Childhood adversity drives cannabis use disorder risk differently across racial and ethnic groups
Adverse childhood experiences increased cannabis use disorder risk for all racial groups, but the effect was strongest among Asian/Pacific Islander respondents, and early cannabis use onset amplified the relationship in complex, race-specific ways.
Quick Facts
What This Study Found
As ACEs increased, odds of lifetime CUD rose across all groups (aOR 1.45-3.03). The ACE-CUD relationship was strongest among Asian/Pacific Islander respondents. American Indian/Alaska Native individuals had the highest prevalence of lifetime CUD, most ACEs, and earliest onset. Earlier cannabis onset was associated with more CUD for most groups.
Key Numbers
Adjusted ORs for ACEs on lifetime CUD: 1.45-3.03 across groups. American Indian/Alaska Native: highest CUD prevalence, most ACEs, earliest onset. Asian/Pacific Islander: strongest ACE-CUD relationship. Earlier onset: lower lifetime CUD aORs 0.85-0.94 for most groups.
How They Did This
Cross-sectional analysis of NESARC-III data examining ACEs, age of cannabis onset, and their interaction on lifetime cannabis use and CUD across five racial/ethnic groups. Logistic regressions stratified by race/ethnicity with sociodemographic controls.
Why This Research Matters
Treating cannabis use disorder risk as uniform across racial groups misses important differences. The finding that ACEs interact with age of onset differently by race suggests that prevention programs need culturally tailored approaches.
The Bigger Picture
This study connects three major risk factors, childhood trauma, early substance use, and racial disparities, in a single analysis, showing they interact in ways that simple additive models miss.
What This Study Doesn't Tell Us
Cross-sectional NESARC-III data cannot establish temporal causation. Self-reported ACEs and cannabis use subject to recall bias. Some racial/ethnic subgroups had smaller sample sizes. Lumping diverse ethnicities into broad categories may mask within-group variation.
Questions This Raises
- ?What cultural factors explain the particularly strong ACE-CUD relationship among Asian/Pacific Islander respondents?
- ?Would ACE-informed, culturally tailored prevention programs reduce cannabis use disorder disparities?
Trust & Context
- Key Stat:
- adjusted odds ratios for ACEs predicting lifetime CUD, varying by racial/ethnic group
- Evidence Grade:
- Large nationally representative sample (NESARC-III) with appropriate stratified analysis, though cross-sectional design limits causal inference.
- Study Age:
- 2025 publication.
- Original Title:
- Relations between adverse childhood experiences, racial and ethnic Identity, and cannabis use outcomes.
- Published In:
- Addictive behaviors, 167, 108361 (2025)
- Authors:
- Gette, Jordan A(2), Espinosa, Adriana
- Database ID:
- RTHC-06530
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why does race matter for cannabis use disorder risk?
Different racial and ethnic groups face different rates of childhood adversity, different average ages of first cannabis use, and different social and cultural contexts that may either buffer or amplify the effects of these risk factors on developing a cannabis use disorder.
Why was the ACE effect strongest for Asian/Pacific Islander individuals?
The study found the association but cannot fully explain it. Possible factors include cultural stigma around substance use that may mean those who do develop CUD have experienced more extreme adversity, or different baseline rates of cannabis exposure that concentrate risk.
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Cite This Study
https://rethinkthc.com/research/RTHC-06530APA
Gette, Jordan A; Espinosa, Adriana. (2025). Relations between adverse childhood experiences, racial and ethnic Identity, and cannabis use outcomes.. Addictive behaviors, 167, 108361. https://doi.org/10.1016/j.addbeh.2025.108361
MLA
Gette, Jordan A, et al. "Relations between adverse childhood experiences, racial and ethnic Identity, and cannabis use outcomes.." Addictive behaviors, 2025. https://doi.org/10.1016/j.addbeh.2025.108361
RethinkTHC
RethinkTHC Research Database. "Relations between adverse childhood experiences, racial and ..." RTHC-06530. Retrieved from https://rethinkthc.com/research/gette-2025-relations-between-adverse-childhood
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.