Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies

Macleod, John; Oakes, Rachel; Copello, Alex; Crome, Ilana; Egger, Matthias; Hickman, Matthew; Oppenkowski, Thomas; Stokes-Lampard, Helen; Smith, George Davey

doi:10.1016/s0140-6736(04)16200-4

Cited by 576 publications

(408 citation statements)

References 91 publications

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“…Our results are broadly consistent with other evidence suggesting the adverse effect of cannabis use on subsequent educational performance 2, 19, 20, 21, 22, 23. Other studies in general have not considered both cannabis and tobacco use by young people and subsequent educational outcomes in the same cohort; rather, they have reported the effects of cannabis use adjusted for tobacco use.…”

Section: Discussionsupporting

confidence: 91%

“…Few studies have investigated the specific effect of school‐based outcome data with substance use, rather than self‐reported education variables 19, 20, 28. The heterogeneity between current studies’ measures of education and of substance use allows for little statistical comparison between studies.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have not attempted to adjust for as comprehensive a range of confounding factors as we included in our multivariable analyses 1, 19, 28. Adjustment for these factors considerably attenuated our estimates of effects of cannabis use.…”

Section: Discussionmentioning

confidence: 99%

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Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study

Stiby

Hickman²,

Munafò

et al. 2015

Addiction

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AimsTo investigate the relationship between cannabis and tobacco use by age 15 and subsequent educational outcomes.DesignBirth cohort study.SettingEngland.ParticipantsThe sample was drawn from the Avon Longitudinal Study of Parents and Children; a core sample of 1155 individuals had complete information on all the variables.MeasurementsThe main exposures were cannabis and tobacco use at age 15 assessed in clinic by computer‐assisted questionnaire and serum cotinine. The main outcomes were performance in standardized assessments at 16 [Key Stage 4, General Certificate of Secondary Education (GCSE)] in English and mathematics (mean scores), completion of five or more assessments at grade C level or higher and leaving school having achieved no qualifications. Analyses were sequentially adjusted for multiple covariates using a hierarchical approach. Covariates considered were: maternal substance use (ever tobacco or cannabis use, alcohol use above recommended limits); life course socio‐economic position (family occupational class, maternal education, family income); child sex; month and year of birth; child educational attainment prior to age 11 (Key Stage 2); child substance use (tobacco, alcohol and cannabis) prior to age 15 and child conduct disorder.FindingsIn fully adjusted models both cannabis and tobacco use at age 15 were associated with subsequent adverse educational outcomes. In general, the dose–response effect seen was consistent across all educational outcomes assessed. Weekly cannabis use was associated negatively with English GCSE results [grade point difference (GPD), –5.93, 95% confidence interval (CI) = –8.34, –3.53] and with mathematics GCSE results (GPD, –6.91, 95% CI = –9.92, –3.89). Daily tobacco smoking was associated negatively with English GCSE (GPD, –11.90, 95% CI = –13.47, –10.33) and with mathematics GCSE (GPD, –16.72, 95% CI = –18.57, –14.86). The greatest attenuation of these effects was seen on adjustment for other substance use and conduct disorder. Following adjustment, tobacco appeared to have a consistently stronger effect than cannabis.ConclusionsBoth cannabis and tobacco use in adolescence are associated strongly with subsequent adverse educational outcomes. Given the non‐specific patterns of association seen and the attenuation of estimates on adjustment, it is possible that these effects arise through non‐causal mechanisms, although a causal explanation cannot be discounted. © 2015 Society for the Study of Addiction

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study

Stiby

Hickman²,

Munafò

et al. 2015

Addiction

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“…Engagement in risk behaviours such as tobacco, alcohol, cannabis and other illicit drug use has multiple negative health consequences, including respiratory problems, violence, injury, sexual risk behaviour, poorer educational attainment, psychosis, mental illness, risk of dependence, morbidity and mortality later in life 1, 2, 3, 4, 5, 6, 7. While the rate of substance use among young people in the United Kingdom is decreasing overall, a substantial proportion of young people continue to use these substances, with 31% of 16–24 year olds in the United Kingdom having ever used cannabis and nearly one‐fifth being regular or occasional smokers 8, 9.…”

Section: Introductionmentioning

confidence: 99%

Peer‐led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years: a systematic review and meta‐analysis

et al. 2016

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Background and AimsPeer‐led interventions may offer a beneficial approach in preventing substance use, but their impact has not yet been quantified. We conducted a systematic review to investigate and quantify the effect of peer‐led interventions that sought to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years.MethodsMedline, EMBASE, PsycINFO, CINAHL, ERIC and the Cochrane Library were searched from inception to July 2015 without language restriction. We included randomized controlled trials only. Screening and data extraction were conducted in duplicate and data from eligible studies were pooled in a random effects meta‐analysis.ResultsWe identified 17 eligible studies, approximately half of which were school‐based studies targeting tobacco use among adolescents. Ten studies targeting tobacco use could be pooled, representing 13 706 young people in 220 schools. Meta‐analysis demonstrated that the odds of smoking were lower among those receiving the peer‐led intervention compared with control [odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.62–0.99, P = 0.040]. There was evidence of heterogeneity (I 2 = 41%, χ2 15.17, P = 0.086). Pooling of six studies representing 1699 individuals in 66 schools demonstrated that peer‐led interventions were also associated with benefit in relation to alcohol use (OR = 0.80, 95% CI = 0.65–0.99, P = 0.036), while three studies (n = 976 students in 38 schools) suggested an association with lower odds of cannabis use (OR = 0.70, 0.50–0.97, P = 0.034). No studies were found that targeted other illicit drug use.ConclusionsPeer interventions may be effective in preventing tobacco, alcohol and possibly cannabis use among adolescents, although the evidence base is limited overall, and is characterized mainly by small studies of low quality.

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“…However, findings from prospective studies have not been completely consistent. The directionality of the association between drug use and externalizing symptomatology remains debated (Bui et al, 2000;D"Amico et al, 2008) and inconsistent associations have been reported between drug use and internalizing symptoms (e.g., Macleod et al, 2004;Rogers et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Adolescent illicit drug use and subsequent academic and psychosocial adjustment: An examination of socially-mediated pathways

Brière

Fallu

Morizot

et al. 2014

Drug and Alcohol Dependence

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Background. Questions remain regarding the consequences of illicit drug use on adolescent adjustment and the nature of mechanisms that may explain these consequences. In this study, we examined whether early-onset illicit drug use predicts subsequent academic and psychosocial adjustment and whether associations are socially-mediated by decreased school engagement and increased peer deviancy.Method. 4885 adolescents were followed throughout secondary school. We used regressions to determine whether illicit drug use in grade 7 predicted academic achievement, school dropout, depressive symptoms, and conduct problems in grades 10-11, adjusting for potential confounders.We used path analysis to test whether significant associations were mediated by school engagement and peer deviancy in grade 8.Results. Illicit drug use predicted conduct problems and school dropout, but not academic achievement and depressive symptoms. The association between illicit drug use and conduct problems was fully mediated by increased peer deviancy. The association between illicit drug use and school dropout was partially mediated by increased peer deviancy, but remained mostly direct. No indirect association via decreased school engagement was found. Examination of reverse pathways revealed that conduct problems and academic achievement in grade 7 predicted drug use in grades 10-11. These associations were mediated by peer deviancy and school engagement (conduct problems only).Conclusion. Adolescent illicit drug use influences the risk of school dropout and conduct problems in part by contributing to deviant peer affiliation. Reciprocal social mediation characterizes the association between drug use and conduct problems. A reverse mechanism best explains the association with academic achievement.

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Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies

Cited by 576 publications

References 91 publications

Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study

Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study

Peer‐led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11–21 years: a systematic review and meta‐analysis

Adolescent illicit drug use and subsequent academic and psychosocial adjustment: An examination of socially-mediated pathways

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