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The Relationship Between Childhood Physical and Sexual Abuse and Adolescent Cannabis Use: A Systematic Review

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Víctor De la Peña-Arteaga, Sarah O. Nogueira, Michael Lynskey, Lindsey A. Hines

Original languageEnglish
Article number631245
JournalFrontiers in Psychiatry
Published26 May 2021

Bibliographical note

Funding Information: The project that gave rise to these results received the support of a fellowship from la Caixa Foundation (ID 100010434). The fellowship code for VD is LCF/BQ/DI17/11620071 and for SN LCF/BQ/DI17/11620022. LH was supported by a Wellcome Trust Sir Henry Wellcome Postdoctoral Fellowship (209158/Z/17/Z). Publisher Copyright: © Copyright © 2021 De la Peña-Arteaga, Nogueira, Lynskey and Hines. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Background: Among adolescents, cannabis use is a health concern due to associations with drug addiction and mental health disorders across the life course. It has been shown that childhood maltreatment is associated with drug addiction in adulthood. However, a better understanding of the relationship between maltreatment and drug use may improve targeted prevention and interventions. The aim of this systematic review is to describe the association between exposure to childhood maltreatment, specifically physical and sexual abuse, with adolescent cannabis use. Methods: A systematic search strategy was applied to Embase, PsycINFO, and Ovid MEDLINE(R) databases. Methods followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Abstract and title screening was performed to identify papers which reported an estimate of the association between childhood physical or sexual abuse and adolescent cannabis use. Full text screening of each paper was performed, and data were extracted and study quality assessed. Weighted means meta-analysis was performed on studies reporting odds ratios as effect estimates. Results: Of 8,780 screened articles, 13 were identified for inclusion. Eight papers received a quality rating score indicating lower risk of bias. Eleven papers reported the relationship between childhood sexual abuse and adolescent cannabis use; effect estimates ranged from AOR 0.53–AOR 2.18 (weighted mean OR 1.29, 95% CI 1.08–1.49). The relationship between childhood physical abuse and adolescent cannabis use was reported in 7 papers; effect estimates ranged from AOR 1.25–AOR 1.87 (weighted mean OR 1.39, 95% CI 1.12–1.66). Differences in the strength of the evidence were observed by the method of exposure ascertainment, and there was some evidence of differences in association by gender, age of cannabis initiation, and the severity of the abuse. Conclusions: This systematic review indicates childhood physical or sexual abuse may increase risk of adolescent-onset cannabis use. Few studies considered variation in timing of onset, or by gender. Adolescent cannabis use precedes is strongly associated with increased risk of negative mental health outcomes; further exploration of adolescent cannabis use's place on the causal pathway between childhood abuse and adult mental health problems is warranted to improve intervention.

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