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JAMA: Escalation of Drug Use in Early-Onset Cannabis Users vs Co-twin Controls

Lynskey, M. et al

Journal of the Americal Medical Association

Wednesday 22 Jan 2003

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http://jama.ama-assn.org/issues/v289n4/rfull/joc21156.html


Michael T. Lynskey, PhD; Andrew C. Heath, DPhil; Kathleen K. Bucholz, PhD;
Wendy S. Slutske, PhD; Pamela A. F. Madden, PhD; Elliot C. Nelson, MD; Dixie J.
Statham, MA; Nicholas G. Martin, PhD


Context Previous studies have reported that early initiation of cannabis
(marijuana) use is a significant risk factor for other drug use and
drug-related problems.

Objective To examine whether the association between early cannabis use and
subsequent progression to use of other drugs and drug abuse/dependence persists
after controlling for genetic and shared environmental influences.

Design Cross-sectional survey conducted in 1996-2000 among an Australian
national volunteer sample of 311 young adult (median age, 30 years) monozygotic
and dizygotic same-sex twin pairs discordant for early cannabis use (before age
17 years).

Main Outcome Measures Self-reported subsequent nonmedical use of prescription
sedatives, hallucinogens, cocaine/other stimulants, and opioids; abuse or
dependence on these drugs (including cannabis abuse/dependence); and alcohol
dependence.

Results Individuals who used cannabis by age 17 years had odds of other drug
use, alcohol dependence, and drug abuse/dependence that were 2.1 to 5.2 times
higher than those of their co-twin, who did not use cannabis before age 17
years. Controlling for known risk factors (early-onset alcohol or tobacco use,
parental conflict/separation, childhood sexual abuse, conduct disorder, major
depression, and social anxiety) had only negligible effects on these results.
These associations did not differ significantly between monozygotic and
dizygotic twins.

Conclusions Associations between early cannabis use and later drug use and
abuse/dependence cannot solely be explained by common predisposing genetic or
shared environmental factors. The association may arise from the effects of the
peer and social context within which cannabis is used and obtained. In
particular, early access to and use of cannabis may reduce perceived barriers
against the use of other illegal drugs and provide access to these drugs.

JAMA. 2003;289:427-433

 

 

 

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