Midlife Social and Behavioral Consequences of Adolescent Marijuana Use for African American Men and Women

Introduction: Historically, African American adolescents have reported lower rates of marijuana use compared to Whites; however, recent national surveys have found significant increases among African American boys and girls. According to the most recent Youth Risk Behavior Surveillance System survey, African American male adolescents now have the highest rate of current marijuana use compared to all other racial, ethnic, and gender groups. Coupled with increased use is evidence of decreased risk perception around marijuana. However, research suggests that marijuana is associated with a wide range of adverse social and behavioral outcomes. To date, the research base is limited by a lack of understanding of long-term causal effects. In particular, longitudinal studies extending into midlife are rare, as is the ability to distinguish negative consequences of marijuana use from consequences of shared risk factors. These gaps are particularly evident among African Americans.

Methods: This presentation utilizes data from the Woodlawn Study, a prospective longitudinal study of a community cohort of urban African Americans assessed first in childhood in 1966 at age 6 (N=1242), then in adolescence, and again at ages 32 and 42. We extend previously published findings on social and behavioral consequences of heavy adolescent marijuana use in young adulthood to midlife. Our analyses account for selection bias by applying propensity score matching techniques, which adjust for childhood and adolescent confounders. We also further investigate the role of continued substance use and educational achievement in explaining long-term effects and identify gender differences.

Results: We find evidence that heavy adolescent marijuana use by age 16 increases the risk of drug use and problems in midlife, as well as continued social role and socioeconomic consequences. Mediation analyses find that reduced educational attainment and increased risk of continued marijuana use into adulthood partly explain these long-term consequences. We also find evidence of gender differences, in particular more severe socio-economic consequences at age 42 in women compared to men.

Conclusions: By better understanding the long-term impact of heavy marijuana use during adolescence and the key mediators and moderators throughout the life course, substance use prevention programs can be strengthened and made more relevant for African American populations. This topic is particularly timely given that marijuana use among African American adolescents is on the rise, marijuana legalization efforts are gaining momentum, and risk perceptions are low. A promising avenue is linking substance use prevention with educational initiatives aimed at keeping high-risk individuals in school.