Cannabis Use and Violent Behavior in Young US Adults: Complex Sex-Specific Patterns | Research

The takeaway

Among 113,000 young US adults, daily cannabis use was associated with 1.7-1.8x higher violent behavior in males specifically with or without CUD, while in females any cannabis use was associated with 1.6-2.4x higher odds regardless of frequency or CUD status.

Violence prevention researchers, criminal justice professionals, and addiction specialists

Sex-specific patterns: daily use matters for males; any use for females

What the researchers found

For males, only daily cannabis use (with or without CUD) was associated with violent behavior (adjusted PRs: 1.7-1.8). For females, cannabis use at any frequency and CUD status was associated with violent behavior (adjusted PRs: 1.6-2.4). The sex-specific patterns suggest different pathways linking cannabis to violent behavior in men and women.

Why it matters

Young adults commit 52% of violent crimes but are only 23% of the population. Understanding how cannabis use intersects with violence risk in this demographic has direct implications for prevention and risk assessment.

The numbers in context

113,454 participants aged 18-34. 28.9% past-year cannabis use. Males: daily use without CUD PR=1.7, daily with CUD PR=1.8 (vs no use baseline 1.7%). Females: any cannabis use PR=1.6-2.4 (vs no use baseline 1.0%).

How the study worked

Analysis of 113,454 participants aged 18-34 from the 2015-2019 National Surveys on Drug Use and Health. Cannabis use (daily/non-daily, with/without CUD by DSM-IV) and violent behavior (attacking someone with intent to seriously harm) were assessed. Multivariable logistic regression with sex stratification.

What this study cannot tell us

Cross-sectional design cannot determine directionality. Violent behavior may lead to cannabis use rather than vice versa. Self-reported measures may underestimate both cannabis use and violent behavior. Cannot control for all confounders.

How to read the evidence

Very large nationally representative dataset with appropriate adjustment, but cross-sectional design limits causal conclusions.

When this study was published

2024 study using 2015-2019 data

The bigger picture

The sex-specific pattern is important: in males, only daily use matters, suggesting a dose-response or chronic exposure mechanism. In females, any use is associated, suggesting either a lower threshold or different confounding structure.

Questions still open

Does cannabis use directly increase violence risk, or are both driven by shared factors? Why is the female association present at any use level? Would longitudinal data clarify the causal direction?

Common questions

Is cannabis use linked to violence?

In this national study, daily cannabis use was associated with higher violent behavior in males (1.7-1.8x), while any cannabis use was associated in females (1.6-2.4x). The study cannot determine if cannabis causes violence or if shared factors explain both.

Why is the pattern different for men and women?

The researchers found males showed elevated violence only with daily use, while females showed elevated violence at any use level. This suggests different mechanisms or threshold effects by sex, though the reasons remain unclear.

Read the original research

Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States.

The International journal on drug policy, 128, 104431

View on PubMed ↗Publisher’s paper ↗

Citation

Volkow, Nora D; Compton, Wilson M; Blanco, Carlos; Einstein, Emily B; Han, Beth. (2024). Associations of cannabis use, use frequency, and cannabis use disorder with violent behavior among young adults in the United States.. The International journal on drug policy, 128, 104431. https://doi.org/10.1016/j.drugpo.2024.104431