Understanding the Relationships between ADHD Symptoms and Cannabis-Related Consequences among Young Adults

Objective: The link between attention-deficit/hyperactivity disorder (ADHD) and cannabis-related problems is well documented, though research has primarily focused on cannabis use disorder (CUD) or cannabis consequences in aggregate. This study examined how inattentive (IN) versus hyperactive/impulsive (HI) ADHD symptoms relate to CUD symptoms as well as distinct domains of cannabis consequences (social-interpersonal consequences, impaired control, negative self-perception, self-care, risk behaviors, academic/occupational consequences, physical dependence, and blackout use) in young adults. Total amount of cannabis flower used over the past 90 days was explored as a potential mediator of these associations. Method: Young adults (N = 160; 41% male; ages 19-25, M = 22, SD = 2.06) with a history of regular cannabis use completed self-report measures of ADHD symptoms and cannabis consequences. Participants also completed a 90-day Timeline Follow Back assessing grams of cannabis flower consumed each day, along with a structured clinical interview for CUD. Results: IN symptoms were directly associated with cannabis-related occupational/academic consequences, self-care consequences, and blackouts/memory impairment, independent of quantity of cannabis consumption. HI symptoms showed positive indirect associations with physical dependence, impaired control, and CUD through greater amount of cannabis used. Conversely, IN symptoms had negative indirect associations with these outcomes, mediated by amount of cannabis used. Conclusions: Findings reveal distinct pathways through which IN and HI ADHD symptoms relate to cannabis problems in young adults. Findings highlight the need to consider ADHD symptom domains separately when assessing specific cannabis-related risks, which may have implications for tailoring interventions.