Why Women With Childhood Trauma Choose Cannabis

Cannabis is readily available and its daily use over the past decades has increased significantly. It is currently approved for medicinal use in 38 states while 30 states have fully legalized it for both medicinal and recreational. [Disclosure: I am a member of the Ohio Governor’s Medical Marijuana Advisory Committee.] Given current trends, it is critical that we understand the psychological factors that influence whether someone chooses regular cannabis use.

Stress-related mental disorders are often reported by individuals who use cannabis regularly. A few studies have reported an association between childhood trauma and cannabis use. The connection is, of course, not surprising; childhood trauma is a risk factor for all substance use disorders. Does childhood trauma bias abuse toward cannabis? Possibly yes. Scientists have speculated that childhood trauma, as compared to adulthood trauma, may alter the responsiveness of the endogenous cannabinoid system.

A recent study investigated the association between childhood trauma and cannabis use. Importantly, the investigators focused on a community with a low rate of other drug use. Furthermore, because trauma appears to interact with gender with respect to the changes induced in the endocannabinoid system alterations, and because the use of cannabis by women is increasing dramatically, the study also assessed the potential gender differences.

The results confirmed that childhood trauma was associated with a higher rate of cannabis use as adults. Interestingly, the study did not find a significant association between cannabis use and any particular type of childhood trauma. When the authors analyzed the association between cannabis use and childhood trauma in men and women separately, the association between cannabis use and childhood trauma was statistically significant in only women.

The higher rate of cannabis use in individuals with a history of trauma could potentially be an attempt to compensate for a dysregulated endocannabinoid system. However, regular cannabis use has been reported to suppress the endocannabinoid system which would further compromise the endocannabinoid regulation of the stress response in these individuals. If the altered endocannabinoid system can partially explain the high rate of cannabis use in traumatized individuals, the further suppression of the endocannabinoid system by cannabis might underly the high rate of regular cannabis use and the development of cannabis use disorder in these individuals.

These results are interesting because ordinarily, men are more likely to use cannabis for all reasons. Yet, in the current study, the association between cannabis use and childhood trauma was significant only for females. It is well known that childhood trauma affects boys and girls in differential patterns. This likely explains why traumatized women report higher rates of cannabis use to cope with negative feelings.

The neurobiological mechanisms that underlie this gender bias are unknown. However, human and animal studies have shown that chronic stress reduced the number of cannabinoid receptors more in females than males. Taken together, these animal and human studies suggest that female survivors of childhood trauma are compensating for the trauma-induced reduction in cannabinoid receptor number by self-medicating with a cannabinoid receptor stimulant.