Veterans with ADHD Symptoms Use Cannabis Mainly for Sleep, but Coping Use Leads to Problems

Among 361 veterans, sleep disturbance was the key motivator linking ADHD symptoms to cannabis use, while using cannabis to cope with negative emotions predicted cannabis-related problems.

Stevens, Angela K et al.·Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors·2021·Moderate EvidenceProspective Cohort
RTHC-03553Prospective CohortModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Prospective Cohort
Evidence
Moderate Evidence
Sample
N=361

What This Study Found

Sleep motives mediated the prospective relationship between ADHD symptoms and cannabis use frequency, while coping with negative affect was the only significant mediator of the ADHD-to-cannabis-problems pathway, controlling for demographics, other substance use, and psychopathology.

Key Numbers

361 veterans; 93% male; 80% White; 3 semiannual assessments; sleep motives robustly mediated ADHD-to-cannabis-use path; coping with negative affect was the only significant mediator for cannabis problems.

How They Did This

Prospective mediation study of 361 veterans reporting lifetime cannabis use (93% male, 80% White) across three semiannual assessments, using structural equation modeling with zero-inflated negative binomial models.

Why This Research Matters

Understanding why people with ADHD use cannabis can guide targeted interventions. Addressing sleep problems in ADHD may reduce cannabis use, while targeting coping motives may prevent cannabis-related problems.

The Bigger Picture

The distinction between why people use (sleep) and what leads to problems (emotional coping) suggests that interventions need to address both the functional motivations and the dysfunctional patterns of cannabis use in ADHD.

What This Study Doesn't Tell Us

Predominantly male veteran sample limits generalizability; self-reported cannabis use and motives; latent variable modeling may obscure individual variation.

Questions This Raises

  • ?Would treating sleep disturbance in ADHD reduce cannabis use?
  • ?Could teaching healthier coping strategies prevent the transition from cannabis use to cannabis problems?

Trust & Context

Key Stat:
Sleep disturbance drove cannabis use frequency while emotional coping drove cannabis problems
Evidence Grade:
Prospective design with structural equation modeling and multiple time points, limited by predominantly male veteran sample.
Study Age:
Three semiannual assessments of veterans.
Original Title:
Examining motivational pathways from adult attention-deficit/hyperactivity disorder symptoms to cannabis use: Results from a prospective study of veterans.
Published In:
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 35(1), 16-28 (2021)
Database ID:
RTHC-03553

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Enrolls participants and follows them forward in time.

What do these levels mean? →

Frequently Asked Questions

Why do people with ADHD use cannabis?

This study found that sleep disturbance was the primary motivator linking ADHD symptoms to cannabis use frequency among veterans. Cannabis was being used functionally to address a common ADHD-related problem.

When does cannabis use become a problem for people with ADHD?

Using cannabis specifically to cope with negative emotions, rather than for sleep, was the pathway that predicted cannabis-related problems. This suggests that emotional coping motives are a red flag for problematic use.

Read More on RethinkTHC

Cite This Study

RTHC-03553·https://rethinkthc.com/research/RTHC-03553

APA

Stevens, Angela K; Gunn, Rachel L; Jackson, Kristina M; Borsari, Brian; Metrik, Jane. (2021). Examining motivational pathways from adult attention-deficit/hyperactivity disorder symptoms to cannabis use: Results from a prospective study of veterans.. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 35(1), 16-28. https://doi.org/10.1037/adb0000682

MLA

Stevens, Angela K, et al. "Examining motivational pathways from adult attention-deficit/hyperactivity disorder symptoms to cannabis use: Results from a prospective study of veterans.." Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 2021. https://doi.org/10.1037/adb0000682

RethinkTHC

RethinkTHC Research Database. "Examining motivational pathways from adult attention-deficit..." RTHC-03553. Retrieved from https://rethinkthc.com/research/stevens-2021-examining-motivational-pathways-from

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.