Research & Resources

Adverse Childhood Experiences and Risk Patterns of Alcohol and Cannabis Co-Use: A Longitudinal Study of Puerto Rican Youth

In this study, researchers investigated the prospective association between simultaneous alcohol and marijuana use (SAM) and adverse childhood experiences (ACEs), which are common among Puerto Rican youth. Participants included 2,400 Puerto Rican youth in a longitudinal study. Multinomial logistic regressions were used to test the associations between prospectively reported ACEs (11 types, reported by parents and/or children, categorized as 0–1, 2–3, and 4+ ACEs) with young adult alcohol/cannabis use patterns in the past month (i.e., no lifetime use, low-risk [fewer than 10 instances of binge drinking and cannabis use], binge drinking only, regular cannabis use only, and SAM). While overall SAM among 12th graders decreased from 23.65% to 18.31% between 2000 and 2020, SAM increased among students who had never used cigarettes or vaped nicotine (from 5.42% to 7.03%). Among students who had ever used cigarettes or vaped nicotine, SAM increased from 39.2% in 2000–2005 to 44.1% in 2010–2014, then declined to 37.8% in 2015–2020. Adjusted models controlling for demographics indicated that among students with no lifetime cigarette or vaped nicotine use, students in 2015–2020 were 1.40 times as likely to report SAM, and 5.43 times as likely to report marijuana-only use (i.e., no alcohol use) compared to students who used neither in 2000–2005. Alcohol-only use declined over time among all participants, regardless of their use or non-use of cigarettes or nicotine vape products. Overall, findings showed that exposure to 4 or more ACEs was associated with the occurrence of adolescent/young adulthood regular cannabis use and SAM. Importantly, exposure to ACEs differentiated young adults who were co-using from those engaged in low-risk use (i.e., fewer than 10 instances of binge drinking and cannabis use). Researchers proposed that preventing ACEs and promoting interventions for Puerto Rican youth experiencing 4 or more ACEs might mitigate negative consequences associated with SAM.

This paper, “Adverse childhood experiences and risk patterns of alcohol and cannabis co-use: A longitudinal study of Puerto Rican youth,” was funded by the National Institute on Drug Abuse (NIDA) and the National Center for Injury Prevention and Control (NCIPC) and published in the Journal of adolescent health.

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