# Characterizing Proximal Risk for Depressive Symptoms and Suicidal Ideation with Acute Cannabis Use and Withdrawal Among Adolescents Using Ecological Momentary Assessment

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $762,101

## Abstract

PROJECT SUMMARY/ABSTRACT
Adolescence is the period of highest risk for the initiation and escalation of cannabis use and emergence of co-
morbid psychopathology, including depression and suicidal ideation (SI). Cross-sectional and prospective
studies have found that cannabis co-occurs with depression and SI at alarmingly high rates. However, these
distal associations do not explain how changes in cannabis use impact intensity and variability in depressive
symptoms and SI over shorter, clinically relevant periods of time (e.g., days, weeks, months), including during
intoxication and withdrawal. Understanding these proximal relationships will inform the mechanisms that
reinforce cannabis use in adolescents at high risk for depression and suicide, yield actionable information
about the specific moments during intoxication and withdrawal when a user will be at highest risk for increased
intensity and volatility of negative mood and SI, and guide clinical decision-making on the potential therapeutic
effect of sustained cannabis abstinence on depression and SI. We propose to conduct a 10-week, multi-
method, randomized study, and will recruit 200 school-based adolescents, ages 12-18 years, with daily or near
daily cannabis use, current depression, and past month SI. Participants will complete 2 weeks of real-time,
ambulatory smartphone monitoring (ecological momentary assessment; EMA) during baseline cannabis use to
quantify the temporal relationship between use and mood and SI, and the within-subject (e.g., concurrent other
substance use, social context of use) and between-subject (e.g., average severity of cannabis use, depression
and SI) factors that may moderate these linkages. To determine how depression and SI change across short-
and longer-term cannabis withdrawal, participants will then be randomized to 8 weeks of monitoring (CB-Mon)
or abstinence incentivized via contingency management (CB-Abst), and will complete a 1-week phase of EMA
at weeks 1 and 8 post-randomization. The overarching aims of this proposal are to test if negative mood and SI
are temporarily relieved and stabilized through acute cannabis use (i.e., cycle of negative reinforcement) and
to test if negative mood and SI decrease in overall (mean) levels and variability after cannabis wash-out. These
aims can be uniquely achieved using EMA via smartphones, which enables high-resolution, within-subjects
data collection, thus allowing for elucidation of the specific temporal relationships between cannabis
use/intoxication and withdrawal, and depressive symptoms and SI. This will improve on existing data due to its
high ecological validity, prospective reporting, and ability to collect dynamic, time-specific changes in the
periods immediately before, during, and after acute cannabis intoxication, as well as across the course of
withdrawal. Particularly with widespread cannabis legalization, which will likely bring greater drug availability
and enhanced societal acceptance, there is...

## Key facts

- **NIH application ID:** 10976759
- **Project number:** 1R01DA054145-01A1
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Randi Melissa Schuster
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $762,101
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10976759

## Citation

> US National Institutes of Health, RePORTER application 10976759, Characterizing Proximal Risk for Depressive Symptoms and Suicidal Ideation with Acute Cannabis Use and Withdrawal Among Adolescents Using Ecological Momentary Assessment (1R01DA054145-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10976759. Licensed CC0.

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