Association of Recent Cannabis Use with Attention-Deficit/Hyperactivity Disorder Symptom Severity in U.S. Adults

Chidimma Azubuike, PharmD, MA
University of Florida

Co-authors: Amie Goodin, University of Florida

Background: Prenatal cannabis (marijuana) exposure has been associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring. However, less is known about the relationship between cannabis use and ADHD symptoms among adults.

Objective: To examine the association between recency and frequency of cannabis use and ADHD symptom severity among adults.

Methods: We conducted a cross-sectional study using data from the 2024 National Survey on Drug Use and Health. An ADHD symptom scale was constructed from five survey items assessing domains consistent with DSM-5 ADHD symptom criteria, including difficulty with remembering tasks, restlessness or fidgeting, difficulty concentrating, managing daily responsibilities at work or school, and completing work as quickly as needed. Higher scores indicated greater symptom severity. The analysis included adults aged ≥18 years who worked or attended school and completed all ADHD symptom items (n = 13,294). Marijuana use recency was categorized as use within the past 30 days, 30 days to 12 months, or more than 12 months. Frequency was measured as the number of days of marijuana use in the past year. Survey-weighted linear regression accounting for complex survey design was used to assess the association between recency of marijuana use and ADHD symptom severity. The model adjusted for demographic characteristics, health status, and use of other substances. A sensitivity analysis included participants who completed at least four of the five items.

Results: The ADHD symptom scale ranged from 5 to 21, with a mean score of 11. Compared with individuals who never used cannabis, ADHD symptom scores were associated with 0.88, 0.95, and 0.62 higher points among those who used cannabis within the past 30 days, 30 days to 12 months prior, and more than 12 months prior, respectively (p<0.001). Each additional 30 days of cannabis use in the past year was associated with a 0.03-point increase in ADHD symptom score (p=0.26). Higher ADHD symptom scores were also associated with younger age, race/ethnicity, divorced or separated marital status, some college or college or higher education, lower income, and poorer self-rated health. Sensitivity analysis findings were consistent with the primary analysis.

Conclusion: Among adults, recent marijuana use was associated with greater ADHD symptom severity. Although the findings were statistically significant, they were not clinically meaningful. These findings provide evidence of an association but do not establish causality. Further longitudinal controlled studies are needed to clarify the temporal and causal relationship between cannabis use and ADHD symptoms.