ADHD and Cannabis Use in College Students: Examining Indirect Effects of Coping Motives

Abstract

ADHD is a developmental risk factor for cannabis misuse and cannabis use disorder. Individuals with ADHD also struggle to cope with negative affect and are more likely to engage in maladaptive, avoidant coping behaviors. This may be particularly salient in college, a developmental period characterized by increased stress and autonomy and easy access to highly reinforcing substances. However, despite this increased risk, little is known about mechanisms underlying why college students with ADHD use cannabis more frequently than their peers. This study examined associations between ADHD, coping motives (i.e., using cannabis to avoid or reduce negative affect), and frequency of cannabis use in a sample of college students (49% female) with (n=42) and without (n=30) ADHD using a two-week daily diary protocol. Results showed that ADHD was significantly associated with elevated coping motives and more days of cannabis use during the daily diary period. Additionally, there was a significant indirect effect of ADHD on number of cannabis use days through coping motives; students with ADHD endorsed a stronger drive to use cannabis to cope with negative emotions, which in turn was associated with more cannabis use days. Findings align with theory linking ADHD to increased vulnerability for avoidant coping behaviors. Further work may explore the potential of targeted, proactive interventions to help youth with ADHD build and utilize adaptive substance-free coping skills, particularly in the college context.