ORCID

0000-0002-1476-113X (Chakraborty)

Document Type

Article

Publication Date

2026

DOI

10.1002/hsr2.72746

Publication Title

Health Science Reports

Volume

9

Issue

7

Pages

e72746

Abstract

Background and Aims

Given the rising prevalence of cannabis use as an alternative strategy for managing mental health symptoms, there is a crucial need to understand the determinants of substitution behavior, particularly among midlife women who may experience distinct psychosocial and clinical profiles. This study examined the predictors of cannabis substitution among midlife women by comparing profiles of women who substituted cannabis for antidepressant medications versus those who substituted for anxiolytic medications.

Methods

A cross-sectional survey of 172 women who reported substituting cannabis for either anxiety or depression medications was conducted. Measures included the PHQ-8, OASIS, AUDIT, and ACEs. Logistic regression was used to identify predictors of substitution behavior.

Results

Among participants, 88 (51%) substituted cannabis for antidepressants and 84 (49%) for anxiolytics. Clinically significant anxiety (M = 12.5, SD = 4.3) and depression (M = 11.6, SD = 5.3) were observed. Average ACE scores exceeded four in both groups. In multivariate models, sleep difficulties (OR = 4.2, 95% CI: 2.1-8.0) and alcohol use (OR = 1.1, 95% CI: 1.01-1.09) predicted substitution for anxiety. For depression, predictors included sleep difficulties (OR = 6.6, 95% CI: 3.1-14.1), alcohol use (OR = 1.1, 95% CI: 1.1-1.2), lower education (OR = 0.71, 95% CI: 0.53-0.95), and loneliness (OR = 2.0, 95% CI: 1.2-3.8).

Conclusion

Sleep difficulties and alcohol use were found to be strong predictors for substituting cannabis for anxiety and depression medications among middle-aged women. These findings highlight the need for clinical awareness of symptom-specific substitution patterns and emphasize the importance of addressing co-occurring sleep and substance use problems.

Rights

© 2026 The Authors

This is an open access article under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Data Availability

Article states: "The data that support the findings of this study are available from the corresponding author upon reasonable request."

Original Publication Citation

Mueller, J., Sapp, J., Attonito, J., Chakraborty, A., & Villalba, K. (2026). Substitution of cannabis for prescribed medications in the management of anxiety and depression among midlife women: A cross-sectional study. Health Science Reports, 9(7), Article e72746. https://doi.org/10.1002/hsr2.72746

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