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

The takeaway

Among 339 emerging adult cannabis users, using cannabis to cope with emotional distress mediated the link between childhood abuse and problematic use, with this pathway persisting into later adulthood while other motives attenuated over time.

People interested in why childhood trauma leads to problematic cannabis use and potential intervention targets.

Emotional coping motives persisted as mediator into later adulthood

What the researchers found

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.

Why it matters

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 numbers in context

339 participants at baseline (mean age 21.23). 4 follow-up waves (2016-2020). Emotional distress motive persisted as mediator into later adulthood. Sleep and pain motives associated with lower problematic use in some models.

How the study worked

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.

What this study cannot tell us

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.

How to read the evidence

Longitudinal design with multiple waves and mediation analysis testing specific pathways. Limited by self-report and attrition.

When this study was published

Published in 2024 with data spanning 2016-2020.

The bigger picture

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.

Questions still open

Would providing trauma-focused therapy reduce emotional coping motives and thereby prevent problematic cannabis use? Are medical cannabis patients with trauma histories using cannabis more adaptively than recreational users? Could screening for emotional distress motives identify at-risk users?

Common questions

Why do people with childhood trauma use cannabis problematically?

This study found that using cannabis specifically to cope with emotional distress was the key pathway connecting childhood abuse to problematic use. This emotional coping motive persisted into later adulthood while other motives faded.

Does all cannabis use by trauma survivors become problematic?

No. The study found that using cannabis for sleep or pain was actually associated with fewer cannabis-related problems in some models, suggesting that the reason for use matters more than use itself.

Read the original research

Mental and Physical Health-Related Cannabis Motives Mediate the Relationship between Childhood Trauma and Problematic Cannabis Use over Time among Emerging Adult Cannabis Users.

Substance use & misuse, 59(2), 193-207

View on PubMed ↗Publisher’s paper ↗

Citation

Conn, Bridgid M; Brammer, Whitney A; Choi, Susie; Fedorova, Ekaterina V; Ataiants, Janna; Lankenau, Stephen E; Wong, Carolyn F. (2024). Mental and Physical Health-Related Cannabis Motives Mediate the Relationship between Childhood Trauma and Problematic Cannabis Use over Time among Emerging Adult Cannabis Users.. Substance use & misuse, 59(2), 193-207. https://doi.org/10.1080/10826084.2023.2267111