Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-17T14:37:50.409Z Has data issue: false hasContentIssue false
  • English
  • Français

Cannabis or alcohol first? Differences by ethnicity and in risk for rapid progression to cannabis-related problems in women

Published online by Cambridge University Press:  18 July 2012

C. E. Sartor ,
A. Agrawal ,
M. T. Lynskey ,
A. E. Duncan ,
J. D. Grant ,
E. C. Nelson ,
P. A. F. Madden ,
A. C. Heath  and
K. K. Bucholz
C. E. Sartor*
Affiliation:
Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
A. Agrawal
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
M. T. Lynskey
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
A. E. Duncan
Affiliation:
George Warren Brown School of Social Work, Washington University, St Louis, MO, USA
J. D. Grant
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
E. C. Nelson
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
P. A. F. Madden
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
A. C. Heath
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
K. K. Bucholz
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
*Address for correspondence: C. E. Sartor, Ph.D., Department of Psychiatry, Yale School of Medicine, VA Connecticut Healthcare System, 950 Campbell Ave. (151D), West Haven, CT 06516, USA. (Email: carolyn.sartor@yale.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Initiation of cannabis use typically follows alcohol use, but the reverse order does occur and is more common for African-Americans (AAs) than European-Americans (EAs). The aim of this study was to test for differences in the order of initiation of cannabis and alcohol use between AA and EA women and to determine whether order and ethnicity contribute independently to risk for rapid progression to cannabis-related problems.

Method

Data were drawn from structured psychiatric interviews of 4102 women (mean age = 21.6 years), 3787 from an all-female twin study and 315 from a high-risk family study; 18.1% self-identified as AA, 81.9% as EA. Ethnicity and order of initiation of cannabis and alcohol use were modeled as predictors of transition time from first use to onset of cannabis use disorder symptom(s) using Cox proportional hazards regression analyses.

Results

AA women were nearly three times as likely as EA women to initiate cannabis use before alcohol use. Using cannabis before alcohol [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.08–1.93] and AA ethnicity (HR 1.59, 95% CI 1.13–2.24) were both associated with rapid progression from first use to cannabis symptom onset even after accounting for age at initiation and psychiatric risk factors.

Conclusions

The findings indicate that AA women are at greater risk for rapid development of cannabis-related problems than EA women and that this risk is even higher when cannabis use is initiated before alcohol use. Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.

Keywords

African-Americansalcoholcannabiswomen
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 4 , April 2013 , pp. 813 - 823
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anthony, JC, Warner, L, Kessler, R (1994). Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmacology 2, 244–268.CrossRefGoogle Scholar
Behrendt, S, Beesdo-Baum, K, Hofler, M, Perkonigg, A, Buhringer, G, Lieb, R, Wittchen, HU (2012). The relevance of age at first alcohol and nicotine use for initiation of cannabis use and progression to cannabis use disorders. Drug and Alcohol Dependence 123, 48–56.CrossRefGoogle ScholarPubMed
Brook, DW, Brook, JS, Rubenstone, E, Zhang, C, Saar, NS (2011). Developmental associations between externalizing behaviors, peer delinquency, drug use, perceived neighborhood crime, and violent behavior in urban communities. Aggressive Behavior 37, 349–361.CrossRefGoogle ScholarPubMed
Brook, JS, Adams, RE, Balka, EB, Johnson, E (2002). Early adolescent marijuana use: risks for the transition to young adulthood. Psychological Medicine 32, 79–91.CrossRefGoogle ScholarPubMed
Brook, JS, Balka, EB, Whiteman, M (1999). The risks for late adolescence of early adolescent marijuana use. American Journal of Public Health 89, 1549–1554.CrossRefGoogle ScholarPubMed
Bucholz, KK, Cadoret, R, Cloninger, CR, Dinwiddie, SH, Hesselbrock, VM, Nurnberger, JI, Reich, T, Schmidt, I, Schuckit, MA (1994). A new, semi-structured psychiatric interview for use in genetic linkage studies: a report of the reliability of the SSAGA. Journal of Studies on Alcohol and Drugs 55, 149–158.CrossRefGoogle ScholarPubMed
Burt, SA, McGue, M, Iacono, WG (2009). Nonshared environmental mediation of the association between deviant peer affiliation and adolescent externalizing behaviors over time: results from a cross-lagged monozygotic twin differences design. Developmental Psychology 45, 1752–1760.CrossRefGoogle ScholarPubMed
Caetano, R, Babor, TF (2006). Diagnosis of alcohol dependence in epidemiological surveys: an epidemic of youthful alcohol dependence or a case of measurement error? Addiction 101 (Suppl. 1), 111–114.CrossRefGoogle ScholarPubMed
Calvert, WJ, Bucholz, KK, Steger-May, K (2010). Early drinking and its association with adolescents' participation in risky behaviors. Journal of the American Psychiatric Nurses Association 16, 239–251.CrossRefGoogle ScholarPubMed
Chen, CY, O'Brien, MS, Anthony, JC (2005). Who becomes cannabis dependent soon after onset of use? Epidemiological evidence from the United States: 2000–2001. Drug and Alcohol Dependence 79, 11–22.CrossRefGoogle ScholarPubMed
Chen, P, Jacobson, KC (2012). Developmental trajectories of substance use from early adolescence to young adulthood: gender and racial/ethnic differences. Journal of Adolescent Health 50, 154–163.CrossRefGoogle ScholarPubMed
Chung, T, Martin, CS (2005). What were they thinking? Adolescents' interpretations of DSM-IV alcohol dependence symptom queries and implications for diagnostic validity. Drug and Alcohol Dependence 80, 191–200.CrossRefGoogle ScholarPubMed
Coffey, C, Carlin, JB, Degenhardt, L, Lynskey, MT, Sanci, L, Patton, GC (2002). Cannabis dependence in young adults: an Australian population study. Addiction 96, 187–194.CrossRefGoogle Scholar
Coffey, C, Lynskey, M, Wolfe, R, Patton, GC (2000). Initiation and progression of cannabis use in a population-based Australian adolescent longitudinal study. Addiction 95, 1679–1690.CrossRefGoogle Scholar
Compton, WM, Grant, BF, Colliver, JD, Glantz, MD, Stinson, FS (2004). Prevalence of marijuana use disorders in the United States: 1991–1992 and 2001–2002. Journal of the American Medical Association 291, 2114–2121.CrossRefGoogle ScholarPubMed
Copeland, J, Swift, W (2009). Cannabis use disorder: epidemiology and management. International Review of Psychiatry 21, 96–103.CrossRefGoogle ScholarPubMed
D'Amico, EJ, McCarthy, DM (2006). Escalation and initiation of younger adolescents' substance use: the impact of perceived peer use. Journal of Adolescent Health 39, 481–487.CrossRefGoogle ScholarPubMed
Degenhardt, L, Chiu, WT, Conway, K, Dierker, L, Glantz, M, Kalaydjian, A, Merikangas, K, Sampson, N, Swendsen, J, Kessler, RC (2009). Does the ‘gateway’ matter? Associations between the order of drug use initiation and the development of drug dependence in the National Comorbidity Study Replication. Psychological Medicine 39, 157–167.CrossRefGoogle ScholarPubMed
Degenhardt, L, Chiu, WT, Sampson, N, Kessler, RC, Anthony, JC, Angermeyer, M, Bruffaerts, R, de Girolamo, G, Gureje, O, Huang, Y, Karam, A, Kostyuchenko, S, Lepine, JP, Mora, ME, Neumark, Y, Ormel, JH, Pinto-Meza, A, Posada-Villa, J, Stein, DJ, Takeshima, T, Wells, JE (2008). Toward a global view of alcohol, tobacco, cannabis, and cocaine use: findings from the WHO World Mental Health Surveys. PLoS Medicine 5, 1053–1067.CrossRefGoogle Scholar
Ellickson, PL, Tucker, JS, Klein, DJ, Saner, H (2004). Antecedents and outcomes of marijuana use initiation during adolescence. Preventive Medicine 39, 976–984.CrossRefGoogle ScholarPubMed
Ensminger, ME, Juon, HS, Green, KM (2007). Consistency between adolescent reports and adult retrospective reports of adolescent marijuana use: explanations of inconsistent reporting among an African American population. Drug and Alcohol Dependence 89, 13–23.CrossRefGoogle ScholarPubMed
Fendrich, M, Johnson, TP (2005). Race/ethnicity differences in the validity of self-reported drug use: results from a household survey. Journal of Urban Health 82, iii67–iii81.CrossRefGoogle Scholar
Fergusson, DM, Lynskey, MT, Horwood, LJ (1996). Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalence of sexual abuse and factors associated with sexual abuse. Journal of the American Academy of Child and Adolescent Psychiatry 35, 1355–1364.CrossRefGoogle ScholarPubMed
Finlay, AK, White, HR, Mun, EY, Cronley, CC, Lee, C (2012). Racial differences in trajectories of heavy drinking and regular marijuana use from ages 13 to 24 among African-American and White males. Drug and Alcohol Dependence 121, 118–123.CrossRefGoogle ScholarPubMed
Gil, AG, Vega, WA, Turner, RJ (2002). Early and mid-adolescence risk factors for later substance abuse by African Americans and European Americans. Public Health Reports 117 (Suppl. 1), S15–S29.Google ScholarPubMed
Gillmore, MR, Catalano, RF, Morrison, DM, Wells, EA, Iritani, B, Hawkins, JD (1990). Racial differences in acceptability and availability of drugs and early initiation of substance use. American Journal of Drug and Alcohol Abuse 16, 185–206.CrossRefGoogle ScholarPubMed
Grambsch, P, Therneau, TM (1994). Proportional hazards tests and diagnostics based on weighted residuals. Biometrika 81, 515–526.CrossRefGoogle Scholar
Guerra, LM, Romano, PS, Samuels, SJ, Kass, PH (2000). Ethnic differences in adolescent substance initiation sequences. Archives of Pediatrics and Adolescent Medicine 154, 1089–1095.CrossRefGoogle ScholarPubMed
Haller, M, Handley, E, Chassin, L, Bountress, K (2010). Developmental cascades: linking adolescent substance use, affiliation with substance use promoting peers, and academic achievement to adult substance use disorders. Developmenal Psychopathology 22, 899–916.CrossRefGoogle ScholarPubMed
Harford, TC, Yi, HY, Faden, VB, Chen, CM (2009). The dimensionality of DSM-IV alcohol use disorders among adolescent and adult drinkers and symptom patterns by age, gender, and race/ethnicity. Alcoholism: Clinical and Experimental Research 33, 868–878.CrossRefGoogle ScholarPubMed
Heath, AC, Howells, W, Bucholz, KK, Glowinski, A, Nelson, EC, Madden, PAF (2002). Ascertainment of a mid-western U.S. female adolescent twin cohort for alcohol studies: assessment of sample representativeness using birth record data. Twin Research 5, 107–112.CrossRefGoogle ScholarPubMed
Hesselbrock, M, Easton, C, Bucholz, KK, Schuckit, MA, Hesselbrock, VM (1999). A validity study of the SSAGA – a comparison with the SCAN. Addiction 94, 1361–1370.CrossRefGoogle ScholarPubMed
Hoffmann, JP, Su, SS (1998). Parental substance use disorder, mediating variables and adolescent drug use: a non-recursive model. Addiction 93, 1351–1364.CrossRefGoogle ScholarPubMed
Johnston, LD, O'Malley, PM, Bachman, JG, Schulenberg, JE (2008). Monitoring the Future. National Results on Adolescent Drug Use: Overview of Key Findings. National Institute on Drug Abuse: Bethesda, MD.Google Scholar
Kandel, D, Faust, R (1975). Sequence and stages in patterns of adolescent drug use. Archives of General Psychiatry 32, 923–932.CrossRefGoogle ScholarPubMed
Kandel, DB, Yamaguchi, K, Chen, K (1992). Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory. Journal of Studies on Alcohol 53, 447–457.CrossRefGoogle ScholarPubMed
Korhonen, T, Huizink, AC, Dick, DM, Pulkkinen, L, Rose, RJ, Kaprio, J (2008). Role of individual, peer and family factors in the use of cannabis and other illicit drugs: a longitudinal analysis among Finnish adolescent twins. Drug and Alcohol Dependence 97, 33–43.CrossRefGoogle ScholarPubMed
Lessem, JM, Hopfer, CJ, Haberstick, BC, Timberlake, D, Ehringer, MA, Smolen, A, Hewitt, JK (2006). Relationship between adolescent marijuana use and young adult illicit drug use. Behavior Genetics 36, 498–506.CrossRefGoogle Scholar
Lev-Ran, S, Imtiaz, S, Taylor, BJ, Shield, KD, Rehm, J, Le Foll, B (2012). Gender differences in health-related quality of life among cannabis users: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence 123, 190–200.CrossRefGoogle ScholarPubMed
Lynskey, M, Hall, W (2000). The effects of adolescent cannabis use on educational attainment: a review. Addiction 95, 1621–1630.CrossRefGoogle ScholarPubMed
Mackesy-Amiti, ME, Fendrich, M, Goldstein, PJ (1997). Sequence of drug use among serious drug users: typical vs atypical progression. Drug and Alcohol Dependence 45, 185–196.CrossRefGoogle ScholarPubMed
Newes-Adeyi, G, Chen, CM, Williams, GD, Faden, VB (2004). Trends in Underage Drinking in the United States, 1991–2003 (Surveillance Report #74). National Institute on Alcohol Abuse and Alcoholism, Division of Epidemiology and Prevention Research, Alcohol Epidemiologic Data System, Bethesda, MD.Google Scholar
Nocon, A, Wittchen, HU, Pfister, H, Zimmermann, P, Lieb, R (2006). Dependence symptoms in young cannabis users? A prospective epidemiological study. Journal of Psychiatric Research 40, 394–403.CrossRefGoogle ScholarPubMed
Rothman, EF, Wise, LA, Bernstein, E, Bernstein, J (2009). The timing of alcohol use and sexual initiation among a sample of Black, Hispanic, and White adolescents. Journal of Ethnicity in Substance Abuse 8, 129–145.CrossRefGoogle ScholarPubMed
Sartor, CE, Agrawal, A, Lynskey, MT, Bucholz, KK, Heath, AC (2008). Genetic and environmental influences on the rate of progression to alcohol dependence in young women. Alcoholism: Clinical and Experimental Research 32, 632–638.CrossRefGoogle ScholarPubMed
Sartor, CE, Lynskey, MT, Heath, AC, Jacob, T, True, W (2007). The role of childhood risk factors in initiation of alcohol use and progression to alcohol dependence. Addiction 102, 216–225.CrossRefGoogle ScholarPubMed
SAS Institute (2008). SAS Software Version 9.2. SAS Institute Inc.: Cary, NC.Google Scholar
Schepis, TS, Desai, RA, Cavallo, DA, Smith, AE, McFetridge, A, Liss, TB, Potenza, MN, Krishnan-Sarin, S (2011). Gender differences in adolescent marijuana use and associated psychosocial characteristics. Journal of Addiction Medicine 5, 65–73.CrossRefGoogle ScholarPubMed
Shih, RA, Miles, JN, Tucker, JS, Zhou, AJ, D'Amico, EJ (2010). Racial/ethnic differences in adolescent substance use: mediation by individual, family, and school factors. Journal of Studies on Alcohol and Drugs 71, 640–651.CrossRefGoogle ScholarPubMed
Stallings, MC, Hewitt, JK, Beresford, T, Heath, AC, Eaves, LJ (1999). A twin study of drinking and smoking onset and latencies from first to regular use. Behavior Genetics 6, 409–421.CrossRefGoogle Scholar
StataCorp (2007). Stata Statistical Software: Release 8.2. Stata Corporation: College Station, TX.Google Scholar
Stinson, FS, Ruan, WJ, Pickering, RP, Grant, BF (2006). Cannabis use disorders in the USA: prevalence, correlates and co-morbidity. Psychological Medicine 36, 1447–1460.CrossRefGoogle ScholarPubMed
Tarter, RE, Vanyukov, M, Kirisci, L, Reynolds, M, Clark, DB (2006). Predictors of marijuana use in adolescents before and after licit drug use: examination of the gateway hypothesis. American Journal of Psychiatry 12, 2134–2140.CrossRefGoogle Scholar
Teesson, M, Baillie, A, Lynskey, MT, Manor, B, Degenhardt, L (2006). Substance use, dependence and treatment seeking in the United States and Australia: a cross-national comparison. Drug and Alcohol Dependence 81, 149–155.CrossRefGoogle Scholar
van den Bree, MB, Pickworth, WB (2005). Risk factors predicting changes in marijuana involvement in teenagers. Archives of General Psychiatry 62, 311–319.CrossRefGoogle ScholarPubMed
Vega, WA, Aguilar-Gaxiola, S, Andrade, L, Bijl, R, Borges, G, Caraveo-Anduaga, JJ, DeWit, DJ, Heeringa, SG, Kessler, RC, Kolody, B, Merikangas, KR, Molnar, BE, Walters, EE, Warner, LA, Wittchen, HU (2002). Prevalence and age of onset for drug use in seven international sites: results from the international consortium of psychiatric epidemiology. Drug and Alcohol Dependence 68, 285–297.CrossRefGoogle Scholar
Wagner, EF, Lloyd, DA, Gil, AG (2002). Racial/ethnic and gender differences in the incidence and onset age of DSM-IV alcohol use disorder symptoms among adolescents. Journal of Studies on Alcohol 63, 609–619.CrossRefGoogle ScholarPubMed
Wagner, FA, Anthony, JC (2007). Male-female differences in the risk of progression from first use to dependence upon cannabis, cocaine, and alcohol. Drug and Alcohol Dependence 86, 191–198.CrossRefGoogle ScholarPubMed
Walker, JL, Carey, PD, Mohr, N, Stein, DJ, Seedat, S (2004). Gender differences in the prevalence of childhood sexual abuse and in the development of pediatric PTSD. Archives of Women's Mental Health 7, 111–121.CrossRefGoogle ScholarPubMed
Wallace, Jr. JM, Forman, TA, Guthrie, BJ, Bachman, JG, O'Malley, PM, Johnston, LD (1999). The epidemiology of alcohol, tobacco and other drug use among black youth. Journal of Studies on Alcohol 60, 800–809.CrossRefGoogle ScholarPubMed
Wang, J, Simons-Morton, BG, Farhat, T, Luk, JW (2009). Socio-demographic variability in adolescent substance use: mediation by parents and peers. Prevention Science 10, 387–396.CrossRefGoogle ScholarPubMed
Wells, JE, McGee, MA (2008). Violations of the usual sequence of drug initiation: prevalence and associations with the development of dependence in the New Zealand Mental Health Survey. Journal of Studies on Alcohol and Drugs 69, 789–795.CrossRefGoogle ScholarPubMed
White, HR, Jarrett, N, Valencia, EY, Loeber, R, Wei, E (2007). Stages and sequences of initiation and regular substance use in a longitudinal cohort of black and white male adolescents. Journal of Studies on Alcohol and Drugs 68, 173–181.CrossRefGoogle Scholar
Supplementary material: File

Sartor et al. supplementary material

Appendices
Download Sartor et al. supplementary material(File)
File 16.3 KB