Family stress and sleep problems predicted marijuana use among Black adults with criminal justice contact

In sex-stratified analyses, lifetime marijuana use among males was associated with family stressors (APR=2.31) and sleep problems (APR=2.07). Among females, marijuana use was associated with neighborhood stressors (APR=1.72). Different stressor types predicted different substance use patterns: family stressors drove marijuana and cigarette use in males, while financial stressors drove alcohol abuse in females.

Data from 1,476 Black adults with criminal justice involvement from the National Survey of American Life. Sex-separate generalized linear models estimated adjusted prevalence ratios for lifetime alcohol abuse, cigarette, and marijuana use. Independent variables included five stressor types and sleep problems.

Black adults with criminal justice contact face compounding stressors that drive substance use, but the specific stressor pathways differ by sex. Understanding these patterns is essential for designing targeted interventions rather than one-size-fits-all approaches.

This study applies a social determinants of health framework to substance use, showing that structural factors like neighborhood environment, family dysfunction, and sleep disruption drive marijuana use in a population already marginalized by criminal justice contact. Addressing upstream determinants may be more effective than substance-focused interventions alone.

Cross-sectional survey cannot establish whether stressors precede marijuana use or vice versa. Self-reported lifetime use may be subject to recall bias. National Survey of American Life data may not represent current patterns. Criminal justice contact itself may be both a cause and consequence of substance use.