Adverse childhood experiences as precursors to cannabis use in adulthood: A systematic review

Background: Individuals with a history of Adverse Childhood Experiences (ACEs) are at risk of subsequent cannabis use. However, at present no existing systematic review explores ACEs as they relate to cannabis use. Objective: The aim of this systematic review paper is to examine how adverse childhood experiences (ACEs) impact rates, patterns, and the nature of cannabis use in adulthood. Methods: Guided by the PRISMA statement, this systematic review focuses on longitudinal studies that report cannabis use in adulthood. Databases searched include PubMed and Embase. Results: Ultimately, 28 manuscripts were selected for inclusion, ranging in scope from smaller community-focused studies to nationally representative longitudinal surveys; 22 of 28 studies occurred in the United States, with sample size ranging from 303 to 15,960 participants. Instruments used to assess ACEs and cannabis use varied considerably across studies, leading to loss of consistency. Nevertheless, presence of ACEs-childhood sexual abuse in particular-was consistently associated with cannabis use later in life. Frequency and severity of ACEs was found to exert an additive cumulative effect on severity of cannabis use. Conclusions: This systematic review lays the foundation of the current state of the science regarding ACEs and cannabis use, which can provide further insight into a better understanding of this relationship and provide potential intervention opportunities.