Escalation of Drug Use in Early-Onset Cannabis Users vs Co-twin Controls | Adolescent Medicine | JAMA | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.204.227.34. Please contact the publisher to request reinstatement.
1.
Bachman  JG, Johnston  LD, O'Malley  PM.  Explaining recent increases in students' marijuana use: impacts of perceived risks and disapproval, 1976 through 1996.  Am J Public Health. 1998;88:887-892. PubMedGoogle ScholarCrossref
2.
Reid  A, Lynskey  MT, Copeland  J.  Cannabis use among Australian youth.  Aust N Z J Public Health. 2000;24:596-602.Google ScholarCrossref
3.
Substance Abuse and Mental Health Services Administration.  The DASIS Report: Marijuana treatment admissions increase: 1993-1999.  Available at: http://www.samhsa.gov/oas/2k2/MJtx.pdf. Accessed May 17, 2002.
4.
Hall  W, Solowij  N.  Adverse effects of cannabis.  Lancet. 1998;352:1611-1616. PubMedGoogle ScholarCrossref
5.
Solwij  N, Stephens  RS, Roffman  RA,  et al.  Cognitive functioning of long-term heavy cannabis users seeking treatment.  JAMA. 2002;287:1123-1131. PubMedGoogle ScholarCrossref
6.
McLellan  AT, Lewis  DC, O'Brien  CP, Kleber  HD.  Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.  JAMA. 2000;284:1689-1695. PubMedGoogle ScholarCrossref
7.
Substance Abuse and Mental Health Services Administration.  The DASIS Report: Treatment referral sources for adolescent marijuana users.  Available at: http://www.samhsa.gov/oas/2k2/YouthMJtx/YouthMJtx.pdf. Accessed May 17, 2002.
8.
Kandel  DB.  Stages in adolescent involvement in drug use.  Science. 1975;190:912-914. PubMedGoogle ScholarCrossref
9.
Kandel  DB, Faust  R.  Sequences and stages in patterns of adolescent drug use.  Arch Gen Psychiatry. 1975;32:923-932. PubMedGoogle ScholarCrossref
10.
Kandel  DB, Yamaguchi  K, Chen  K.  Stages of progression in drug involvement from adolescence to adulthood: further evidence for the gateway theory.  J Stud Alcohol. 1992;53:447-457. PubMedGoogle ScholarCrossref
11.
MacCoun  R.  In what sense (if any) is marijuana a gateway drug? FAS Drug Policy Analysis Bulletin , 1998; Issue 4. Available at: http://www.fas.org/drugs/issue4.htm#gateway. Accessed May 17, 2002.
12.
Ellickson  PL, Hayes  RD, Bell  RM.  Stepping through the drug use sequence: longitudinal scalogram analysis of initiation and regular use.  J Abnorm Psychol. 1992;101:441-451. PubMedGoogle ScholarCrossref
13.
Graham  JW, Collins  LM, Wugalter  SE, Chung  NK, Hansen  WB.  Modeling transitions in latent stage-sequential processes: a substance use prevention example.  J Consult Clin Psychol. 1991;59:48-57. PubMedGoogle ScholarCrossref
14.
Baumrind  D.  Specious causal attribution in the social sciences: the reformulated steeping stone hypothesis as exemplar.  J Pers Soc Psychol. 1983;45:1289-1298. PubMedGoogle ScholarCrossref
15.
Yamaguchi  K, Kandel  DB.  Patterns of drug use from adolescence to young adulthood, III: predictors of progression.  Am J Public Health. 1984;74:673-681. PubMedGoogle ScholarCrossref
16.
Fergusson  DM, Horwood  LJ.  Early onset cannabis use and psychosocial adjustment in young adults.  Addiction. 1997;92:279-296. PubMedGoogle ScholarCrossref
17.
Fergusson  DM, Horwood  LJ.  Does cannabis use encourage other forms of illicit drug use?  Addiction. 2000;95:505-520. PubMedGoogle ScholarCrossref
18.
Grant  BF, Dawson  DA.  Age of onset of drug use and its association with DSM-IV drug abuse and dependence: results from the National Longitudinal Alcohol Epidemiologic Survey.  J Subst Abuse. 1998;10:163-173. PubMedGoogle ScholarCrossref
19.
Kosterman  R, Hawkins  JD, Guo  J, Catalaon  RF, Abbott  RD.  The dynamics of alcohol and marijuana initiation: patterns and predictors of first use in adolescence.  Am J Public Health. 2000;90:360-366. PubMedGoogle ScholarCrossref
20.
Lynskey  MT, Heath  AC, Nelson  EC,  et al.  Genetic and environmental contributions to cannabis dependence in a national young adult twin sample.  Psychol Med. 2002;32:195-207. PubMedGoogle ScholarCrossref
21.
Kendler  KS, Karkowski  LM, Neale  MC, Prescott  CA.  Illicit psychoactive substance use, heavy use, abuse, and dependence in a US population-based sample of male twins.  Arch Gen Psychiatry. 2000;57:261-269. PubMedGoogle ScholarCrossref
22.
Tsuang  MT, Lyons  MJ, Meyer  JM,  et al.  Co-occurrence of abuse of different drugs in men: the role of drug-specific and shared vulnerabilities.  Arch Gen Psychiatry. 1998;55:967-972. PubMedGoogle ScholarCrossref
23.
Nelson  EC, Heath  AC, Madden  PAF,  et al.  The consequences and correlates of childhood sexual abuse—a retrospective examination using the twin study design.  Arch Gen Psychiatry. 2002;59:139-145.Google ScholarCrossref
24.
Heath  AC, Howells  W, Kirk  KM,  et al.  Predictors of non-response to a questionnaire survey of a volunteer twin panel: findings from the Australian 1989 twin cohort.  Twin Res. 2001;4:73-80. PubMedGoogle ScholarCrossref
25.
Cederlof  R, Friberg  L, Jonsson  E, Kaij  L.  Studies on similarity diagnosis in twins with the aid of a mailed questionnaire.  Acta Genetica et Statistica Medica. 1961;11:338-362. PubMedGoogle Scholar
26.
Kasriel  J, Eaves  LJ.  The zygosity of twins: further evidence on the agreement between diagnosis by blood groups and written questionnaires.  J Biosoc Sci. 1976;8:263-266. PubMedGoogle ScholarCrossref
27.
Nichols  RC, Bilbro Jr  WC.  The diagnosis of twin zygosity.  Acta Genet Stat Med. 1966;16:265-275. PubMedGoogle Scholar
28.
Sarna  S, Kaprio  J, Sistonen  P, Koskenvuo  M.  Diagnosis of twin zygosity by mailed questionnaire.  Hum Hered. 1978;28:241-254. PubMedGoogle ScholarCrossref
29.
Bucholz  KK, Cloninger  CR, Dinwiddie  SH,  et al.  A new, semi-structured psychiatric interview for use in genetic linkage studies: a report of the reliability of the SSAGA.  J Stud Alcohol. 1994;55:149-158. PubMedGoogle ScholarCrossref
30.
American Psychiatric Association.  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1994.
31.
SAS Institute Inc.  SAS/STAT Software: Changes and Enhancements for Release 6.12. Cary, NC: SAS Institute Inc; 1996.
32.
StataCorp.  Stata Statistical Software: Release 6.0. College Station, Tex: Stata Corp; 1999.
33.
Chen  K, Kandel  DB.  The natural history of drug use from adolescence to the mid thirties in a general population sample.  Am J Public Health. 1995;85:41-47. PubMedGoogle ScholarCrossref
34.
Australian Institute of Health and Welfare.  1998 National Drug Strategy Household Survey: First Results. Canberra: Australian Institute of Health and Welfare; 1999.
35.
Kendler  KS, Neale  MC, Thornton  LM, Aggen  SH, Gilman  SE, Kessler  RC.  Cannabis use in the last year in a US national sample of twin and sibling pairs.  Psychol Med. 2002;32:551-554. PubMedGoogle ScholarCrossref
36.
Nahas  G.  Keep Off the Grass. Middlebury, Vt: Paul Eriksson; 1990.
37.
Tanda  G, Pontieri  F, Di Chiara  G.  Cannabinoid and heroin activation of mesolimbic dopamine transmission by a common mu 1 opioid receptor mechanism.  Science. 1997;276:2048-2050.Google ScholarCrossref
38.
Lamarque  S, Taghouzti  K, Simon  H.  Chronic treatment with Δ9-tetrahydrocannabinol enhances the locomotor response to amphetamine and heroin: implications for vulnerability to drug addiction.  Neuropharmacology. 2001;41:118-129. PubMedGoogle ScholarCrossref
39.
Cadoni  C, Pisanu  A, Solinas  M, Acqua  E, Di Chiara  G.  Behavioural sensitization after repeated exposure to Δ9 − tetrahydrocannabinol and cross-sensitization with morphine.  Psychopharmacology. 2001;158:259-266. PubMedGoogle ScholarCrossref
40.
Fergusson  DM, Lynskey  MT, Horwood  LJ.  Patterns of cannabis use among 13-14 year old New Zealanders.  N Z Med J. 1993;106:247-250. PubMedGoogle Scholar
41.
Cohen  H.  Multiple drug use considered in the light of the stepping-stone hypothesis.  Int J Addict. 1972;7:27-55. PubMedGoogle ScholarCrossref
42.
MacCoun  R, Reuter  P.  Evaluating alternative cannabis regimes.  Br J Psychiatry. 2001;178:123-128. PubMedGoogle ScholarCrossref
Original Contribution
January 22, 2003

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

Author Affiliations

Author Affiliations: Queensland Institute of Medical Research, Brisbane, Queensland, Australia (Drs Lynskey and Martin and Ms Statham); Missouri Alcoholism Research Center and Department of Psychiatry, Washington University School of Medicine, St Louis (Drs Lynskey, Heath, Bucholz, Madden, and Nelson); and Missouri Alcoholism Research Center and Department of Psychology, University of Missouri, Columbia (Dr Slutske).

JAMA. 2003;289(4):427-433. doi:10.1001/jama.289.4.427
Abstract

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.

×