Predictors Of Cannabis Use Research Articles

Prospective associations between cannabis use and depressive symptoms across adolescence and early adulthood

Cannabis use and occurrences of depression during adolescence are common. However, the temporal relationship between the two is less understood. Does depression lead to cannabis use, or does cannabis use lead to depression, or is it a combination of both? Furthermore, this directionality is confounded by other substance use, specifically binge drinking, which is common during adolescence. This study aimed to examine the temporal directionality of cannabis use and depression among a prospective, longitudinal, sequential cohort of 15 to 24-year-olds. Data were drawn from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. The final sample included 767 participants. Multilevel regression models were run to assess concurrent (at the same time point) and prospective (1 year later) associations between cannabis use and depression. When measured concurrently, depressive symptoms did not significantly predict past-month cannabis use but did significantly predict more days of use among cannabis users. Prospective associations indicated that depressive symptoms significantly predicted cannabis use 1 year later and cannabis use significantly predicted depressive symptoms 1 year later. We found no evidence that these associations varied by age or binge drinking. Overall, the relationship between cannabis use and depression appears to be complex and not unidirectional.

Differential impacts of perceived social support on alcohol and cannabis use in young adults: lessons from the COVID-19 pandemic

Coronavirus (COVID-19) lockdowns provided a unique opportunity to examine how changes in the social environment impact mental health and wellbeing. We addressed this issue by assessing how perceived social support across COVID-19 restrictions alters alcohol and cannabis use in emerging adults, a population vulnerable to adverse outcomes of substance use. Four hundred sixty-three young adults in Canada and the United States completed online questionnaires for three retrospective timepoints: Pre-Covid, Lockdown and Eased Restrictions. Sociodemographic factors, perceived social support, and substance use were assessed. Overall, alcohol use decreased while cannabis use increased during Lockdown. Interestingly, social support negatively predicted alcohol use and positively predicted cannabis use during Lockdown. These findings suggest a difference in motives underlying alcohol and cannabis use in emerging adults. Importantly, these changes were not sustained when restrictions eased, suggesting that emerging adults exhibit resiliency to the impacts of COVID-19 restrictions on substance use.

Problem gambling severity, gambling behavior, substance use, and mental health in gamblers who do and do not use cannabis: Evidence from a Canadian national sample

IntroductionCannabis use frequently co-occurs with gambling, and evidence indicates that both acute and chronic cannabis use may influence gambling behavior. The primary aim of the present study was to further contribute to the literature on this relationship by examining data collected from a Canadian national study of gambling. MethodsRespondents consisted of 10,054 Canadian gamblers recruited from Leger Opinion’s (LEO) online panel. In this study, gamblers who used cannabis were compared with non-users across a number of gambling as well as demographic and mental health variables. ResultsOf the total sample, 25.4 % reported past 12-month cannabis use. Among the 2,553 cannabis-users, 21.3 % reported daily use, and 69.9 % reported using once a month or more. A total of 56.2 % indicated they had used cannabis while gambling in the past 12 months. Bivariate analysis found significant differences between cannabis use and non-use on numerous demographic, mental health, and gambling-related variables. Individuals with greater problem gambling severity scores, more hours gambling, and a larger range of gambling activities were more likely to endorse using cannabis. Hierarchical logistic regression revealed that tobacco use, and having experienced significant child abuse were predictors of cannabis use. Non-use of cannabis was associated with older age, less engagement in online gambling, and being less likely to consume alcohol. ConclusionThe present findings both corroborate previous studies and expand upon the relationship between cannabis and gambling.

Sociodemographic predictors of cannabis use among patients with cancer residing in states with legalized cannabis.

299 Background: Cannabis is increasingly legal and available to cancer patients, but the pattern of cannabis use among cancer patients is unknown. We aimed to characterize cannabis use patterns and beliefs among subgroups of cancer patients. Methods: We identified adults who received treatment between March and August 2021 for any of 10 cancers (brain, breast, head and neck, gynecological, gastrointestinal, lymphoma, prostate, testicular, and lung) at Memorial Sloan Kettering Cancer Center. We included patients residing in New York, New Jersey, or Connecticut, where medical and recreational cannabis use is legal. We contacted patients by email, phone, and mail to invite them to complete an anonymous online or phone survey regarding experiences with cannabis. We administered surveys from August 2021 to April 2022. The survey used harmonized measures developed by investigators from 12 NCI-designated cancer centers to elicit patient-reported cannabis use, Cannabis was defined as any cannabis product, including CBD-only products. Weighting was assigned based on characteristics (age, sex assigned at birth, race, ethnicity, cancer) of the sampled hospital population to account for potential nonresponse bias. We used weighted multivariable logistic regression to identify self-reported sociodemographic predictors (gender, age, race, ethnicity, income, insurance, marital status, employment status) and clinical predictors (cancer) of cannabis use during treatment. Results: 1258 patients completed the survey (35% response rate). 75% of respondents were white non-Hispanic; 51% were under age 65. Regardless of cannabis use during treatment, 82% (N = 1032) perceived benefits of cannabis use. The most commonly endorsed benefits were relief of stress, anxiety, or depression (68%), pain management (66%), sleep improvement (48%), and managing cancer side effects (42%). 53% of patients (N = 666) perceived risks to cannabis use; commonly endorsed risks were inability to drive (24%), difficulty concentrating (23%), addiction (22%), and lung damage (21%). Across all respondents, 22% (N = 278) reported cannabis use during treatment, and 53% used cannabis a few times a week or more frequently. Weighted multivariable models (N = 991) showed that accounting for all predictors, only age showed a significant association with cannabis use. Patients ≤45 years old were more likely to use cannabis than patients ≥65 years old (odds ratio 4.65, 95% confidence interval 2.11-10.23). Conclusions: In a large sample of cancer patients, a large proportion reported beliefs that cannabis can benefit symptoms relevant to cancer, and about half of patients acknowledged potential harms. Younger patients were significantly more likely to use cannabis during treatment than their older counterparts. This may represent a generational shift in attitudes toward cannabis, as access to medical and recreational cannabis expands.

Event-level associations among minority stress, coping motives, and substance use among sexual minority women and gender diverse individuals

BackgroundSexual minority women and gender diverse individuals (SMWGD) are at heightened risk for alcohol and cannabis use disorders compared to heterosexual and cisgender individuals, and their heightened risk has been attributed to minority stress. However, few longitudinal studies have examined mechanisms through which minority stress may impact substance use, and none have done so at the event-level. MethodsWe utilized data from a 30-day ecological momentary assessment study of 429 SMWGD who used alcohol or cannabis regularly to test a mechanistic process in which minority stress predicts alcohol and cannabis use via coping motives for use at the event-level. ResultsWhen individuals experienced more enacted stigma (e.g., microaggressions) than usual during one assessment, they were more likely to use cannabis to cope during the next. In turn, occasions when cannabis was used to cope were marked by more sessions of cannabis use, longer intoxication, higher subjective intoxication, and more cannabis consequences. Indirect effects of enacted stigma on cannabis use via coping motives were significant. However, only one of internalized stigma’s indirect effects was significant, with internalized stigma predicting cannabis consequences via daily coping motives. No indirect effects predicting alcohol use were significant. ConclusionsFindings provide robust evidence that using to cope is a mechanism through which enacted stigma predicts cannabis use and internalized stigma predicts cannabis consequences. Results did not provide evidence for similar associations for alcohol. Our findings suggest that interventions designed to reduce cannabis use among SMWGD should attend to their minority stress experiences and cannabis use motives and teach alternative coping strategies.

Cannabis use prevalence among Baby Boomers before and after implementation of recreational retail sales in California

BackgroundAs of 2021, 21 US states and territories allowed recreational cannabis use. Although previous research has identified an overall increase in prevalence of cannabis use after legalization, it has been less clear how this change will affect different parts of the population, including older adults, and specifically Baby Boomers, born 1946–1964, given their historically higher rates of use and a higher prevalence of comorbid conditions that could be either exacerbated or addressed by cannabis use. In this study we assessed whether implementation of recreational retail sales in California was associated with increased prevalence of cannabis use among Baby Boomers.MethodsWe conducted a retrospective study of cannabis use prevalence one year before and after the implementation of recreational retail sales in California using the California Health Interview Survey (CHIS), a statewide public health surveillance dataset.ResultsWe found that cannabis use prevalence did not change among Baby Boomers but increased among non-Baby Boomers. Most of the factors found to be predictive of cannabis use in past research did not predict cannabis use among Baby Boomers.ConclusionsBaby Boomers did not change their consumption of cannabis in the first year after opening the retail market, despite previous research suggesting that cannabis consumption increases with access, and most previously identified predictors of use did not identify people who use cannabis in this generation. Further research is needed to determine whether these effects persist over time.

Elevated social anxiety symptoms across childhood and adolescence predict adult mental disorders and cannabis use

AimWe assessed the heterogeneous development of self-reported social anxiety symptoms across childhood and adolescence (ages 10 to 18; N = 701) and examined whether these groups predicted clinically derived diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), depressive episodes, panic disorder (PD), agoraphobia, obsessive compulsive disorder (OCD), and substance use in adulthood (ages 19 to 22). ResultsThree distinct social anxiety symptom trajectories were found: a high increasing group (15.5%), a moderate group (37.3%), and a low group (47.2%). The high increasing and moderate trajectory groups were differentiated from the low trajectory group on the adult mental disorders examined: SAD (high OR = 15.74; moderate OR = 11.72), GAD (high OR = 13.08; moderate OR = 8.98), depressive episode (high OR = 19.75), PD (high OR = 8.43; moderate OR = 5.90), agoraphobia (high OR = 16.39; moderate OR = 9.68), and OCD (high OR = 3.49; moderate OR = 2.98). The high and moderate groups were not differentiated on SAD, GAD, PD, or OCD but were differentiated on depressive episodes (OR = 3.24). Relative to the low and moderate trajectory groups, the high increasing social anxiety symptoms trajectory group also predicted cannabis use, but not alcohol use in adulthood. Gender, ethnicity, household income, and parental education were accounted for when predicting adult outcomes. ConclusionThese results highlight the importance of early treatment of symptoms of childhood social anxiety in the prevention of mental health problems in adulthood.

Cannabis use in high school adolescents of SousseTunisia: Incidence and predictors

Abstract Background Adolescence is a period of physical, psychological and social transformation. It is during adolescence that people are introduced to psychoactive substances such as cannabis. Understanding the predictors of this risk behavior, would help dealing with this problem more efficiently. The current study aimed to determine the incidence and the predictors of cannabis use among high school students in Sousse governorate between 2017/2018 and 2018/2019 Methods A prospective longitudinal study was conducted in four high schools in the governorate of Sousse during the period from 15/09/2017 to 30/06/2019. Pre-tested self-administered questionnaire served to collect data anonymously among participants about their socio-demographic characteristics, cannabis use, tobacco use, use of electronic cigarettes, illicit substances use, sedentary behavior and mental health disorders among them. Results A total of 404 students were included in our study. The average age of participants was 16.4 (±1.1) years. The cumulative incidence of cannabis use among high school students was 2.2%, (95%CI: 0.8%-3.6%). School failure, anxiety problem, cigarette smoking, vaping and illlicit substances use among friends were found to be significantly associated with cannabis experimentation among them. Whereas its most influential factors were: Current cigarette smoking and current vaping with adjusted odds ratio of: 12.9; 95% CI: 2.4-70.2) and 7.2; 95% CI: 1.3-38.8 respectively. Conclusions This study highlights the association between cigarette and e-cigarette smoking and cannabis use. Future prevention interventions should focus on these risk behaviors with regard to the environmental context. Key messages Cannabis use is not rare among the adolescents of Sousse, Tunisia. Adolescents represent vulnerable sub-group that merit special attention regarding substances use.

Independent contribution of polygenic risk for schizophrenia and cannabis use in predicting psychotic-like experiences in young adulthood: testing gene × environment moderation and mediation.

It has not yet been determined if the commonly reported cannabis-psychosis association is limited to individuals with pre-existing genetic risk for psychotic disorders. We examined whether the relationship between polygenic risk score for schizophrenia (PRS-Sz) and psychotic-like experiences (PLEs), as measured by the Community Assessment of Psychic Experiences-42 (CAPE-42) questionnaire, is mediated or moderated by lifetime cannabis use at 16 years of age in 1740 of the individuals of the European IMAGEN cohort. Secondary analysis examined the relationships between lifetime cannabis use, PRS-Sz and the various sub-scales of the CAPE-42. Sensitivity analyses including covariates, including a PRS for cannabis use, were conducted and results were replicated using data from 1223 individuals in the Dutch Utrecht cannabis cohort. PRS-Sz significantly predicted cannabis use (p = 0.027) and PLE (p = 0.004) in the IMAGEN cohort. In the full model, considering PRS-Sz and covariates, cannabis use was also significantly associated with PLE in IMAGEN (p = 0.007). Results remained consistent in the Utrecht cohort and through sensitivity analyses. Nevertheless, there was no evidence of a mediation or moderation effects. These results suggest that cannabis use remains a risk factor for PLEs, over and above genetic vulnerability for schizophrenia. This research does not support the notion that the cannabis-psychosis link is limited to individuals who are genetically predisposed to psychosis and suggests a need for research focusing on cannabis-related processes in psychosis that cannot be explained by genetic vulnerability.

Effects of Risk Perception and Accessibility on Cannabis Use among Young Population in Spain: Findings from the 2016 National Survey (ESTUDES)

Background Cannabis use in the young population has undergone a significant increase in Europe. Empirical assessments of individual and contextual mediating variables in relation to cannabis use are informative for prevention actions and have yet to be conducted in Spain. Objectives: This study used the 2016 National Survey on Drug Use in Secondary Education in Spain (ESTUDES) to inform on potentially relevant cannabis prevention targets. We examined individual variables (sex, age, and cannabis risk perception), past 30-day legal and illicit substance use, substance-free activities, and contextual factors (perceived accessibility to cannabis) associated to past 30-day cannabis use. Methods: Data were drawn from 35,369 adolescents (% females: 50.1). Structural equation modeling (SEM) was implemented to identify predictors of cannabis use, and indirect paths were tested via bootstrapping to examine the mediating effects of cannabis risk perception and accessibility. Results: Demographics (male sex, higher age), and past 30-day tobacco, alcohol, and illicit substance use were associated with past 30-day cannabis use. Frequency of past-year engagement in hobbies and reading did also predict past 30-day cannabis use. The mediators worked on most of the relationships examined, except for hobbies and illegal substance use in the case of accessibility and reading and hobbies in the case of risk perception. Conclusions/importance: Cannabis use is more likely to emerge in the event of low risk perception and high accessibility. Lower frequency of past year reading and higher engagement in some hobbies that are often carried out alone represent risk factors, which could potentially influence prevention programs.

Stress, anxiety, binge drinking, and substance use among college student-athletes: A cross-sectional analysis

The immense pressure faced by college student-athletes to balance participation in sports with other responsibilities can contribute to unhealthy coping behaviors including alcohol and drug use. We administered online surveys to 188 college student-athletes to examine stress, athletics-related anxiety, and perceived control of stress as predictors of binge drinking, substance use, and associated risk behaviors. Participants rated athletics as the second greatest source of stress in their lives, trailing only academics. Athletics-related anxiety was a significant predictor of cannabis use and substance-related risk behaviors, and represents an understudied area in the literature. Reports of alcohol and drug use in our sample were comparable to national surveys of student-athletes, but opioid misuse was troublingly high. Participants over the age of 21 and males were more likely to report substance use and risk behaviors. Athletes are susceptible to orthopedic injury and associated pain, which may lead to early exposure to opioids with high potential for abuse. Interventions for this population must target social contributors to substance use among student-athletes, opioid prescription and misuse as a gateway to opioid use disorders, and untreated anxiety as a potential driver of substance use, including anxiety associated with athletic performance.

Family Climate and Intention to Use Cannabis as Predictors of Cannabis Use and Cannabis-Related Problems among Young University Students.

Determining the predictive variables associated with cannabis use and cannabis-related problems can ease the identification of young cannabis consumers who can benefit from prevention interventions. This study aimed: (1) to describe, among university students, the cannabis use and cannabis-use problems, intention to use cannabis and family climate based on the gender and the people the student lives with; (2) to explore whether the family climate and intention to use cannabis are predictors of cannabis use and cannabis-related problems. The sample was composed of 339 Spanish undergraduates (51.9% females) in a 17-to-25 age range (19.67 ± 1.53). The variables were assessed through a battery based on the ESPAD survey, cannabis abuse screening test, cannabis use intention questionnaire and family climate scale. More men than women had used cannabis in the precedent year and showed greater intention to use cannabis, whereas more women than men showed greater self-efficacy in not using cannabis. The family climate did not predict cannabis use and cannabis-related problems. However, subjective norms and self-efficacy were key predictors of cannabis use and cannabis-use problems, respectively. Different factors seemed to predict the use cannabis in the past year versus cannabis-related problems, and these differences may help inform the development and delivery of preventative efforts.

NIAAA 2‐question screen can predict subsequent CUD in youth

A recent study shows that even low‐risk alcohol use by adolescents is associated with subsequent cannabis use disorder (CUD). The analysis, “Adolescent alcohol use predicts cannabis use over a three year follow‐up period,” by James Linakis, M.D., professor of pediatrics and emergency medicine at Brown University, and colleagues, is based on the use of the two‐question screen from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) when young people present in the emergency department (ED). The screener is already known to work for assessing alcohol use in teens, but this new study suggests it is better to ask questions about both alcohol and cannabis use in these patients.

The Relationship between Drug Consumption and Dating App Use: Results from an Italian Survey

To date, the literature regarding the relationship between drug consumption and dating app use is still very scant and inconclusive. The present study was thus aimed at investigating the association between drug consumption and dating app use in the general population. A total of 1278 Italian respondents completed an online ad hoc questionnaire assessing drug consumption (cannabis versus other illicit drugs), dating app use, the primary motive for installing dating apps, and demographics. Multiple logistic regression analyses were run to investigate the role of demographics and dating app use on drug consumption. Being single predicted cannabis use. Using dating apps accounted for higher odds of cannabis use; however, people who intensely used the apps were less likely to consume marijuana. Conversely, dating app use was not associated with the consumption of other drugs. This study suggests the presence of common underlying factors between dating app use and cannabis use, and it highlights the mediating role of the intensity of app use. Conversely, the study suggests that dating app use and the use of other drugs are quite independent behaviors.

Development of a cortical delay discounting assay: a potential biomarker of externalizing disorders.

People who tend to impulsively choose smaller, sooner rewards over larger, later rewards are at increased risk for addiction and psychiatric disorders. A neurobiological measure of the tendency to overvalue immediate gratification could facilitate the study of individuals who are susceptible to these mental disorders. The objective of this research was to develop a cortical assay of impulsive choice for immediate rewards. A cortex-based assay of impulsive choice was developed using 1105 healthy adults from the Human Connectome Project, and then cross-validated in two independent samples of adults with elevated rates of psychiatric disorders. Study 1: Cortical delay discounting (C-DD) was developed using a multivariate additive model of gray matter thickness across both hemispheres. Higher C-DD corresponded to thinner cortex and greater impulsive choice for immediate rewards. It also predicted cannabis use beyond established risk factors for drug use, including familial substance use, childhood conduct problems, personality traits, and cognitive functioning. Study 2: C-DD replicated the association with delay discounting performance from study 1. Structural equation modeling showed C-DD covaried with symptoms of externalizing, but not internalizing disorders. Study 3: C-DD positively predicted future delay discounting behavior (6-34 months later). Across three studies, a cortical assay of impulsive choice evidenced consistent associations with drug use and delay discounting task performance. It was also uniquely associated with psychiatric disorders that share impulsivity as a core feature. Together, findings support the utility of C-DD as a neurobiological assay of impulsive decision-making and a possible biomarker of externalizing disorders.

Contextualizing Cannabis Implicit Associations: Consideration of Peers and Personality.

Implicit cannabis associations (ICAs) inconsistently predict cannabis use (CU), and little is known about their formation. Personality, behavioral approach and inhibition, were tested as predictors of ICAs, which in turn, was expected to predict CU (mediation). Peer context was tested as a moderator. Data were taken from three annual assessments of a larger longitudinal study. The community sample (314 emerging adults, mean age = 19.13, 54% female, 76% White/non-Hispanic at the first assessment) completed an ICA task and questionnaire assessments of CU, personality, and peer norms. ICAs were positively associated with CU at high but not low levels of perceived peer approval/use. Behavioral inhibition was negatively associated ICAs, which in turn, predicted infrequent CU at high levels of peer approval/use (moderated mediation). Behavioral approach was marginally associated with ICAs. Peer context and personality are important for understanding the formation of ICAs and their association with CU.

Adolescent Work Values and Drug Use in Adulthood: A Longitudinal Prospective Cohort Study

Background: Personal values have been considered as a predictor of drug use. Methods: We examined the association between work values in adolescence and drug use in adulthood using 23-year longitudinal data from the Youth Development Study. Results: Partial extrinsic and intrinsic work values predicted cannabis use in the past year after adjusting for sociodemographic variables and alcohol and tobacco use at baseline. A part of intrinsic work values was negatively associated with illicit drug use in the past year. Conclusions: The present study suggested that some personal values might influence future drug use. Investigating the association between personal values and subsequent drug use through personal value theory and self-determination theory could help to understand risk and preventive factors in drug use.

Predictors of cannabis use among first-time justice-involved youth: A cohort study

BackgroundJustice-involved youth use cannabis at higher rates than their same-aged peers increasing likelihood of adverse behavioral health consequences and continued legal involvement. This study examined individual level predictors of early onset use cannabis use (<13 years of age) and cannabis use initiation in the 12 months following first court contact. MethodsParticipants were 391 first-time justice-involved youth (56.9 % male; Mage = 14.6 years; 32.1 % White, 11.1 % Black, 14.7 % Other/Multi-racial, 42.2 % Latinx) and an involved caregiver (87.2 % female; Mage = 41.0 years). Baseline assessments captured individual level factors; cannabis use was assessed every four months post-baseline for 12 months. Primary analyses involved multivariable modified Poisson regressions and survival analysis. ResultsIn multivariable models, youth who reported lifetime cannabis use (n = 188, 48.1 %) were older, reported alcohol use and positive cannabis use expectancies. Greater self-control and self-concept were associated with lower likelihood of lifetime cannabis use. Youth who initiated cannabis during the 12-month follow-up (n = 30, 14.8 %) tended to be older, White/non-Latinx, and to report more psychiatric symptoms (posttraumatic stress, externalizing, internalizing, and affect dysregulation), delinquent behavior, lower levels of self-control, poorer self-concept, greater drug use intentions and positive cannabis expectancies. In the multivariable survival analysis, affect dysregulation, internalizing symptoms, and more positive cannabis expectancies remained independently and positively associated with cannabis initiation. ConclusionsThere is a critical and unique window of opportunity to prevent cannabis use initiation among first-time justice-involved youth. Research is needed to determine whether brief interventions that aim to modify expectancies about cannabis use reduce rates of cannabis initiation in this underserved population.

Social Anxiety, Cannabis Use Motives, and Social Context's Impact on Willingness to Use Cannabis.

Social anxiety is often purported to be a risk factor for increased cannabis use. Cannabis use motives are strong explanatory predictors of cannabis use embedded within social contexts. This investigation explored the impact of social anxiety, cannabis motives, and their interaction on willingness to use cannabis in a community sample of emerging adults. Social anxiety was anticipated to positively correlate with coping and conformity motives and greater willingness to use cannabis in peer social contexts. Motives to use were hypothesized to potentiate social anxiety’s influence on cannabis use decision-making. In total, 124 participants completed an audio simulation of social cannabis use contexts (Can-SIDE) and standard measures of social anxiety (SIAS) and use motives (MMM). Contrary to expectations, social anxiety exerted a protective effect on willingness to use cannabis, but only when conformity, social, and expansion motives were at or below average. These effects varied by social contexts of use. Social anxiety leading to increased cannabis use may be most apparent in clinical samples and in high-risk cannabis users, but this pattern was not supported in this sample of community living emerging adults below clinical cutoffs for cannabis use disorder with relatively high social anxiety.

Cultural race-related stress and cannabis use among incarcerated African American men.

Research suggests African American men use cannabis to cope with racial discrimination. This conjecture may also be true for incarcerated African American men, who report high rates of cannabis use prior to and after incarceration. However, no studies to date have examined the association between race-related stress and chronic cannabis use among incarcerated African American men. As this population encounters pervasive negative cultural stereotypes and devaluation from larger society, cultural race-related stress may predict cannabis use among this population. Therefore, the purpose of this brief report was to examine the relationship between cultural race-related stress and years of regular cannabis use among a sample of incarcerated African American men. Study staff completed interviews with N = 177 African American men nearing release from four prisons in Kentucky. The interviews focused on mental health, drug use, and HIV risk behaviors. Participants provided their demographics (e.g., age, years of education, and length of incarceration), self-reported their years of regular cannabis use (3 times or more per week), and completed the Brief Index of Race-Related Stress (IRRS-B; Utsey, Measurement & Evaluation in Counseling & Development, 1999, 32, 149). Multivariate regression analyses demonstrated cultural race-related stress was significant and positively associated with the number of years of regular cannabis use (p = .003) among this population. This finding has implications for culturally tailored substance abuse treatment, specifically for cannabis use, with African American men upon their community re-entry from prison. (PsycInfo Database Record (c) 2021 APA, all rights reserved).