Among 401 predominantly Hispanic at-risk youth, 74% maintained low cannabis use, 12% showed chronic early-onset use, and 14% escalated, with boys more likely to be in the chronic or escalating groups and conduct disorder showing the strongest bidirectional link.
Parents of teens, youth prevention specialists, and anyone interested in why some teens develop cannabis problems while most don't.
74% of at-risk youth maintained low cannabis use; conduct disorder was the strongest predictor of escalation
What the researchers found
Three cannabis use trajectories were identified: low (74%), chronic (12%), and escalating (14%). Boys were more likely to show escalating and chronic patterns. Conduct disorder symptoms showed the most robust bidirectional association with cannabis use trajectories, both predicting and being predicted by them.
Why it matters
Most at-risk youth didn't develop problematic cannabis patterns, challenging assumptions about inevitability. The conduct disorder connection suggests behavioral problems and cannabis use fuel each other, creating a cycle that interventions could target.
The numbers in context
401 youth, 90% Hispanic, 46% female. Low trajectory: 74%. Chronic: 12%. Escalating: 14%. Boys more likely in chronic and escalating groups. Conduct disorder most strongly and bidirectionally associated with cannabis trajectories.
How the study worked
Trajectory-based modeling in 401 predominantly Hispanic (90%) at-risk youth (46% female) tracked from ages 14-18, controlling for baseline substance use and demographics, with psychopathology measured as both predictor and outcome.
What this study cannot tell us
Predominantly Hispanic sample from one region limits generalizability. Four-year follow-up from ages 14-18 may miss later trajectory changes. Self-reported substance use. At-risk sample may not represent general population.
How to read the evidence
Moderate: prospective trajectory modeling with appropriate controls in a specific at-risk population.
When this study was published
Published in 2019.
The bigger picture
That three-quarters of at-risk youth maintained low cannabis use is an important counterpoint to narratives about cannabis in vulnerable populations. The minority who escalate may be identifiable through conduct disorder symptoms, offering a potential screening and intervention target.
Questions still open
- Would targeting conduct disorder symptoms reduce cannabis escalation in at-risk youth? Do these trajectory patterns persist into young adulthood? Why were girls less likely to escalate despite similar overall use prevalence?
Common questions
Do most at-risk teens develop cannabis problems?
What predicts which teens will escalate cannabis use?
Read the original research
Developmental pathways of adolescent cannabis use: Risk factors, outcomes and sex-specific differences.
Substance use & misuse, 54(2), 271-281
Citation
Hawes, Samuel W; Trucco, Elisa M; Duperrouzel, Jacqueline C; Coxe, Stefany; Gonzalez, Raul. (2019). Developmental pathways of adolescent cannabis use: Risk factors, outcomes and sex-specific differences.. Substance use & misuse, 54(2), 271-281. https://doi.org/10.1080/10826084.2018.1517177
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