Predictors of Early-Onset Cannabis Use in Adolescence and Risks for Substance Use Disorder Symptoms in Young Adulthood

• DOI: 10.1177/00220426211049356
• Published date: 01 April 2022
• Author: Megan E. Ames,Gabriel J. Merrin,Bonnie J. Leadbeater,Kara Thompson,Clea M. B. Sturgess
• Date: 01 April 2022
• Subject Matter: Articles

Article

Journal of Drug Issues

2022, Vol. 52(2) 182–206

© The Author(s) 2021

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DOI: 10.1177/00220426211049356

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Predictors of Early-Onset

Cannabis Use in Adolescence

and Risks for Substance Use

Disorder Symptoms in Young

Adulthood

Gabriel J. Merrin

1

, Bonnie J. Leadbeater

2

, Clea M. B. Sturgess

2

,

Megan E. Ames

2

, and Kara Thompson

3

Abstract

Early detection of risks for substance use disorders is essential to lifelong health and well-being for

some youth. Very early-onset use is proposed as an indicator of risk for substance use disorders,

but risk and protective factors related to early-onset use have not been identif‌ied. The current

study compared risk and protective factors that distinguish early- and late-onset cannabis users

from abstainers using data collected from a large community sample. The study also examined

onset-group differences in participants’reports of substance use disorder symptoms a decade

later. Heavy episodic drinking (early-onset: OR = 7.29 CI = [1.60, 33.19]) and engagement with

peers involved in deviant behaviors (early-onset: OR = 2.50 CI = [1.50, 4.13]) are risk factors for

early-onset cannabis use. Protective factors, including parent monitoring (early-onset: OR = 0.73

CI = [0.58, 0.93]), engagement with peers involved in positive behaviors (early-onset: OR = 0.54

CI = [0.39, 0.76]), school engagement (early-onset: OR = 0.83 CI = [0.72, 0.96]), and academic

grades (early-onset: OR = 0.37 CI = [0.21, 0.65]) also predicted early versus later onset-group

differences. Early age of onset may be distinctly related to risk and protective factors previously

associated with risks for substance use in all adolescents.

Keywords

cannabis use, early-onset, substance use, adolescence, young adulthood, risk and protective

factors

1

Department of Human Development and Family Science, Syracuse University, NY, USA

2

Department of Psychology, University of Victoria, British Columbia, Canada

3

Department of Psychology, St Francis Xavier University, Antigonish, Nova Scotia, Canada

Corresponding Author:

Gabriel J. Merrin, Department of Human Development and Family Science, Syracuse University, 150 Crouse Dr,

Syracuse, NY 13244-1100, USA.

Email: gjmerrin@syr.edu

Introduction

In the context of rising acceptance of recreational cannabis, societal concerns about preventing

harm to children and adolescents have increased; however, clear targets for policies and inter-

ventions remain elusive. Leading up to and following legislation, legalizing cannabis use for

medicinal or recreational purposes may have a direct impact on access and acceptance of cannabis

for young adolescents (Compton, Grant, Colliver, Glantz, & Stinson, 2004;Parker & Anthony,

2018;Schmidt, Jacobs, & Spetz, 2016). Recent research with young samples suggests that early-

onset cannabis use (i.e., 15 years or younger) carry age-specif‌ic risks for concurrent and adult-

onset of mental health disorders and substance use dependency (Grant & Dawson, 1998;Levine,

Clemenza, Rynn, & Lieberman, 2017;Luciana, 2013;Rioux et al., 2018), and can also result in

academic and economic challenges in young adulthood (Epstein et al., 2015;Thompson,

Leadbeater, Ames, & Merrin, 2018a). However, policy efforts singularly directed at postpon-

ing cannabis use may overlook the social contexts of cumulative risks and protective factors that

make early-onset use more or less likely. Early identif‌ication and treatment require a better

understanding of the unique individual and environmental risks that are implicated in the course of

the development of substance use disorders from adolescence to young adulthood. The current

study examines social-ecological risk and protective factors of early-onset cannabis use in a

variety of domains using data from a large community-based sample of Canadian adolescents who

began using cannabis before legislative changes in cannabis were implemented (i.e., prior or

during 2013). Specif‌ically, the study examines whether unique risk and protective factors

characterize early-onset users as adolescents, and youth who start use after age 15 (i.e., late-onset)

compared to those who abstain from cannabis use (i.e., abstainers). In addition, the study examines

their risks for substance use disorders in young adulthood.

Early-Onset Cannabis Use

Early-onset of cannabis use is variously def‌ined in the literature as beginning use by ages 14, 15,

or 16 (Bagot, Milin, & Kaminer, 2015;Levine et al., 2017;Luciana, 2013;Rioux et al., 2018;

Wilson et al., 2000). Data from the 2015 United States (US) National Survey on Drug Use and

Health (Center for Behavioral Health Statistics and Quality, 2016) showthat 13% of users ages

15 and younger report using cannabis in the past year. The 2015 US National Youth Risk

Behaviors Survey found that 8% of youth used before age 13 (Centers for Disease Control and

Prevention, 2015). In Canada, the percentages of youth using by age 15 are not available;

however, among 15- to 17-year-olds, past-year use is approximately one in six adolescents. For

example, combining data from nine national cross-sectional surveys, Rotermann and

Macdonald (2018) report that 17.5% of Canadian adolescents ages 15–17 self-report past-

year use. During 2019 (Rotermann, 2019), rates of cannabis use in 18- to 24-year-olds were

34.8% which was higher than any other age group. In 2015, the Canadian Tobacco,Alcohol, and

Drugs Survey (Statistics Canada, 2016) estimated that 28.9% [CI: 25.7–32.1]ofyouthages15–

19 reported ever using cannabis, and 20.6% [CI: 17.8–23.5] reported past year use. The 2014–

2015 Canadian Student Tobacco, Alcohol, and Drugs Survey (CSTADS; (Health Canada,

PROPEL Centre for Population Health Impact, 2015)) found that the average age of onset of

cannabis use was 14.2 years of age. Analysis of the Canadian Student Tobacco, Alcohol, and

Drugs Survey of students in grades 7–12 showed past-year use was 16.5% in 2014–2015 (Leos-

Toro, Rynard, Murnaghan, MacDonald, & Hammond, 2018). While it is not known how many

cannabis users will develop problematic use patterns by young adulthood in the context of

legalized cannabis, past research suggests that between 9% and 17% of youth who use cannabis

will develop a use disorder, and many within 5 years of age at f‌irst use (Levine et al., 2017).

Merrin et al. 183