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.
Residential care administrators, juvenile justice professionals, youth substance use prevention specialists
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Decade of screening data from a clinical population provides strong trend evidence, limited by single facility and cross-sectional design.
When this study was published
Published 2026 with 2015-2024 clinical data.
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.
Questions still open
- 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?
Common questions
Is teen cannabis use really declining?
Why are high-risk youth different?
Read the original research
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
Citation
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
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