Even Low Adolescent Alcohol Use Predicted Cannabis Use Disorder Over Three Years

Adolescents with even low-level alcohol use in the emergency department had nearly double the odds of developing cannabis use disorder within one to three years.

Linakis, James G et al.·Substance abuse·2022·Moderate EvidenceLongitudinal Cohort
RTHC-04012Longitudinal CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=1,689

What This Study Found

Adolescents classified as low alcohol risk had significantly higher rates of cannabis use disorder versus nondrinkers (OR range: 1.94-2.76) at one-, two-, and three-year follow-up. The NIAAA two-question screen predicted future cannabis use disorder.

Key Numbers

1,689 adolescents; 16 pediatric EDs; OR 1.94-2.76 for CUD with low alcohol risk; 3-year follow-up

How They Did This

Secondary analysis of 1,689 adolescents aged 12-17 treated in 16 pediatric EDs. Baseline alcohol risk was assessed with the NIAAA two-question screen, and cannabis use disorder was evaluated at one, two, and three years via telephone or web survey.

Why This Research Matters

Emergency departments often only screen for alcohol due to time constraints. If a simple alcohol screen can also flag future cannabis risk, clinicians get two screenings for the price of one.

The Bigger Picture

Alcohol and cannabis use frequently co-occur in adolescents. This study suggests that identifying early alcohol use could be a practical gateway to preventing cannabis use disorder before it develops.

What This Study Doesn't Tell Us

Secondary data analysis. Follow-up relied on self-report. Attrition over three years may have introduced bias.

Questions This Raises

  • ?Would brief interventions targeting alcohol use in the ED also reduce subsequent cannabis use?
  • ?Is the alcohol-cannabis link causal or do both reflect shared risk factors?

Trust & Context

Key Stat:
OR 1.94-2.76 for CUD with low alcohol risk
Evidence Grade:
Longitudinal design with validated screening tool and multi-site data, but secondary analysis with self-reported outcomes.
Study Age:
Published in 2022
Original Title:
Adolescent alcohol use predicts cannabis use over a three year follow-up period.
Published In:
Substance abuse, 43(1), 514-519 (2022)
Database ID:
RTHC-04012

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Can an alcohol screening predict cannabis problems?

Yes. This study found the NIAAA two-question alcohol screen predicted cannabis use disorder at one, two, and three years, even among adolescents classified as low alcohol risk.

How strong was the link between alcohol and later cannabis use?

Adolescents with low alcohol risk had 1.94 to 2.76 times higher odds of developing cannabis use disorder compared to nondrinkers over three years.

Read More on RethinkTHC

Cite This Study

RTHC-04012·https://rethinkthc.com/research/RTHC-04012

APA

Linakis, James G; Thomas, Sarah A; Bromberg, Julie R; Casper, T Charles; Chun, Thomas H; Mello, Michael J; Richards, Rachel; Ahmad, Fahd; Bajaj, Lalit; Brown, Kathleen M; Chernick, Lauren S; Cohen, Daniel M; Dean, J Michael; Fein, Joel; Horeczko, Timothy; Levas, Michael N; McAninch, B; Monuteaux, Michael C; Mull, Colette C; Grupp-Phelan, Jackie; Powell, Elizabeth C; Rogers, Alexander; Shenoi, Rohit P; Suffoletto, Brian; Vance, Cheryl; Spirito, Anthony. (2022). Adolescent alcohol use predicts cannabis use over a three year follow-up period.. Substance abuse, 43(1), 514-519. https://doi.org/10.1080/08897077.2021.1949665

MLA

Linakis, James G, et al. "Adolescent alcohol use predicts cannabis use over a three year follow-up period.." Substance abuse, 2022. https://doi.org/10.1080/08897077.2021.1949665

RethinkTHC

RethinkTHC Research Database. "Adolescent alcohol use predicts cannabis use over a three ye..." RTHC-04012. Retrieved from https://rethinkthc.com/research/linakis-2022-adolescent-alcohol-use-predicts

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.