Adolescent cannabis and tobacco use are associated with opioid use in young adulthood—12‐year longitudinal study in an urban cohort

Background and aims Cannabis, tobacco and alcohol use are prevalent among youth in the United States and may be risk factors for opioid use. The current study aimed at investigating associations between developmental trajectories of cannabis, tobacco and alcohol use in adolescence and opioid use in young adulthood in an urban cohort over the span of 12 years. Design Cohort study of adolescents originally recruited for a randomized prevention trial with yearly assessments into young adulthood. Setting Nine urban elementary schools in Baltimore, MD in the United States. Participants Participants (n = 583, 86.8% African American, 54.7% male) were originally recruited as first grade students. Measurements Cannabis, tobacco and alcohol use were assessed annually from ages 14-18 years and opioid use from ages 19-26. Socio-demographics were assessed at age 6. Intervention status was also randomly assigned at age 6. Gender, race, free/reduced-priced lunch and intervention status were included as covariates in individual and sequential growth models. Findings There were significant positive associations between the cannabis use intercept at age 14 and the opioid use intercept at age 19 (beta = 1.43; P = 0.028), the tobacco use intercept at age 14 and the opioid use intercept at age 19 (beta = 0.82; P = 0.042). Specifically, more frequent use of cannabis or tobacco at age 14 was associated with more frequent use of opioids at age 19. Conclusions Cannabis and tobacco use in early adolescence may be risk factors for opioid use in young adulthood among African Americans living in urban areas.