Exploring Associations between Social Isolation, Marijuana Use and Mental Health in Emerging Adults: Findings from the 2023 National Survey on Drug Use and Health

Background:

Marijuana use is increasingly common among emerging adults (traditionally aged 18–25), a developmental period marked by significant social and emotional transitions. Individuals in this age group may be particularly vulnerable to substance use as they navigate challenges related to identity formation, interpersonal connection, and mental health. Despite growing attention to marijuana use in this population, limited research has examined how social factors such as loneliness and social isolation are associated with use patterns. Drawing on Erikson’s theory of psychosocial development, which positions emerging adulthood within the stage of Intimacy versus Isolation, this study explores the associations between indicators of social isolation, marijuana use and mental health in a community sample of emerging adults. This study is guided by the research question: How do activities associated with social isolation relate to the initiation and frequency of marijuana use behaviors in emerging adults?

Methods:

We used data from the nationally representative 2023 National Survey on Drug Use and Health, a large-scale, annual survey by SAMHSA that gathers information on substance use and mental health in the United States civilian, non-institutionalized population, 12 and older. The analytic sample included adults aged 18 to 34. Multivariate linear regressions were conducted using either age of initial marijuana use or number of days of past-year marijuana use as a dependent variable. Social isolation was operationalized using responses to perceived difficulty in participating in social activities, going out of the house without help and interacting with less familiar people. Mental health status was used as a control in exploring these associations, through scores from the Kessler Screening Scale for Psychological Distress (K6).

Results:

Key findings from multivariate regressions revealed no significant association between perceived difficulty in social activities and the initial age of marijuana use (p = .966). However, increased past-year marijuana use was significantly associated with severe difficulty in social activities (B = 19.96, p = .02), after controlling for K6 scores. Similarly, severe difficulty with engaging with less familiar people was also associated with increased past-year marijuana use (B = 25.91, p = .01) and severe difficulty with going out without help was significantly associated with earlier marijuana use initiation (B = -.052, p = .01). No significant moderating effects of K6 scores were observed on these relationships.

Conclusions:

While not causal, the findings support the need for a more intention investigation of marijuana use for this age group, to add context to the associations identified in this study. These associations highlight a potential vulnerability for this population and the need for possible targeted interventions in higher education, substance use facilities or therapeutic settings.