Determinants of marijuana use, abuse and dependence.

Marijuana is a preparation from the Cannabis plant that is smoked.

The active ingredient in Cannabis is delta-9-tetrahydrocannabinol (THC).
Hashish, charas, ganja, sinsemilla, bhang, and hash oil are some forms
in which Cannabis is used. Marijuana or Cannabis use is becoming a major
public health problem. According to Youth Risk Behavior Survey (YRBS)
done in 2007 the percentage pipes of students that used marijuana one or more
times during their lives was 38.1% (95% CI: 35.5-40.7) and those that
used marijuana in the past 30 days was 19.7% (95% CI: 17.8-21.8)
(National Center for Chronic Disease Prevention and Health Promotion,
Centers for Disease Control and Prevention, 2008). In a prevalence study
of adults in 2001-02 in the United States it was found that 4.1% of the
adults were marijuana users in the past year (Compton, Grant, Colliver,
Glantz, & Stinson, 2004). Diagnostic and Statistical Manual-IV-TR
(American Psychiatric Association, 2000) has defined marijuana abuse as
repeated instances of use under hazardous conditions; repeated,
clinically meaningful impairment in social/occupational/educational
functioning; or legal problems related to marijuana use; and marijuana
dependence as increased tolerance, compulsive use, impaired control, and
continued use despite physical and psychological problems caused or
exacerbated by use. Compton and colleagues (2004) found that marijuana
abuse increased from 0.9% in 1991-92 to 1.1% in 2001-02, and marijuana
dependence increased from 0.3% to 0.4%. In absolute numbers this
translates to an increase of 0.8 million people who are marijuana

abusers or dependent on it thereby implying a significant public health

problem.

Several studies have been done to understand the determinants of

marijuana use. A study by Tu, Rather, and Johnson (2008) examined gender
differences with regard to marijuana use in a Canadian sample of
adolescents. The study found that 47% of the sample had used marijuana.
The characteristics of male heavy users were being in Grade 9 or higher,
being Aboriginal, reporting poorer socio-economic status, never feeling
like an outsider, frequently using alcohol and tobacco, and having lower
satisfaction with family, friends, and school. The characteristics of
female heavy users were being in higher grades, reporting poorer
socio-economic status, having poorer mental health, having poorer
academic performance, frequently using alcohol and tobacco, and having
lower satisfaction with their school.
An Australian study by Hayatbakhsh and colleagues (2008) examined
early childhood factors for initiation of tobacco, alcohol, and
marijuana and found that disrupted families, drug-using parents,
childhood problem behaviors, and poor parental monitoring and
supervision in childhood were associated with early initiation. An
American study by Brook, Saar, and Brook (2008) showed that exposure to
violent television programs in late adolescence was related to marijuana
use. A study done with Belgian teenagers found that Cannabis use was
higher among general education students and truants (Kohn, Dramaix,
Favresse, Kittel, & Piette, 2005). Another study by Kohn and
colleagues (2004) found that age, amount of income in the family, strong

peer group integration and tobacco use were associated with Cannabis
experimentation; while age, gender, nationality, average family
integration and other drugs use such as addiction to nicotine were
related to the current consumption of marijuana. A study by Crano,
Siegel, Alvaro, Lac, and Hemovich (2008) looked at the differences
between resolute non users of marijuana, vulnerable non users and users.
The three groups differed with regard to religiosity, delinquency (self
and friends'), refusal strength, sensation seeking, parental
monitoring and warmth, and adult supervision.

In a study of maternal Cannabis use during early pregnancy it was

found that the strongest determinant was Cannabis use by the biological
father of the child followed by being single or having a partner without
being married, childhood trauma and delinquency (El Marroun et al.,
2008). It was also found that maternal age, ethnicity, psychopathology,
family functioning and perceived stress were not related to maternal
Cannabis use. Being of Islam religion was found to be protective against
Cannabis use.

A study by Galea and colleagues (2007) examined relationships

between neighborhood income and income distribution with marijuana
smoking. The study found that neighborhoods with both the highest income
and the highest income maldistribution had the highest prevalence of
smoking marijuana. Further the study found that after adjusting for
individual income, age, race, sex, and education, high neighborhood
median income and maldistributed neighborhood income were both

significantly associated with a greater likelihood of marijuana use.

So we see that several determinants have been identified in the
literature with regard to marijuana use. These include sensation seeking
behavior, use of other drugs such as tobacco, strong peer group
integration, disrupted families, drug-using parents or spouse, childhood
problem behaviors, poor parental monitoring and supervision, childhood
trauma, delinquency, exposure to violent television programs, high
neighborhood median income, and maldistributed neighborhood income.
Religiosity, parental monitoring and warmth, and adult supervision have
been found to be protective factors. In the literature there are very
few interventions that have been designed to prevent marijuana use. On
the basis of these determinants interventions that prevent Cannabis use
must be designed.

REFERENCES

American Psychiatric Association. (2000). Diagnostic and

statistical manual-IV-TR (4th ed., text revision) Arlington, VA: Author.

Brook, D. W., Saar, N. S., & Brook, J. S. (2008). Earlier

violent television exposure and later drug dependence. American Journal
on Addictions, 17(4), 271-277.

Compton, W. M., Grant, B.F., Colliver, J. D., Glantz, M.D., &

Stinson, F.S. (2004). Prevalence of marijuana use disorders in the
United States: 1991-1992 and 2001-2002. JAMA, 291(17), 2114-2121.

Crano, W. D., Siegel, J. T., Alvaro, E. M., Lac, A., &

Hemovich, V. (2008). The at-risk adolescent marijuana nonuser: Expanding
the standard distinction Prevention Science, 9(2), 129-137.

El Marroun, H., Tiemeier, H., Jaddoe, V. W., Hofman, A.,

Mackenbach, J. P., Steegers, E. A., et al. (2008). Demographic,
emotional and social determinants of cannabis use in early pregnancy:
The Generation R study Determinants of cannabis use in early pregnancy.
Drug and Alcohol Dependence, Epub ahead of publication PMID # 18606505.

Galea, S., Ahern, J., Tracy, M., & Vlahov, D. (2007).

Neighborhood income and income distribution and the use of cigarettes,
alcohol, and marijuana. American Journal of Preventive Medicine, 32(6
Suppl), S195-S202.

Hayatbakhsh, M. R., Mamun, A. A., Najman, J. M., O'Callaghan,

M. J., Bor, W., & Alati, R. (2008). Early childhood predictors of
early substance use and substance use disorders: Prospective study. The
Australian and New Zealand Journal of Psychiatry, 42(8), 720-731.

Kohn, L., Dramaix, M., Favresse, D., Kittel, F., & Piette, D.
(2005). Trends in cannabis use and its determinants among teenagers in
the French-speaking community of Belgium. Revue d'Epidemiologie et
de Sante Publique, 53(1), 3-13.

Kohn, L., Kittel, F., & Piette, D. (2004). Peer, family

integration and other determinants of cannabis use among teenagers.

International Journal of Adolescent Medicine & Health, 16(4),
359-370.

National Center for Chronic Disease Prevention and Health

Promotion, Centers for Disease Control and Prevention. (2008). YRBSS.
Youth online: Comprehensive results. Retrieved from
http://apps.nccd.cdc.gov/yrbss/

Tu, A. W.,Ratner, P. A., & Johnson, J. L. (2008). Gender

differences in the correlates of adolescents' cannabis use.
Substance Use & Misuse, 43(10), 1438-1463.

Manoj Sharma, MBBS, CHES, Ph.D.

Editor, Journal of Alcohol & Drug Education

University of Cincinnati
526 J Teachers College

PO Box 210068

Cincinnati, OH 45221-0068

https://www.thefreelibrary.com/Determinantsofmarijuanause,abuseanddependence.-a0198849240