Among 323 patients with cannabis use disorder, the vast majority had pre-existing adverse childhood experiences, social-emotional impairments, or neurodevelopmental disorders, suggesting these conditions precede and may contribute to problematic cannabis use.
Addiction clinicians, child psychologists, neurodevelopmental disorder specialists, and prevention researchers.
323 CUD patients; majority had pre-existing ACEs or neurodevelopmental conditions
What the researchers found
Adverse childhood experiences (ACEs), social-emotional impairments (SEIs), and neurodevelopmental disorders (NDs) were highly prevalent among CUD patients. Those with pre-CUD-onset ACEs, SEIs, or NDs differed significantly from those without, suggesting these conditions shape vulnerability to cannabis use disorder.
Why it matters
If ACEs, neurodevelopmental conditions, and social-emotional problems precede cannabis use disorder in most cases, prevention efforts should target these upstream vulnerabilities rather than focusing solely on cannabis availability.
The numbers in context
323 patients with CUD, ages 12-35, mean age 22.94, 64.5% male. Non-premorbid group: 52 patients. The majority had pre-CUD-onset ACEs, SEIs, or neurodevelopmental disorders.
How the study worked
Cross-sectional study of 323 inpatients and outpatients (ages 12-35, mean 22.9, 64.5% male) with current or past cannabis use disorder. Assessed for ACEs, SEIs, and NDs. Compared those with pre-CUD-onset conditions to those without.
What this study cannot tell us
Cross-sectional design cannot confirm temporal ordering despite attempting to identify pre-CUD conditions. Recall bias for childhood events. Clinical sample may not represent all people with CUD. Single-interview assessment.
How to read the evidence
Cross-sectional study with retrospective assessment of pre-morbid conditions. Informative but cannot establish causal pathways.
When this study was published
Published 2023.
The bigger picture
Cannabis use disorder rarely develops in isolation. This study reinforces the view that problematic substance use is often downstream of childhood adversity and neurodevelopmental challenges, pointing toward integrated treatment that addresses root causes.
Questions still open
- Would addressing ACEs and neurodevelopmental conditions earlier in life prevent CUD development? Do treatment outcomes improve when comorbid ACEs and NDs are addressed alongside CUD?
Common questions
Does childhood trauma lead to cannabis addiction?
Should cannabis addiction treatment address childhood trauma?
Read the original research
A comprehensive evaluation of adverse childhood experiences, social-emotional impairments, and neurodevelopmental disorders in cannabis-use disorder: Implications for clinical practice.
European psychiatry : the journal of the Association of European Psychiatrists, 66(1), e77
Citation
Trovini, Giada; Amici, Emanuela; Bauco, Piergiorgio; Matrone, Marta; Lombardozzi, Ginevra; Giovanetti, Valeria; Kotzalidis, Georgios D; De Filippis, Sergio. (2023). A comprehensive evaluation of adverse childhood experiences, social-emotional impairments, and neurodevelopmental disorders in cannabis-use disorder: Implications for clinical practice.. European psychiatry : the journal of the Association of European Psychiatrists, 66(1), e77. https://doi.org/10.1192/j.eurpsy.2023.2436
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