Among mothers with high resilience scores, each additional adverse childhood experience increased odds of cannabis use by 38%, while mothers with low resilience showed consistently high cannabis use regardless of trauma history.
People interested in the intersection of trauma, motherhood, and substance use, and those working in maternal health.
Cannabis use probability: 8.5% at 0 ACEs to 62.9% at 10 ACEs (high resilience group)
What the researchers found
In 126 predominantly low-income mothers followed through three years postpartum, the relationship between adverse childhood experiences (ACEs) and cannabis use depended on resilience level. Among high-resilience mothers, each additional ACE increased cannabis use odds by 38% (adjusted OR=1.38). Predicted probability of cannabis use in this group rose from 8.5% at 0 ACEs to 62.9% at 10 ACEs. Among low-resilience mothers, cannabis use probability remained around 36% regardless of ACE exposure.
Why it matters
Cannabis use in early motherhood is increasing, and understanding what drives it can inform more targeted support. The finding that resilience appears protective at low-to-moderate trauma exposure but loses its protective effect at high ACE levels suggests that different intervention strategies may be needed depending on a mother's trauma history.
The numbers in context
126 mothers. High resilience group: cannabis use probability 8.5% at 0 ACEs, 62.9% at 10 ACEs (OR=1.38 per ACE). Low resilience group: ~36% cannabis use probability regardless of ACE score (OR=1.02, not significant).
How the study worked
Longitudinal study of 126 predominantly low-income, diverse mothers in the South Central US. Multiple logistic regression evaluated ACEs and cannabis use through 3 years postpartum, stratified by resilience (median split). Adjusted for sociodemographics, postnatal depression, and prenatal substance use.
What this study cannot tell us
Small sample size (n=126). Predominantly low-income population in one US region. Cannabis use was self-reported. Resilience measured at a single point. Cannot determine whether cannabis use represents problematic use or intentional self-management. Observational design limits causal claims.
How to read the evidence
Moderate: longitudinal design with adjusted models, but small sample size and single-region population.
When this study was published
Published in 2025.
The bigger picture
This study adds nuance to the ACEs-substance use connection. Rather than a simple 'more trauma equals more use' model, the relationship depends on protective factors. The finding that resilience's protective effect has limits at high trauma levels has implications for how support programs are designed for mothers with extensive childhood adversity.
Questions still open
- Why does resilience appear to lose its protective effect at high ACE levels?
- Are mothers using cannabis to cope with trauma symptoms, and if so, does it help or hinder recovery?
- Would trauma-focused interventions reduce cannabis use in high-ACE mothers?
Common questions
Does childhood trauma increase cannabis use in mothers?
Can resilience protect against trauma-related cannabis use?
Read the original research
Adverse childhood experiences, resilience, and cannabis use in early motherhood.
Frontiers in psychiatry, 16, 1621161
Citation
Roland, Alysa; Charron, Elizabeth; Shreffler, Karina M. (2025). Adverse childhood experiences, resilience, and cannabis use in early motherhood.. Frontiers in psychiatry, 16, 1621161. https://doi.org/10.3389/fpsyt.2025.1621161
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