Cannabis Use Is Rising Among High-Risk Youth in Care — Especially Girls and Older Teens
Unlike the general population's declining trends, hazardous cannabis use has been increasing among youth entering residential care from 2015-2024, particularly among females, older teens, and White youth.
Quick Facts
What This Study Found
While general population youth show declining substance use, hazardous cannabis use significantly increased over 2015-2024 among residential care youth — particularly females and older teens (15-18). Hazardous alcohol use increased among females but decreased among males. Alcohol-cannabis co-use increased among older, White, and female youth.
Key Numbers
2,256 youth over 10 years. Cannabis: significant increase among females (OR=1.043/year) and older teens. Alcohol: increased for females, decreased for males. Co-use: increased among older, White, and female youth. Ages 9-18.
How They Did This
Repeated cross-sectional analysis of 2,256 youth (ages 9-18) entering a Midwestern US residential care facility from 2015-2024. AUDIT and CUDIT-R screening at intake. Logistic regressions with age, sex, and race/ethnicity interaction terms.
Why This Research Matters
Youth in residential care represent one of the most vulnerable populations, and the divergence from general population trends means they're being left behind by prevention efforts that may be working for their peers.
The Bigger Picture
The widening gap between substance use trends in the general youth population (declining) and high-risk youth in care (increasing) suggests that whatever is working for mainstream teens — school-based prevention, parental monitoring — isn't reaching the most vulnerable.
What This Study Doesn't Tell Us
Single residential facility in one US region. Cross-sectional snapshots at intake — no longitudinal follow-up. Screening tools may have variable sensitivity across age, sex, and cultural groups. Selection bias in who enters residential care.
Questions This Raises
- ?Why are general-population prevention gains not reaching youth in care?
- ?Do trauma histories explain the different trends?
- ?Should residential care facilities have specialized substance use protocols for girls?
Trust & Context
- Key Stat:
- Evidence Grade:
- Decade of screening data from a clinical population provides strong trend evidence, limited by single facility and cross-sectional design.
- Study Age:
- Published 2026 with 2015-2024 clinical data.
- Original Title:
- Secular Trends in Hazardous Alcohol and Cannabis Use from 2015 to 2024 in Diverse Subgroups of Youth Entering Residential Care.
- Published In:
- Substance use & misuse, 61(4), 491-499 (2026)
- Authors:
- Mason, W Alex(2), Wilmayani, Ni Ketut, Chmelka, Mary B
- Database ID:
- RTHC-08467
Evidence Hierarchy
Frequently Asked Questions
Is teen cannabis use really declining?
In the general population, yes — but not for everyone. Among high-risk youth entering residential care, hazardous cannabis use has actually been increasing from 2015-2024, particularly among girls and older teens.
Why are high-risk youth different?
Youth in residential care face unique challenges — trauma, family instability, mental health issues — that mainstream prevention programs may not address. The increasing cannabis use among these youth, especially females, suggests they need targeted interventions.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08467APA
Mason, W Alex; Wilmayani, Ni Ketut; Chmelka, Mary B. (2026). Secular Trends in Hazardous Alcohol and Cannabis Use from 2015 to 2024 in Diverse Subgroups of Youth Entering Residential Care.. Substance use & misuse, 61(4), 491-499. https://doi.org/10.1080/10826084.2025.2565434
MLA
Mason, W Alex, et al. "Secular Trends in Hazardous Alcohol and Cannabis Use from 2015 to 2024 in Diverse Subgroups of Youth Entering Residential Care.." Substance use & misuse, 2026. https://doi.org/10.1080/10826084.2025.2565434
RethinkTHC
RethinkTHC Research Database. "Secular Trends in Hazardous Alcohol and Cannabis Use from 20..." RTHC-08467. Retrieved from https://rethinkthc.com/research/mason-2026-secular-trends-in-hazardous
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.