Study Finds Children of Moms Who Used Cannabis During Pregnancy More Likely to Use Cannabis Themselves Interview with:

Alex P. Miller, PhDTranSTAR T32 Postdoctoral Fellow Department of Psychiatry  Washington University School of Medicine St. Louis, MO

Dr. Miller

Alex P. Miller, PhD
TranSTAR T32 Postdoctoral Fellow
Department of Psychiatry
Washington University School of Medicine
St. Louis, MO What is the background for this study?

Response: Adolescent cannabis use is increasing in the United States. Prior research suggests that people who start using cannabis earlier are more likely to engage in problematic use and also experience greater mental health challenges and socioeconomic disadvantages overall. For example, children who begin using cannabis early are more likely to have behavioral problems and disorders and are more less likely to complete school.

In our study, we used data from the Adolescent Brain Cognitive Development (ABCD) Study, which is following nearly 12,000 kids across the nation to track behavior and brain development as well as health from middle childhood to young adulthood. We looked at what factors are associated with the initiation of cannabis use by age 12-14. What are the main findings?

Response:  We found that around 2% of the ABCD sample has reported using cannabis at this point in the study by age 12-14. This is consistent with recent estimates from other nationally-representative studies, which also show that this quickly escalates to around 12% once adolescents start high school. Results of our study indicate that children reporting use of cannabis by around 13 years of age are less socioeconomically advantaged than their non-using peers. After accounting for differences in socioeconomic variables as well as other variables like family membership, we also found that children initiating cannabis use at this stage showed greater behavioral problems and depressed mood as 9-11-year-olds. They also endorsed more positive expectations about using cannabis, reported more peer use and favorable attitudes around cannabis use by peers, and greater ease of access to cannabis.

The strongest association we observed was related to maternal use of cannabis during pregnancy (i.e., prenatal cannabis exposure). Children with mothers reporting use of cannabis during their pregnancies were more than twice as likely to use cannabis themselves at this stage even after accounting for risk factor like their use of other substances, having parents or family members reporting substance use problems, or prenatal alcohol or tobacco exposure. What should readers take away from your report?

Response: Our study demonstrates that there are a number of characteristics that are associated with early cannabis use. Taken together our findings suggest greater caution in cannabis-related attitudes, access, and use during periods of vulnerability (e.g., pregnancy), particularly for youth with other mental health issues, as they have may have implications for early initiation of cannabis use and risk for other potential consequences as they enter adolescence and transition into adulthood. What recommendations do you have for future research as a results of this study?

Response:  Though the ABCD Study is of unprecedented scale, at this stage a relatively small number of children have used cannabis and likely many of them have only cannabis a few times. As they age and transition into adolescence, the number of children using cannabis is likely to increase, and some will begin to use more regularly and may develop cannabis-related problems. Future research examining how the risk factors identified in our study may help to identify youth at greater risk for later consequences will be key. Beyond following this group of children as they age and develop, our group is also beginning studies to examine more closely the effects of substance use on prenatal and infant development.

We think it will be important to extend this work to early stages of brain and behavioral development – for example during the neonatal period and early childhood. We are currently conducting a study that is recruiting pregnant women and assessing children shortly after birth so that we may understand neonatal associations with prenatal cannabis exposure. We are also part of a large national study, the HEALthy Brain and Child Development (HBCD) Study, that plans to recruit approximately 7,500 pregnant women across 30 sites within the United States to better understand how all kinds of prenatal exposures, genetic factors, and early experiences may shape early development, health, and behavior in early childhood. These studies will be important to assess the potential effects of prenatal exposures and other factors on early child development and health.

It will also be important for more basic science to further elucidate the role of the endocannabinoid system in brain and behavioral development across the lifespan including during the prenatal period and how specific cannabis constituents (e.g., THC, CBD) may interact with this.

Disclosures: No


Miller APBaranger DAAPaul SE, et al. Characteristics Associated With Cannabis Use Initiation by Late Childhood and Early Adolescence in the Adolescent Brain Cognitive Development (ABCD) Study. JAMA Pediatr. Published online June 26, 2023. doi:10.1001/jamapediatrics.2023.1801

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Last Updated on June 26, 2023 by Marie Benz