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Young adult sequelae of adolescent cannabis use: an integrative analysis.

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Silins, Edmund, Horwood, L John, Patton, George C, Fergusson, David M, Olsson, Craig A, Hutchinson, Delyse M, Spry, Elizabeth, Toumbourou, John W +7 more·2014·The Lancet Psychiatry
DOI 10.1016/s2215-0366(14)70307-4
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Abstract

Background Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use.Methods We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765).Findings We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0·37, 95% CI 0·20-0·66) and degree attainment (0·38, 0·22-0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44-34·12), use of other illicit drugs (7·80, 4·46-13·63), and suicide attempt (6·83, 2·04-22·90).Interpretation Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects.Funding Australian Government National Health and Medical Research Council.

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  • There is a likelihood of a window of risk during adolescence when the deleterious effects of cannabis are most pronounced.

    “Given the likelihood of a window of risk during adolescence when the deleterious effects of cannabis are most pronounced, 10”

    From Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood (2019) · cites this paper as [10]

    The Introduction (page unavailable) describes adolescence as a vulnerable developmental period for the consequences of cannabis exposure. The copy's Comment section says cognitive functions were more severely affected in adolescents than adults, but the study does not establish that cannabis's deleterious effects generally are most pronounced during adolescence. (LLM, conf=0.84)

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  • Strong evidence for cognitive dysfunction associated with adolescent-onset, long-term frequent cannabis use comes from a longitudinal study of the Dunedin cohort, which showed that individuals with adolescent-onset daily cannabis use who continued heavy use throughout adulthood had declines in IQ and poorer cognitive functioning at age 38 years, even after adjusting for multiple relevant covariate

    “Strong evidence for cognitive dysfunction associated with adolescent-onset, long-term frequent cannabis use comes from a longitudinal study of the Dunedin cohort, 102 showing that individuals with adolescentonset daily cannabis use who continued heavy use throughout adulthood showed declines in IQ and poorer cognitive functioning at age 38 years, even after adjusting for multiple relevant cov”

    From Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis (2018) · cites this paper as [102]

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  • The sample size of the Dunedin cohort subgroup was small, raising questions about generalizability.

    “However, the sample size of this specific subgroup was small, which raises questions about generalizability.”

    From Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis (2018) · cites this paper as [102]

    The Introduction identifies the three cohorts analyzed as the Australian Temperament Project, Christchurch Health and Development Study, and Victorian Adolescent Health Cohort Study—not a Dunedin cohort. Searches for Dunedin and for a small subgroup linked to generalizability found no passage addressing the claimed subgroup or its sample size. The discussion of generalisability concerns the study’s findings more broadly. (LLM, conf=0.76)

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Research works printed but not linked: 2

  1. [39]39. Macleod J, Oakes R, Copello A, et al. Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies. Lancet 2004; 363: 1579-88.
  2. [40]40. Silins E, Horwood LJ, Patton GC, for the Cannabis Cohorts Research Consortium. Young adult sequelae of adolescent cannabis use: an integrative meta-analysis. Lancet Psychiatry 2014; 1: 286-93.

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Authors
Silins, E., Horwood, L. J., Patton, G. C., Fergusson, D. M., Olsson, C. A., Hutchinson, D. M., Spry, E., Toumbourou, J. W., Degenhardt, L., Swift, W., Coffey, C., Tait, R. J., Letcher, P., Copeland, J., & Mattick, R. P.
Affiliations
  • UNSW Sydney (AU)
  • University of Otago (NZ)
  • Royal Children's Hospital (AU)
  • Australian National University (AU)
  • The University of Melbourne (AU)
Corresponding author
Silins, Edmund
ORCID
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2014-09
Volume
1
Issue
4
Pages
286-293
ISSN
2215-0366 (ISSN-L)
DOI
10.1016/s2215-0366(14)70307-4
OpenAlex
W2147909359
Cited by
443
References
39
Citations by year
2026: 12 · 2025: 38 · 2024: 27 · 2023: 32 · 2022: 31 · 2021: 39 · 2020: 54 · 2019: 36 · 2018: 45 · 2017: 49 · 2016: 42 · 2015: 32 · 2014: 6
FWCI
31.34
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • eSpace (Curtin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • ANU Open Research (Australian National University) (submittedVersion)
Funders
  • Australian Government
  • University of New South Wales
  • Medical Research Council
  • National Health and Medical Research Council (1041742, 1045318, 1019887)
  • National Drug and Alcohol Research Centre
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
Keywords
adolescent cannabis use, young adult outcomes, cannabis use disorder, illicit drug use, suicide attempts, depression, welfare dependency, educational attainment, dose-response relationship, psychosocial sequelae, cannabis legislation

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