Marijuana use and service utilization among adolescents 7 years post substance use treatment

Drug Alcohol Depend. 2016 Nov 1;168:1-7. doi: 10.1016/j.drugalcdep.2016.08.012. Epub 2016 Aug 23.


Background: In an environment of increasingly liberal attitudes towards marijuana use and legalization, little is known about long-term trajectories of marijuana use among clinical samples of adolescents, and how these trajectories relate to health services utilization over time.

Methods: Latent growth curve analysis was used to identify distinct trajectories of marijuana use in a clinical sample of adolescents (N=391) over 7 years post substance use treatment in an integrated health system. We examined psychiatric problems and polysubstance use associated with the identified trajectory groups using general linear models. Nonlinear mixed-effects logistic regressions were used to examine associations between health services use and the trajectory groups.

Results: We identified three marijuana use trajectory groups: (1) Abstinent (n=117); (2) Low/Stable use (n=174); and (3) Increasing use (n=100). Average externalizing and anxiety/depression scores were significantly lower over time for the Abstinent group compared to the Increasing and Low/Stable groups. The Low Stable and the Increasing group had fewer psychiatric visits over time (p<0.05) and the Low/Stable group used more substance use treatment services over time compared with the Abstinent group (p<0.001).

Conclusions: Treated adolescents showed distinct marijuana use patterns, one of which indicated a group of adolescents at risk of increased use over time. These individuals have greater psychiatric and polysubstance use over time, but may not be accessing needed services.

Keywords: Adolescents; Longitudinal; Marijuana; Service utilization; Trajectories.

MeSH terms

  • Adolescent
  • Anxiety / psychology
  • Depression / psychology
  • Female
  • Health Services / statistics & numerical data*
  • Humans
  • Longitudinal Studies
  • Male
  • Marijuana Smoking / psychology*
  • Patient Acceptance of Health Care*
  • Substance-Related Disorders / psychology
  • Substance-Related Disorders / therapy*