Childhood trauma drives problematic cannabis use through emotional coping motives that persist into adulthood

Cannabis use to cope with nausea, sleep, pain, and emotional distress mediated relationships between childhood abuse types and problematic cannabis use at follow-up. Most pathways attenuated by later adulthood, but emotional distress coping continued to mediate the connection between abuse and problematic use. Sleep and pain motives were uniquely associated with lower problematic use in emotional neglect models.

Longitudinal study of 339 medical cannabis patient and non-patient emerging adults from Los Angeles (mean age 21.2 at baseline). Four waves of follow-up from 2016-2020. Mediation analyses tested whether specific cannabis use motives explained the link between childhood trauma types and problematic cannabis use.

Understanding why some trauma survivors develop problematic cannabis use while others do not can inform targeted interventions. The finding that emotional coping motives are the most persistent pathway suggests this is where clinical attention should focus.

The self-medication hypothesis suggests people use substances to cope with trauma-related distress. This longitudinal data supports that model for cannabis but adds nuance: not all coping motives lead to problems, and some (sleep, pain) may actually be associated with healthier use patterns.

Los Angeles-based sample may not generalize. Self-report measures of trauma and cannabis motives. Attrition over 4 waves of follow-up. Cannot determine whether addressing motives would prevent problematic use.