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.
ADHD clinicians, veteran health researchers, substance use counselors
Sleep disturbance drove cannabis use frequency while emotional coping drove cannabis problems
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot tell us
Predominantly male veteran sample limits generalizability; self-reported cannabis use and motives; latent variable modeling may obscure individual variation.
How to read the evidence
Prospective design with structural equation modeling and multiple time points, limited by predominantly male veteran sample.
When this study was published
Three semiannual assessments of veterans.
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.
Questions still open
- Would treating sleep disturbance in ADHD reduce cannabis use? Could teaching healthier coping strategies prevent the transition from cannabis use to cannabis problems?
Common questions
Why do people with ADHD use cannabis?
When does cannabis use become a problem for people with ADHD?
Read the original research
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
Citation
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
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