BACKGROUND: Initiation of cannabis use typically follows alcohol use, but the reverse order does occur and is more common for African-Americans (AAs) than European-Americans (EAs). The aim of this study was to test for differences in the order of initiation of cannabis and alcohol use between AA and EA women and to determine whether order and ethnicity contribute independently to risk for rapid progression to cannabis-related problems. Method Data were drawn from structured psychiatric interviews of 4102 women (mean age = 21.6 years), 3787 from an all-female twin study and 315 from a high-risk family study; 18.1% self-identified as AA, 81.9% as EA. Ethnicity and order of initiation of cannabis and alcohol use were modeled as predictors of transition time from first use to onset of cannabis use disorder symptom(s) using Cox proportional hazards regression analyses. RESULTS: AA women were nearly three times as likely as EA women to initiate cannabis use before alcohol use. Using cannabis before alcohol [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.08-1.93] and AA ethnicity (HR 1.59, 95% CI 1.13-2.24) were both associated with rapid progression from first use to cannabis symptom onset even after accounting for age at initiation and psychiatric risk factors. CONCLUSIONS: The findings indicate that AA women are at greater risk for rapid development of cannabis-related problems than EA women and that this risk is even higher when cannabis use is initiated before alcohol use. Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.
BACKGROUND:Initiation of cannabis use typically follows alcohol use, but the reverse order does occur and is more common for African-Americans (AAs) than European-Americans (EAs). The aim of this study was to test for differences in the order of initiation of cannabis and alcohol use between AA and EA women and to determine whether order and ethnicity contribute independently to risk for rapid progression to cannabis-related problems. Method Data were drawn from structured psychiatric interviews of 4102 women (mean age = 21.6 years), 3787 from an all-female twin study and 315 from a high-risk family study; 18.1% self-identified as AA, 81.9% as EA. Ethnicity and order of initiation of cannabis and alcohol use were modeled as predictors of transition time from first use to onset of cannabis use disorder symptom(s) using Cox proportional hazards regression analyses. RESULTS: AA women were nearly three times as likely as EA women to initiate cannabis use before alcohol use. Using cannabis before alcohol [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.08-1.93] and AA ethnicity (HR 1.59, 95% CI 1.13-2.24) were both associated with rapid progression from first use to cannabis symptom onset even after accounting for age at initiation and psychiatric risk factors. CONCLUSIONS: The findings indicate that AA women are at greater risk for rapid development of cannabis-related problems than EA women and that this risk is even higher when cannabis use is initiated before alcohol use. Prevention programs should be tailored to the various patterns of cannabis use and relative contributions of risk factors to the development of cannabis-related problems in different ethnic groups.
Authors: William A Vega; Sergio Aguilar-Gaxiola; Laura Andrade; Rob Bijl; Guilherme Borges; Jorge J Caraveo-Anduaga; David J DeWit; Steven G Heeringa; Ronald C Kessler; Bo Kolody; Kathleen R Merikangas; Beth E Molnar; Ellen E Walters; Lynn A Warner; Hans-Ulrich Wittchen Journal: Drug Alcohol Depend Date: 2002-12-01 Impact factor: 4.492
Authors: Andrea K Finlay; Helene R White; Eun-Young Mun; Courtney C Cronley; Chioun Lee Journal: Drug Alcohol Depend Date: 2011-09-09 Impact factor: 4.492
Authors: Tellervo Korhonen; Anja C Huizink; Danielle M Dick; Lea Pulkkinen; Richard J Rose; Jaakko Kaprio Journal: Drug Alcohol Depend Date: 2008-05-02 Impact factor: 4.492
Authors: Kimberly B Werner; Julia D Grant; Vivia V McCutcheon; Pamela A F Madden; Andrew C Heath; Kathleen K Bucholz; Carolyn E Sartor Journal: Psychol Addict Behav Date: 2016-06
Authors: Joan L Luby; Arpana Agrawal; Andy Belden; Diana Whalen; Rebecca Tillman; Deanna M Barch Journal: Am J Psychiatry Date: 2018-03-21 Impact factor: 18.112
Authors: Kimberly B Werner; Renee M Cunningham-Williams; Whitney Sewell; Arpana Agrawal; Vivia V McCutcheon; Mary Waldron; Andrew C Heath; Kathleen K Bucholz Journal: Womens Health Issues Date: 2018-06-11
Authors: Kimberly B Werner; Carolyn E Sartor; Vivia V McCutcheon; Julia D Grant; Elliot C Nelson; Andrew C Heath; Kathleen K Bucholz Journal: Alcohol Clin Exp Res Date: 2016-09-22 Impact factor: 3.455