitive development of people that hinders their learning capability. It also causes impairment of free recalling of previous learned things when cannabis is used during the recalling and the learning periods (Spindle et al., 2021). As mentioned by Theunissen et al. (2021), increased cannabis use causes impairment of the psychomotor performance in variety of actions like divided attention, motor coordination and operation of different nature of task by the people. This is because of the effect of the chemicals present in the cannabis that has the ability to make performance of the human to be impaired for more than 24 hours after smoking it. It also raises issues among people making motor vehicle accidents who drive after smoking cannabis as it impairs the cognitive efficiency of the person (WHO, 2022).
The chronic health impact of cannabis use includes selective damage of the cognitive functioning that makes individual develop impairment of the integration and organisation skill of complex information and data leading the individual to show failure of effective processing of memory and attention (Plunk et al., 2019). The prolonged use of cannabis causes increased impairment that may not allow the person to recover even after cessation of the use of cannabis leading the individual to suffer from hindered activity of life (Trivers et al., 2018). According to Nicksic et al. (2020), cannabis use is found to exacerbate schizophrenia in individual affected by the disease. This is because the presence of THC (delta-9-tetrahydrocananbinol) causes individuals with schizophrenia to develop psychotic symptoms which are common in schizophrenia relapse. As mentioned by Hammond et al. (2021), long-term smoking of cannabis causes epithelial injury of the trachea and bronchi. This leads the individuals to suffer from complex respiratory problem with breathlessness being the major symptoms shown in most of the cases. As criticised by Wadsworth and Hammond (2019), increased smoking of cannabis leads to cause impairment of foetal development. This is because the harmful chemicals in the cannabis smoke create adverse impact on the growth factors leading the foetus to be underweight. The cannabis use during pregnancy is also seen to cause postnatal risk of cancer even though enough researcher is required in the context to prove its prevalence (Goodwin et al., 2020).
The existing studies mention that increased cannabis use leads to creation of physical as well as mental health problem. However, it is found to show greater affinity towards impairment of mental health construct of the people due to which the current study is developed to understand its relationship with mental health problems in individual involved with smoking cannabis. This is to attain greater knowledge regarding the way cannabis use impairs mental health and way it could be managed in youth for their better life.
In the UK, the use of cannabis is seen to be most prominent nature of drug used for substance abuse. This is evident as nearly 89% of the youths in the UK are reported to smoke cannabis (gov.uk, 2021). In 2001, only 23.6% of individuals between the age of 16-59 years in the UK were involved in cannabis use which was raised to 31.1% in 2014-15 but it was reduced to 29.6% people of 16-59 years of age using cannabis in 2020 (statista.com, 2021). This indicates cannabis use is still highly prevalent among the youth and adults in the UK. The youth population is focussed in the study because early cannabis users at young age are found to show hindered mental health condition compared to the adults. It is evident from the study of Gilman (2015) which mentions that adolescent and youth cannabis use causes more adverse impact on their learning and memory compared to adult users. The MRI scans show the youth involved in cannabis use has significant impact on their brain volume, neural connectivity, folding patterns of cortex and integrity of white matter. The data drawn from IQVIA Medical Research Database (IMRD-UK) informs that researchers identified the youths who are involved in cannabis use are three times more likely to suffer from common mental health problems such as anxiety and depression. Moreover, they are seven times more likely to suffer from severe mental illness like schizophrenia and psychosis (johnnysambassadors.org, 2022). This indicates that cannabis use has adverse effect on the mental health of youth who are involved in smoking it due to which the relationship of substance abuse on their mental health is to be determined.
The relationship of cannabis on mental health of the youths is a key issue to be discussed because cannabis results youth developing extensive mood disorder which intends them to cause self-harm, homicide, death by accidental dose and others (gov.uk, 2021). It is evident from the study of Yasgur (2021) which mentions that all-cause mortality as a result of mental health issue executed by cannabis use in youth was 59% higher and their intension to perform unintentional dose was 2.5 time higher compared to youths who are not involved in its use. The fact is also evident from the study of Sideli et al. (2020) which mentions that frequent use of cannabis results youth suffering from mania and execute suicide. This is because the cannabis use leads to deteriorate their cognitive thinking ability leading the to develop extreme mood disorder and hindered ability in controlling emotions causing the individuals to make unintentional harm to self. Thus, the issue is grave, and the relationship between cannabis use on mental health is to be understood as it leads people to experience loss of life due to adverse condition created by its use among them.
The relationship of cannabis use as substance abuse on the mental health of youths in the UK has currently become a key issue to be focused on because it is seen that nearly 60,000 cases are reported to last year in the UK among the youth of 16-39 years who expressed increased depression at the age as result of increased use of cannabis for substance abuse (ox.ac.uk, 2019). In another report by Triggle (2019), it is current mentioned that use of cannabis in the adolescent stage leads to increased risk of depression by 37% in those people at adulthood. Therefore, cannabis use is highly related with mental health disorder in youths and it have different negative impact on their health. Therefore, the current study is developed to understand the extent of the relationship cannabis has for mental health issues such as anxiety and depression in youths in the UK. Moreover, it is identified that are no existing studies which have analysed the way cannabis use is linked with mental health of youth of 18-26 years are present. Further, there are no studies which identifies the way the cannabis has affected the mental health of the youth (18-26 years) during and after the pandemic. Thus, the current study is required to develop clarified idea regarding the way mental health of youth of 18-26 years before, during and after the pandemic are influenced by cannabis.
The aim of the study is to identify the relationship between cannabis used for substance abuse habit on mental health (anxiety and depression) of the youths.
The objectives of the study are:
To identify the impact of cannabis on the mental health of the youth
To assess the lived experiences of the mental illness as result of cannabis use among the youth
To evaluate the challenges faced as a result of cannabis use by the youth
To identify strategies in overcoming the challenges and negative experiences of cannabis use on the mental health of youth
Research methodology informs the specific techniques or procedures to be used for identifying, selecting, processing and analysing information regarding a topic. In research, the methodology section allows individuals to critically examine the validity and reliability of the study as it contains the measures and approach to be analysed in determining the accuracy of them being used in framing the study (Pandey and Pandey, 2021). The methodology section informs the research design to be used in framing the study along with the approaches used in assessing the quality of the study as well as the data collected.
The research design is mainly of two types which are quantitative research and qualitative research design. The quantitative research design aims to discover the number of people who are involved in thinking, acting and feeling in specific way regarding the questions raised for them as per the study topic (Bloomfield and Fisher, 2019). In contrast, the qualitative research design is aimed to established answers regarding the reason and factors influencing the phenomenon in the research question (Squires and Dorsen, 2018). The qualitative research design will be used in framing the current study. This is because qualitative research helps in capturing the attitude, feelings and thinking of the target population regarding the study topic (Green and Thorogood, 2018). Thus, its use will help in the current study to determine the attitude, feelings and thinking of the existing researcher regarding the impact and relationship of cannabis use on the mental health of the youth. It will help in developing a logical overview or perception through experimental data regarding the study topic.
The qualitative research design acts as a content generator which assist in gathering valuable content that reflects the message to be offered regarding the topic (Vasileiou et al., 2018). Thus, it will be used because it will provide valued concept from existing studies regarding lived mental health experience of the youth who have been involved in cannabis use from the early age. The qualitative research design is cost-effective, open-ended and allows creativity to be implemented in gathering information (Daly et al., 2020). Thus, qualitative design will be used because it will help in gathering data for the study within less expenditure as well as helps in implemented creativity to gather critical information from relevant studies regarding relationship of cannabis use with mental health performance in youths.
The quantitative research design will not be used because it provides limited knowledge regarding the impact of any condition on the patients or individual by sharing basic statistical data which leads the research fail to develop broader look at the relationship and themes of the topic (Bruce et al., 2018). The lack of effective explanation behind the gathered statistical data in the quantitative study design may cause the researcher to mislead in interpreting the results leading to development of error in presentation of findings (Bloomfield and Fisher, 2019). Thus, the quantitative research design will not be used in framing the current study.
The PICO framework is used in framing the study question because it helps in determining the key variables to be considered in framing the research question (Brown, 2020). The PICO stands for population, intervention, comparison and outcomes. In this study, the population are youths of 16-25 years of age, intervention is impact of cannabis use on mental health with no presence of comparison and the outcome is cannabis effect on depression and anxiety among youth. Thus, the research question is: What are the effects of cannabis induced psychosis among youths?
The secondary research method will be used in framing the study instead of the primary research method. This is because primary research method requires in-person participation of the target population to provide their views and opinion regarding the study topic. In the current Covid-19 condition, in-person interaction could not be made as result of social distancing rules due to which the method will not be used (Kurniawan et al., 2021). In contrast, secondary research method is economical in nature leading to save time as well as expenses. This is because the data is collection in the method by analysing results presented in existing studies regarding the study topic. Moreover, it helps in gathering wide amount of data which are extensive in nature for executing the study in enriched way (Richter et al., 2021). Thus, the secondary research method will be used because it allows scientifically proved data regarding the study topic which are logical in nature and avoid duplication of information. The systematic review is the type of secondary research which will be followed in developing the study. This is because it helps in synthesising required evidence from existing research to resolve any problem (Munn et al., 2018).
The secondary research will be performed by electronic search strategy through which the related existing articles regarding the study topic will be identified and analysed in gathering required information for meeting the research objectives and question. The electronic search strategy will be used because it is economical, time-effective and requires less effort in gathering valuable findings for the study (Shah and Khan, 2020). The platforms that will be used in executing the search are Medline, CINHAL, Goggle Scholar and PubMed. This is because the mentioned platforms contain wide number of medical research content regarding various topics from reputed researchers who are well-experienced in their field to provide valued data regarding the study topics. In the study, the keywords that will be used in framing the search are “mental health”, “cannabis”, “marijuana”, “weed”, young people”, “youth”, “relationship”, “impact”, “substance abuse”, “anxiety”, “depression” and others. The keywords will be connected through Boolean operators such as AND or OR in executing meaningful search regarding the study. The analysis of data gathered in this study is to be performed through thematic analysis. This is because the approach flexible in systematically analysing data to present them under themes to avoid duplication of results (Castleberry and Nolen, 2018).
In the study, the inclusion and exclusion criteria will be specified so that the basis on which the selected articles are refined to be used in the study in formulating the findings can be identified. The inclusion criteria for the study will be articles that are published on and after 2016, written in English language, contains data regarding cannabis impact on depression and anxiety in 18-26 years old adults, fully accessible, contains academic information and has presence of primary data. In comparison, the exclusion criteria will be articles published before 2016, written in language other than English, contains data regarding cannabis use among people above 26 years or below 16 years of age, contains secondary information, partially accessible and contains non-academic information. The articles in the last seven years will be included as they contain most advanced data regarding the study topic supported by new experimental data which may nullify the previous results identified. The articles published before 2016 will be excluded because they contain backdated information which may develop error in the study on being included in presenting the findings regarding the topic.
The academic articles will be included in the study because it contains logical data that are gathered through scientific experimentation which leads the researcher in creating rational explanation of the information to be presented in framing the study. The non-academic articles will be avoided because they contain descriptive information which are not backed by logical and scientific explanation due to which critical explanation of the results could not be reached in the study. The articles that are presented in English will be included and others will be excluded because the researchers belong from the UK where the key language spoken and understood is English due to which they do not have detailed idea about other languages to derive effective analysis of information to be presented in the study for its completion. The articles containing primary data will be included because they have facts that are shared directly by the participation without being influenced by the interpretation of the researcher. However, secondary data may include personal bias of the researcher during their interpretation which on inclusion in the current study would led to raise error.
The gathered studies to be included in framing the current research will be assessed for their quality by the use of CASP tool. This is because quality assessment in research is important because it helps in determining the strength of information present in the existing study based on which conclusions are to be developed. It also helps in comparing two studies to determine which of them are better to be included in the research (Long, 2020). The CASP tool will be used for quality assessment of articles because the tool has systematic questionnaire set for analysing studies with different research method in specific way to accurately judge their quality for considering whether to be included or excluded from the research (Long, 2020). The thematic analysis method will be used in data analysis for the study. This is because the thematic analysis method provides flexibility to the researchers in gathering huge amount of data from existing studies (Semaan et al., 2020).
In the present study, the ethical considerations will be ensured by the researcher so that it is executed in a legal way along with the respecting of moral values. For this purpose, the information to be shared from existing studies are to be paraphrased so that plagiarism can be avoided. Moreover, the name of the author and year of publication of the articles are to be mentioned against the information so that effective reference to the original author is made. The studies which have followed ethical consideration will be included as they contain data that have not violated the rights and demands of the participants during data collection.
The study concludes that cannabis is widely used drug for substance abuse by youths mainly in their early age which create adverse impact on their mental health leading them to develop anxiety and depression. This is a major issue because out of the hindered mental health, the youths are found to involve in self-harm, suicidal thoughts and others. The current study is going to perform secondary research to gather qualitative information from existing studies to develop information regarding the relation of cannabis use on depression and anxiety among the youths.
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