Childhood Trauma Predicted Early Cannabis Use Escalation in Adolescents

Among 715 Dutch adolescents tracked from age 16 to 22, childhood trauma was associated with earlier initiation and faster escalation of cannabis use, but differences in stress physiology did not explain the connection.

Schmengler, Heiko et al.·Psychoneuroendocrinology·2025·Moderate EvidenceObservational
RTHC-07594ObservationalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Moderate Evidence
Sample
N=715

What This Study Found

Traumatic experiences before age 16 increased the risk of cannabis use trajectories characterized by early initiation and escalation, as well as consistently low-level use and later-escalation patterns, compared to no use. However, acute neuroendocrine stress reactivity (heart rate, HRV, cortisol) did not mediate this relationship.

Key Numbers

N=715 from TRAILS cohort. Trauma assessed up to age 16. Cannabis trajectories tracked from ~16 to ~22. Trauma was associated with early-initiation/escalation, low-level use, and later-escalation trajectories. No mediation by heart rate, HF-HRV, PEP, or cortisol reactivity.

How They Did This

Longitudinal data from the TRAILS cohort study (N=715). Traumatic experiences assessed up to age 16. Stress reactivity measured via standardized stress test at age 16. Cannabis use trajectories modeled from age 16 to 22. Cox proportional hazards and growth mixture models used.

Why This Research Matters

The link between childhood trauma and substance use is well established, but why it happens remains unclear. This study tested a leading theory (that trauma alters stress physiology, which drives substance use) and found it did not hold up, pushing researchers to look for other mechanisms.

The Bigger Picture

If stress physiology does not explain why traumatized youth start using cannabis earlier and escalate faster, other pathways must be involved. Candidates include psychological factors (coping strategies, emotion regulation), social factors (peer networks, family environment), and epigenetic changes from early adversity.

What This Study Doesn't Tell Us

Single cohort from the Netherlands may not generalize to other populations. Stress reactivity measured at one time point. Self-reported trauma and substance use are subject to recall and reporting biases. Cannabis trajectories may not capture all relevant patterns of use.

Questions This Raises

  • ?What mechanisms beyond stress physiology explain the trauma-to-cannabis-use pathway
  • ?Whether interventions targeting emotion regulation rather than stress physiology would be more effective for trauma-exposed youth

Trust & Context

Key Stat:
Evidence Grade:
Prospective longitudinal cohort with objective stress measures and validated trajectory modeling, though single-cohort design and self-reported outcomes limit generalizability.
Study Age:
Published 2025, using TRAILS cohort data (Netherlands).
Original Title:
The associations between traumatic experiences and trajectories of substance use in adolescence and young adulthood - the role of acute neuroendocrine and subjective stress reactivity.
Published In:
Psychoneuroendocrinology, 182, 107642 (2025)
Database ID:
RTHC-07594

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

Why did the researchers think stress physiology would explain the link?

A leading theory suggests trauma dysregulates the body's stress response, and people with altered stress physiology may use substances to self-regulate. This study tested that theory and found it did not hold, suggesting other pathways are more important.

Does childhood trauma always lead to substance use?

No. While trauma significantly increases the risk, many trauma-exposed youth do not develop problematic substance use. Protective factors like social support, effective coping skills, and access to mental health care can buffer this risk.

Read More on RethinkTHC

Cite This Study

RTHC-07594·https://rethinkthc.com/research/RTHC-07594

APA

Schmengler, Heiko; Hartman, Catharina A; Marceau, Kristine; Giletta, Matteo; Peeters, Margot. (2025). The associations between traumatic experiences and trajectories of substance use in adolescence and young adulthood - the role of acute neuroendocrine and subjective stress reactivity.. Psychoneuroendocrinology, 182, 107642. https://doi.org/10.1016/j.psyneuen.2025.107642

MLA

Schmengler, Heiko, et al. "The associations between traumatic experiences and trajectories of substance use in adolescence and young adulthood - the role of acute neuroendocrine and subjective stress reactivity.." Psychoneuroendocrinology, 2025. https://doi.org/10.1016/j.psyneuen.2025.107642

RethinkTHC

RethinkTHC Research Database. "The associations between traumatic experiences and trajector..." RTHC-07594. Retrieved from https://rethinkthc.com/research/schmengler-2025-the-associations-between-traumatic

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.