This is the part that deserves the most emphasis, because it's the part most likely to get lost in a scary headline. The Oregon State study is cross-sectional, which is a scientific way of saying it captured a single moment rather than following people over time. That design can reveal a link, but it cannot tell you which way the arrow points.
Cservenka was direct about this limitation. "We would need to study the same groups of people over a longer period of time to understand any cause and effect relationship, but we think this provides an important starting point," she said. It's entirely possible that frequent cannabis use nudges cortisol up. It's equally possible that people with more reactive or dysregulated stress systems are simply more likely to reach for cannabis in the first place. Stress and cannabis use also interact with a whole web of other factors, from sleep and diet to exercise and mood, any of which could be shaping both sides of the relationship.
The broader research adds another layer of humility. The science here is genuinely mixed rather than settled. A 2018 review in Frontiers in Psychiatry found that cannabis has been linked to a range of HPA-axis changes across studies, with results shifting depending on how much people used, how recently, and exactly how researchers measured cortisol.
Even the awakening response has produced conflicting findings. A 2025 study reported a lower awakening response among chronic users, a pattern the Oregon State team did not reproduce. Cservenka addressed that head-on: "Earlier studies by other researchers found CAR to be blunted in frequent cannabis users, but we didn't replicate that finding, which suggests there is a lot of nuance that could be related to analytic strategies and sample characteristics." In an evolving field, that kind of disagreement isn't a red flag. It's a sign the questions are still being worked out.