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.
Emergency medicine providers, parents, adolescent health researchers
OR 1.94-2.76 for CUD with low alcohol risk
What the researchers 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.
Why it 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 numbers in context
1,689 adolescents; 16 pediatric EDs; OR 1.94-2.76 for CUD with low alcohol risk; 3-year follow-up
How the study worked
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.
What this study cannot tell us
Secondary data analysis. Follow-up relied on self-report. Attrition over three years may have introduced bias.
How to read the evidence
Longitudinal design with validated screening tool and multi-site data, but secondary analysis with self-reported outcomes.
When this study was published
Published in 2022
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.
Questions still open
- 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?
Common questions
Can an alcohol screening predict cannabis problems?
How strong was the link between alcohol and later cannabis use?
Read the original research
Adolescent alcohol use predicts cannabis use over a three year follow-up period.
Substance abuse, 43(1), 514-519
Citation
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
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