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June 26, 2020
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Youth cannabis use moderately linked to physical violence

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Cannabis use appeared moderately associated with physical violence among young adults, according to results of a meta-analysis published in American Journal of Psychiatry.

“The focus of most cannabis-related harms has been on effects with users themselves; harms to others, including the perpetration of violence, have been largely disregarded,” Alexandre Dumais, MD, PhD, of the Research Center at Montreal University Institute of Mental Health, told Healio Psychiatry. “The association between cannabis and violence in youths has been an ongoing debate, with no consensus being reached. We thus hoped to address this research gap and believed a quantitative synthesis of literature was necessary.”

cannabis in jars
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Specifically, Dumais and colleagues aimed to clarify the association between cannabis use and the perpetration of any type of physical violence by adolescents and young adults, which Dumais noted was important in the context of international legalization of cannabis, which may lead to an increase in the number of users.

The investigators searched four databases for articles published from inception to July 2019 and included all studies that examined both cannabis use and physical violence perpetration among youths and young adults younger than 30 years. They performed the meta-analysis with a random-effects model.

Alexandre Dumais

Dumais and colleagues included 30 studies with a total of 296,815 adolescents and young adults. They reported an odds ratio of 2.11 (95% CI, 1.64-2.72) for the pooled studies, as well as pooled odds ratios of 2.15 (95% CO, 1.58-2.94) and 2.02 (95% CI, 1.26-3.23) for the cross-sectional and longitudinal studies, respectively. According to preliminary results, there was a higher risk for violence among persistent heavy users (OR = 2.81; 95% CI, 1.68-4.74) than among past-year users (OR = 2.05; 95% CI, 1.5-2.8) and lifetime users (OR = 1.94; 95% CI, 1.29-2.93). The researchers reported ORs of 2.62 (95% CI, 1.89-3.62) for unadjusted studies and 2.01 (95% CI, 1.57-2.56) for studies using odds ratios adjusted for potential confounding factors.

“This topic is notably essential given the elevated proportion of youths who use cannabis both occasionally and frequently,” Dumais told Healio Psychiatry. “Youths should therefore be aware of the imminent and long-term potential adverse effects of cannabis use on violence. Professionals should consider strategies to limit this negative effect, for instance, to provide critical educational information for decision-making with the aim of discouraging youths from initiating and adopting chronic patterns of use. With preliminary findings highlighting a potential ‘dose-response’ relationship, research should be aimed at finding a dose at which effects begin to become negative. Until no secure exposure pattern is determined, a better option for youths would be to withhold from regularly using cannabis to avoid potential violent behavior.”