Associations between Cannabis Use and Multiple Substance Use among High School Students in Jamaica

Abstract

Objective: Cigarettes, alcohol, cannabis, inhalants and cocaine are the most commonly used substances among high school students in Jamaica. However, there is limited evidence on their co-use and whether the use of one drug predicts the use of the others (multiple substance use). This study aimed to determine whether cannabis use predicts the co-use of the other substances. Methods: We analysed data from the National Secondary School Survey 2013, Jamaica, using inferential statistics to determine associations. Results: Lifetime cannabis use was significantly associated with lifetime cigarette use for males (X 2 = 282.72, p = 0.000) and females (X 2 = 434.32, p = 0.000). Similarly, it was significantly associated with: (a) lifetime use of alcohol for males (X 2 = 88.62, p = 0.000) and females (X 2 = 99.48, p = 0.000); (b) lifetime use of inhalants for males (X 2 = 13.28, p = 0.00) and females (X 2 = 49.56, p = 0.00); and (c) lifetime cocaine use for males (X 2 = 9.78, p = 0.00) and females (X 2 = 64.54, p = 0.00). Past-month (recent) use of cannabis was significantly associated with past-month use of cigarettes and alcohol, but not inhalants, for males and females. Logistic regression results showed that lifetime cannabis use was a risk factor for lifetime use of cigarettes (adjusted odds ratio [AOR]: 11.38; 95% confidence interval [CI]: 9.02, 14.37) and alcohol (AOR: 5.84; 95% CI: 4.11, 8.30), but a strong protective factor against lifetime use of inhalants and cocaine. Past-month use of cannabis was a strong protective factor against pastmonth use of cigarettes and alcohol. Conclusion: Lifetime cannabis use was significantly associated with multiple substance use and was shown to be a risk factor for lifetime use of cigarettes and of alcohol. However, adolescents who reported recent (past-month) use of cannabis were less likely to report recent use of alcohol and cigarettes. These findings suggest the need for research to further explore the role cannabis plays in multiple drug use and offer more concrete explanations for its role.

Factors associated with children and young people’s mental health in the English-speaking Caribbean region: Systematic review and narrative synthesis

“…YP attending non-traditional and non-prestigious high schools were more likely than other students to report depressive symptoms [44,75]. However, no significant association was found between the type of school or sense of belonging and behaviour/conduct problems [87] and suicidal ideation [61] in other studies. Studies also suggested an association between missing school or classes and suicidality [62,63] and behaviour/conduct behaviours [120].…”

“…In some studies (6 out of 14 or 42.8%), behaviour/conduct problems and depressive symptoms were more common among older adolescents than primary school-aged children [72] or younger adolescents [50,51,76,82,87]. However, self-report depressive symptoms did not always increase with age [77].…”

“…Studies also suggested an association between missing school or classes and suicidality [62,63] and behaviour/conduct behaviours [120]. Relationships with teachers, sometimes impacted by school punishments (e.g., beaten by hand) was inversely associated with behaviour/conduct problems [87,89,110,121]. Among older YP (e.g., university students) the amount of material to be studied, exams/grades, campus facilities and quality of teaching contributed to stress levels [80,100]; while combining employment and studies resulted in lower occurrences of depressive symptoms [47] or psychiatric disorders [57].…”

“…Studies suggested that YP with higher levels of education or better academic performance experienced lower depressive symptoms [48,95], were less likely to plan suicide [64] and were at reduced risk of anxiety [90]. In terms of behaviour/conduct problems, inadequate education or poorer academic performance was associated with increased behaviour/conduct problems [89,94], but higher grade levels were also sometimes significantly associated with more frequent behaviour/conduct problems [87]. Among older students, being in the final year of university or those with academic issues were more likely than other students to experience burnout, higher stress levels and other mental disorders [95,96].…”

“…Most studies (13 out 14 or 92.9%) suggested that YP who admitted to alcohol or drug (mis) use (e.g., cannabis) and unsafe sexual practices were at increased risk of disordered eating/ body image issues [54, 81], psychotic and depressive symptoms [45,77,107,108] and behaviour/conduct problems [87,109]. However, there were mixed findings for suicide ideation indicating that alcohol or drug (mis)use was associated with suicide ideation [60,62,63,67,89] but the association was not always significant [79].…”