Onset of opportunity to use cannabis and progression from opportunity to dependence: Are influences consistent across transitions?

Lindsey A Hines, Katherine I Morley, John Strang, Arpana Agrawal, Elliot C Nelson, Dixie Statham, Nicholas G Martin, Michael T Lynskey

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24 Citations (SciVal)


BACKGROUND: There is a developing body of research looking at cannabis use opportunity, but little research examining timing of opportunity to use cannabis.

AIMS: Identify factors associated with (1) earlier opportunity to use cannabis and (2) faster progression from opportunity to cannabis dependence.

METHOD: Cross-sectional study of 3824 Australian twins and siblings, measuring age of onset of cannabis use opportunity and DSM-IV cannabis dependence. Survival analysis identified factors associated with faster progression to opportunity or dependence.

RESULTS: Factors associated with both speed of progression to opportunity and dependence were conduct disorder (opportunity HR 5.57, 95%CI 1.52-20.47; dependence HR 2.49, 95%CI 1.91-3.25), parental drug problems (opportunity HR 7.29, 95%CI 1.74-30.62; dependence HR 3.30, 95%CI 1.63-6.69), weekly tobacco use (opportunity HR 8.57, 95%CI 3.93-18.68; dependence HR 2.76, 95% CI 2.10-3.64), and female gender (opportunity HR 0.69, 95%CI 0.64-0.75; dependence HR 0.44, 95%CI 0.34-0.55). Frequent childhood religious attendance (HR 0.74, 95%CI 0.68-0.80), parental conflict (HR 1.09, 95%CI 1.00-1.18), parental alcohol problems (HR 1.19, 95%CI 1.08-1.30) and childhood sexual abuse (HR 1.17, 95%CI 1.01-1.34) were uniquely associated with transition to opportunity. Depressive episode (HR 1.44, 95%CI 1.12-1.85), tobacco dependence (HR 1.36, 95%CI 1.04-1.78), alcohol dependence (HR 2.64, 95%CI 1.53-4.58), other drug use (HR 2.10, 95%CI 1.64-2.69) and other drug dependence (HR 2.75, 95%CI 1.70-4.43) were uniquely associated with progression to dependence.

CONCLUSION: The profile of factors associated with opportunity to use cannabis and dependence only partially overlaps, suggesting targeting of interventions may benefit from being tailored to the stages of drug use.

Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalDrug and Alcohol Dependence
Publication statusPublished - 1 Mar 2016

Bibliographical note

Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.


  • Adult
  • Age of Onset
  • Australia/epidemiology
  • Cross-Sectional Studies
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disease Progression
  • Female
  • Humans
  • Male
  • Marijuana Abuse/diagnosis
  • Marijuana Smoking/epidemiology
  • Middle Aged
  • Registries
  • Risk Factors
  • Siblings
  • Survival Analysis
  • Twins/statistics & numerical data
  • Young Adult


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