Adverse childhood experiences drove medical cannabis use through disability and poor health, not directly
ACEs were linked to cannabis use overall, but the connection to medical cannabis specifically was fully explained by disability and poor health, suggesting medical users may be treating ACE-related health consequences.
Quick Facts
What This Study Found
ACEs were significantly associated with cannabis use overall; however, disability and poor health fully accounted for the association between ACEs and medical cannabis use specifically.
Key Numbers
2019 BRFSS data; 4+ ACEs associated with increased cannabis use; disability and poor health fully mediated the ACE-medical cannabis relationship.
How They Did This
Cross-sectional analysis of 2019 BRFSS data separating recreational and medical cannabis users; logistic regression controlling for health status and disability.
Why This Research Matters
Distinguishing why people with trauma histories use cannabis (recreation vs symptom management) has implications for how clinicians approach cannabis use in patients with ACE histories.
The Bigger Picture
Medical cannabis use among people with trauma histories may reflect legitimate symptom management rather than substance misuse, challenging assumptions about cannabis use in this population.
What This Study Doesn't Tell Us
Cross-sectional BRFSS data prevents causal claims; self-reported ACEs and cannabis use; medical vs recreational distinction relies on self-classification; single survey year.
Questions This Raises
- ?Would longitudinal data confirm this mediation pathway?
- ?Should ACE screening be routine when evaluating medical cannabis patients?
- ?Do specific ACE types predict different cannabis use patterns?
Trust & Context
- Key Stat:
- Disability and poor health fully explained the ACE-to-medical-cannabis pathway
- Evidence Grade:
- Large nationally representative dataset with clear mediation finding, but cross-sectional design and self-reported measures limit causal interpretation.
- Study Age:
- Published 2025, 2019 BRFSS data
- Original Title:
- Adverse Childhood Experiences and Cannabis Use Among US Adults: Do Poor Health and Disability Influence Types of Cannabis Use?
- Published In:
- Substance use & misuse, 60(4), 586-595 (2025)
- Authors:
- Chapple, Constance L, Green, Elizabeth M, Milojevich, Helen M, Miller-Cribbs, Julie A, Maher, Erin J
- Database ID:
- RTHC-06185
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Do childhood adversities lead to cannabis use?
ACEs were associated with greater likelihood of any cannabis use. But the specific link to medical cannabis was fully explained by the disability and poor health that often result from ACEs.
What should clinicians do?
The authors recommend screening for both ACEs and disability status when prescribing medical cannabis, recognizing that medical use may reflect genuine symptom management.
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Cite This Study
https://rethinkthc.com/research/RTHC-06185APA
Chapple, Constance L; Green, Elizabeth M; Milojevich, Helen M; Miller-Cribbs, Julie A; Maher, Erin J. (2025). Adverse Childhood Experiences and Cannabis Use Among US Adults: Do Poor Health and Disability Influence Types of Cannabis Use?. Substance use & misuse, 60(4), 586-595. https://doi.org/10.1080/10826084.2024.2445846
MLA
Chapple, Constance L, et al. "Adverse Childhood Experiences and Cannabis Use Among US Adults: Do Poor Health and Disability Influence Types of Cannabis Use?." Substance use & misuse, 2025. https://doi.org/10.1080/10826084.2024.2445846
RethinkTHC
RethinkTHC Research Database. "Adverse Childhood Experiences and Cannabis Use Among US Adul..." RTHC-06185. Retrieved from https://rethinkthc.com/research/chapple-2025-adverse-childhood-experiences-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.