Broad temporal and population spectrum on cannabis use & mental health.
Cannabis linked to depression, anxiety and suicidal tendencies in studies.
Early cannabis use in youth leads to mental health issues in adulthood.
Systematic review and meta-analysis updates cannabis mental health risks evidence.
Abstract: Cannabis is the most widely consumed illicit drug globally. In 2021, 46 % of countries identified cannabis as the predominant substance associated with drug abuse disorders, with 34 % indicating it as the primary cause for seeking treatment. Young individuals represent the largest consumer demographic, experiencing substantial negative health effects. Despite extensive research on its mental health impacts, many aspects remain unclear. This study examines cannabis use among young people including anxiety, depression, and suicidal behavior. Studies involving individuals aged 15–30 were included. Data sources included PubMed, Mendeley, Embase, WOS, CINAHL, and Scopus. After screening 6466 articles, 36 met the inclusion criteria, with 18 included in the meta-analysis. These studies were published between 2013 and 2025. The results indicated that the odds of depression were 51 % higher in young cannabis users (OR = 1.51, 95 %CI = 1.23–1.86), decreasing to 28 % after adjustment (aOR = 1.28, 95 %CI = 1.10–1.50). Anxiety showed a 58 % increase (OR = 1.58, 95 %CI = 1.15–2.15). For suicidal ideation, the increase ranged from 50 % in unadjusted models (OR = 1.50, 95 %CI = 1.05–2.14) to 65 % in adjusted models (aOR = 1.65 95 %CI = 1.40–1.93). Finally, the odds of suicide attempt were 87 % higher (OR = 1.87, 95 %CI = 1.25–2.80), remaining elevated at 80 % after adjustment (aOR = 1.80, 95 %CI = 1.30–2.49).
This commentary argues the need to prioritize regulation and abstinence-based prevention and recovery as critical services in efforts to maximize the reduction of substance-related harm and the promotion of mental health at a population-level. Treatment and harm reduction for those experiencing mental health and or substance use problems tends to be poorly integrated with regulatory and prevention approaches, which seek to reduce the development of these problems. This commentary examines evidence from Australia to argue the benefits of more deliberate service system integration based on life-course science. Harm reduction programs dominated the substance use prevention field in Australia until 2009 and were associated with high levels of youth substance use. The introduction of abstinence-based prevention programs and policies effectively reduced adolescent substance use and these reductions have flowed to generational reductions in adult substance use. The potential benefits of Australia’s movement to abstinence-based prevention continue to be disrupted by conflicting harm reduction treatment messages. This commentary outlines the argument to maximize substance use intervention effectiveness and mental health promotion by increasing investment in abstinence-based substance use regulation and prevention and then restructuring treatment and recovery services to more deliberately integrate with this emphasis. The benefits of this approach are argued to include reduction of substance use harm and mental health burden.
The numbers tell a story that policymakers refuse to hear. Across the globe, millions of children grow up in households that parental alcohol and drug use ravages. In Australia, 1 million children live with at least one adult battling addiction. Furthermore, the European Union counts 9 million children with parents who have alcohol problems. Similarly, the United Kingdom harbours 2.6 million children of school age living with parental alcohol problems, whilst in the United States, more than 10% of children live with a parent struggling with alcohol use.
These are not merely statistics. Instead, these are children whose fundamental rights to safety, stability, and a childhood free from fear face systematic violation whilst society champions the “right” of adults to use substances without consequence.
The Carefully Curated Cover-Up
The Victorian Auditor-General’s recent report on kinship care reveals not through what it examines, but rather through what it deliberately excludes. Specifically, the audit was “at pains to ensure” that only a “harm management” process review took place. Consequently, the audit precluded the sources and origins of harm that necessitate Out of Home Care (OOHC).
This represents carefully curated obfuscation, essentially a systemic avoidance of identifying and addressing the source of initial abuses and neglects that place children in harm’s way. Moreover, the report discusses finding “stable homes” for children, yet the Department of Families, Fairness and Housing (DFFH) has not determined what a stable placement is, has not collected baseline data, and has not assessed its progress against intended outcomes.
Here is what we know about stability: substance use does not make for a stable home in which to raise healthy and psychologically sound children. Nevertheless, this truth, however inconvenient to current policy trends promoting “harm reduction” and decriminalisation, remains inescapable.
Parental Substance Abuse Child Neglect: The Evidence Linking Substance Use and Child Harm
The Addiction Conference Revelation: At the 2022 Australia and New Zealand Addiction Conference, Odyssey House presented findings that should have reverberated through every child protection agency: “Every Drug Rehabilitation programme must see drug use as Family Violence. These go together.”
The Causal Versus Correlate Smokescreen: Pro-drug and alcohol-defending advocates often wield the “causal versus correlate” debate to diminish substance use culpability. Essentially, they inform us that at worst, substances merely correlate with child abuse. However, we have enough data on record to know that alcohol and other drugs involve themselves more often than not in the frequency, intensity, and ferocity of abuses that adults inflict on children.
The Statistical Reality: The evidence is overwhelming. In the United States, mothers convicted of child abuse are 3 times more likely to be alcoholics, whilst fathers are 10 times more likely to be alcoholics. Additionally, more than 50% of all confirmed abuse reports and 75% of child deaths involve the use of alcohol or other drugs by a parent. Meanwhile, in Europe, 16% of all cases of child abuse and neglect are alcohol-related. Furthermore, children are 52% more likely to have anxiety or depression when both parents regularly consume alcohol.
The Alcohol Availability Connection: A groundbreaking study from Ohio State University demolished any remaining pretence that substance availability and child harm are unrelated. Specifically, research in Sacramento, California found that having one more off-premises alcohol outlet in a census tract related to 13.5% more substantiated cases of child abuse and neglect and 10.5% more entries into foster care. Moreover, a 1% higher per capita volume of alcohol consumed in a neighbourhood related to 3.2% more children entering foster care due to alcohol-related concerns.
Professor Bridget Freisthler, the study’s lead author, stated clearly: “We have to pay more attention to how the supply and availability of alcohol has an impact on child maltreatment if we want to make a real difference.”
The Push for More Permission: Yet as evidence mounts, pro-drug activists push for decriminalisation and “permission models” that would extend the same protections currently enjoyed by alcohol to cannabis, cocaine, mushrooms, and crystal methamphetamine. Indeed, the Kincare industry in South East Queensland is reportedly “booming” because ice impacts parents’ ability to care for their children. Consequently, the insanity of promoting permission models for substance use whilst children suffer cannot be overstated.
Parenting today means guiding children through a maze of pro-pot propaganda and surface-level harm reduction messages, all while facing real risks linked to family history. The parental influence on addiction, substance use, and health choices has never been more crucial. We will explore how parents can empower their children against addiction, drawing on research, real-world stats, and expert advice.
Let’s start with some good news and understand that children, their child, your child, our children have a number of Human Rights enshrined in United Nations Conventions, and one of those Conventions is Article 33 of the Rights of the Child, and one every parent/guardian should know, hold dear and wield, when it comes to protecting their children
As you continue through this article keep this in the forefront of your thinking in how this can help you, your family and community be better at delaying or more importantly, denying uptake of potential, health and well-being destroying substances.
Why Parental Influence on Addiction Matters
You might hear everywhere that "all teens experiment with alcohol or drugs". But the data tells a different story. According to the Journal of Studies on Alcohol and Drugs, parental beliefs and conversations directly impact young people’s substance choices—even into college. Teens who understand their parents have a zero-tolerance policy are less likely to drink, both in high school and beyond.
Dr Maria Rahmandar, medical director at Lurie Children’s Hospital, puts it clearly:
“Youth are less likely to use alcohol and other substances when their parents have the expectation that they won’t and communicate this expectation to their children.”
The Dalgarno Institute emphasizes that the belief that drug use is wrong is the most significant protective factor against substance use. Research from the University of Illinois shows that every 'unit' increase in this belief raises the likelihood of abstinence by 39% for 8th graders, 50% for 10th graders, and 53% for 12th graders.
Declining Rates Challenge Old Myths
There’s a stubborn myth that underage drinking is universal. Here’s the truth:
2021: 54.1% of high school seniors had ever used alcohol; only 25.8% had done so in the last 30 days.
1978: A huge 93.1% of seniors reported ever drinking; 72.1% had drunk alcohol in the past month.
This decline aligns with the Dalgarno Institute's advocacy for evidence-based prevention strategies that delay or deny the uptake of alcohol and drugs. Effective drug education in schools, for example, has been shown to delay drug uptake by two years, providing a critical window for intervention.
The Role of Genetics and Family History
While parental guidance matters, genetics, or better stated ‘epigenetics’ play a role too. Dr Marc Schuckit (University of San Diego) reports genetics factors can add up to 60% of a person’s risk for developing alcohol use disorder. However, it’s vital to note that there is no single "alcoholism or drug addiction gene". It is what we like to refer to as a ‘recipe’.
The nature and nurture debate around development was settled well over a decade ago. It is not nature or nurture alone that determine developmental outcomes, but rather a unique mix - one that the Dalgarno Institute calls the R.E.C.I.P.E.
The Epigenome is the ‘coating’, if you like, on the DNA, it is not a ‘gene’ per se, but there is a vast amount of data in this space that can influence how genes express themselves. This is where the above RECIPE can influence the epigenome as much as the epigenome has capacity to influence the recipe. In short, ‘pre-dispositions’ can be created, and can be amended, but it is all found in the mix of the above factors. (see Humpty Dumpty Dilemma Resiliency Projectpar)
Framing it Honestly, Authentically, but not Romantically!
Honesty, not secrecy, is key. Jessica Lahey, author of The Addiction Inoculation, shared with her kids her own battles with alcohol:
“I told them I would not be drinking alcohol anymore because I can’t control it, and in order to be the best mom I could be for them, I had to stop.”
Children sense when things are hidden or "off". Explaining the family history in an age-appropriate way helps them make sense of their world. Michael Roeske, psychologist and director at Newport Healthcare, supports this approach. "If you’re not honest," he says, "kids fill in the gaps themselves, often with worse explanations than reality. Honesty gives them a framework for understanding addiction as a health issue."
Of course, as mentioned previously, this bio-behavioural disorder is about avoiding - preventing this non-communicable dis-ease through behavioural decisions and acts that stop or revert from the behaviours causing the health harms. This must never be lost in the conversation around this issue. Avoiding stigmatising people is important, but calling bad decisions out in view or pointing and empowering toward best practice is a key part of preventative health.
To state the obvious, prevention is far more effective than cure. By focusing on delaying or denying substance use, families can significantly reduce the risk of addiction, even in the presence of genetic predispositions.
Parental Influence on Addiction Prevention Starts Early
Substance use disorder rarely appears out of nowhere in adulthood. Most people with these issues start as teens. The research is unanimous:
The longer a child delays their first drink or experiment, the lower their chance of developing addiction.
Dr Rahmandar highlights, “The longer you can delay, the lower your risk.”
The Dalgarno Institute also advocates for a unified, uncompromised message in drug education: 'Don’t uptake or quit.' (One Focus – One Message – One Voice)
This means the small everyday choices and conversations you have matter hugely. Waiting until college to talk about substance use is already too late.
Environmental and Lifestyle Risk Factors
There are far more important risk factors to focus on than a default referral to ‘genetics’ What has been labelled as Adverse Childhood Experiences is a very significant factor in potential substance use engagement.
If you look closely at the above categories, you can see how substance use is not only a key ACE in its own context but can influence every other ACE in the spectrum. That is how pervasive the harms of substance use are
Lahey suggests picturing risk and protection as a balance scale:
Risk factors: Family history, trauma, untreated mental illness, substance-friendly environments.
Protective factors: Mental health support, strong family connections, meaningful hobbies, supportive schools.
For higher-risk families, you need extra "weights" on the protective side. The more risk, the more robust your protections should be. The community-wide efforts are important, such as Iceland’s successful anti-drug strategy, which relies on clear, consistent messaging and robust protective factors to reduce youth drug use.
The Conversation with the Kids - What May That Look Like?
Start Open Conversations Early: The best prevention starts with honest, ongoing conversation. Begin before your child faces peer pressure. Keep your tone calm, factual, and supportive.
Ask what they’ve heard at school or online about drugs and alcohol.
Share family history in simple, age-appropriate terms.
Make clear your expectations – Not threatening, rather robust, uncompromising and warm.
Example Script
“We have people in our family who’ve struggled with alcohol. That means we all must be really careful, because our bodies might respond differently. If you’re curious or worried, you can always ask me about it.”
Don’t Gloss Over Reality: Don’t hide struggles or make up stories about absent relatives or "illness". Kids notice tension, whispered conversations, or absent family members. Explaining substance use disorders as a bio-behavioural health condition can help not only with avoiding stigma but also completely de-glamorise and strip bare the real cost and harms of substance use.
Empowering Choices and Building Life Skills: Dr Rahmandar notes, “You cannot develop a substance use disorder unless you are exposed to substances in the first place.” Choice matters. Kids with higher genetic risk can sometimes escape the cycle by simply never starting or starting much later than peers. Again, we cannot overemphasise the need for all the community to be on the same page when it comes to substance use. Actors in the community who continue to demand their ‘liberty’ to use psychotropic toxins that bring harm not only to themselves, but on both passive and active levels, negatively impact communities, families and children, must be called out.
Equip Kids with Skills
Refusal Skills: Practise saying "no" using real-world examples and role-play. A person’s NO is the most powerful protective weapon in their tool kit of resilience - teach them how to use it and help them not give it up when they are in toxic coercive or seductive environments.
Exit Strategies: Pre-plan texts or code words they can use if they need to leave an uncomfortable situation.
Safe Environments: Monitor social circles. It’s important to know who your kids’ friends are, but also to know about their family. You become the instigator of social events and make your home ‘The safe space’. Of course, try to avoid open suspicion of people, be discerning, ask careful questions and always balance this with trust.
Healthy Activities: Sports, arts, volunteering, and meaningful hobbies absorb time and fill key social and emotional needs.
Your Role as a Parent Never Ends
Some parents worry that if their child experiments or struggles with substance use, that they’ve "failed". That’s not true. Michael Roeske advises, “It is this ongoing effort that is most important.” Recovery and resilience are built with many small pieces, not single big interventions.
Lahey compares recovery to a 100-piece puzzle. Piece 100 won’t fall into place unless pieces two, 17, 72, and 99 are all there. Your role is to keep putting down puzzle pieces, even if you can't see the end result. The point is that it’s the consistent and uncompromising building of best practice prevention and resilience capacities into your child's environment that will help equip them to come up and out of that dysfunctional arena.
Framing Addiction Like Any Other Health Issue
Parents often talk to kids about family risks for diabetes or heart disease. Substance use disorder is no different. "If they know they are predisposed to alcohol use disorder, that’s another piece of essential information they need to make informed decisions," says Lahey.
Real-World Prevention Works
Data from schools and communities around the world show early prevention works, especially when parents, schools, and communities send unified, evidence-based messages. Dalgarno Institute argues for a prevention-first approach, criticising strategies that seem to normalise or downplay drug risks (like pill testing at festivals or drug consumption rooms).
“Empowering and equipping the emerging generation to exercise the best choice of ‘NO’ should be the strongest incentive in all messaging.” – Shane Varcoe, Executive Director, Dalgarno Institute
The Australian Criminal Intelligence Commission puts it bluntly:
“The risk and harm posed by illicit drugs to the Australian community is ever-growing, which underscores the need for law enforcement and health agencies to work collaboratively to combat both the supply and demand for illicit drugs.”
Why Prevention Works
No safe level for young brains: Science shows there is no safe level of drug use for developing brains (up to 25–32 years old).
Protective beliefs: University of Illinois research proved that every "unit" increase in the belief that drug use is wrong raises the chance of abstinence by:
39% (8th graders)
50% (10th graders)
53% (12th graders)
Economic impact: Every $1 spent on prevention saves $18 in future community costs.
The Collaborative Community Contagion: Parents, Schools, and Community Working Together
Schools cannot do this work alone. The Icelandic model of drug prevention, which saw a steep drop in youth drug use, relies on community-wide effort and clear, consistent messaging. One message - One focus - One Voice in all key community demographics. Both good and bad contagions work the same. More is ‘caught’ than taught - Kids are watching what is being not just spoken, but more importantly, what is being modelled. If the ‘talk’ of the community is stay away, but the ‘walk’ of the community is ‘do what you like when you’re 18’, then the ‘message’ being delivered creates cognitive dissonance in the child and they can all too often go the path of least resistance.
The above, right here, is the single biggest problem.
If the ‘grown ups’ want to engage with substance irresponsibly and use their ‘adult’ status to do so, then the message to the emerging adult - the child - is, “I can ‘act like an adult now’ by using this ‘grown up’ plaything”. The personal desire of the adult then trumps the child's well-being. This egocentricity is a tough one to combat on a societal level, but it can be done in micro-environments, like your family, friends, and even community settings.
One data set reveal (and disappointingly that only 44% of Australian students aged 12–17 received more than one lesson on AOD last year. This needs to and can change with AOD (Alcohol & Other Drug) Education being couched in health and human development studies with sound sociological and anthropological academic underpinnings that build resilience.
For example, the Dalgarno Institute and its coalition of educators have not only incursions but curriculum that can service this need for every year level from grade 5 in primary school up to the end of high school. Along with sporting club, community and family education sessions, an immersion protocol can be engaged to help develop a resilient student who has no need or desire to engage in substance use.
This can all help parents and families add to their resilience building toolkit and any schooling gaps can be filled by families who make substance education part of everyday life.
Practical Steps to Leverage Parental Influence on Addiction
Open Communication: Start early, keep it honest and ongoing.
Encourage Healthy Activities: Support sports, arts, volunteering.
Build safe and inviting family environments for your children and their friends. Not trying to be ‘their buddies’, but environments that honour, respect and monitor recreational spaces in your neighbourhood.
Set Firm Family Values and Rules: Be clear about your expectations on substance use. Teach your children the WHY, not just the What. This helps with...
Teaching Refusal & Exit Skills: Prepare kids for real-life scenarios.
Consistently Enforce Consequences: Be fair, predictable, and calm.
Stay Connected: Stay interested in your child’s friends and routines.
Model Behavior: Demonstrate healthy habits and transparent communication about family risks.
Spot Early Warnings: Address changes in mood or activity promptly.
Facing Substance Normalisation with Confidence
The era of pro-cannabis messaging and normalised substance use can feel overwhelming for parents. The ‘frog in the pot’ and the heat turned right up with first trivialising substance use – it’s not that bad. Then normalising substance use – everyone goes through this phase and it’s part of ‘growing up’. Then decriminalising to affirm cultural inevitability. Then legalise and give psychotropic toxins the greatest permission authority available – enshrined as a right in law.
However, evidence shows that parental influence on potential engagement and or addiction has a significant and measurable impact. By staying present, honest, and proactive, you can help protect your child—even if there’s a family history of addiction.
Prevention isn’t just possible; it’s highly effective.
The Dalgarno Institute highlights the importance of prevention-first approaches that focus on reducing demand and prioritising primary prevention. They caution against strategies that may unintentionally normalise or downplay the risks of drug use, such as pill testing at festivals, drug consumption sites that do not lead to recovery and messaging that suggests drug use is ‘manageable’ and that harms can be dealt with.
Strengthening your family’s protective factors and building resilience through community prevention programmes and professional advice can provide a strong foundation for a substance-free future. Consistent parental involvement remains the most powerful tool in safeguarding your child.
Originating in the US, Communities that Care is a public health prevention framework that has been operating in Australia for 25 years.
Over 30 Local Government Areas have used the framework to reduce alcohol consumption, injuries and crime. In the US it has been used to also reduce smoking, cannabis and depression. An Australian cost benefit analysis has shown that using the CTC approach to adolescent alcohol consumption has a return of investment of $2.60.
This presentation outlines the Communities that Care model and how communities can use the model. It also presents findings from the National Australian Cluster Randomised Control Trial, and other national and international longitudinal evidence. (Watch Webinar Here)
This commentary argues the need to prioritize regulation and abstinence-based prevention and recovery as critical services in efforts to maximize the reduction of substance-related harm and the promotion of mental health at a population-level. Treatment and harm reduction for those experiencing mental health and or substance use problems tends to be poorly integrated with regulatory and prevention approaches, which seek to reduce the development of these problems. This commentary examines evidence from Australia to argue the benefits of more deliberate service system integration based on life-course science. Harm reduction programs dominated the substance use prevention field in Australia until 2009 and were associated with high levels of youth substance use. The introduction of abstinence-based prevention programs and policies effectively reduced adolescent substance use and these reductions have flowed to generational reductions in adult substance use. The potential benefits of Australia’s movement to abstinence-based prevention continue to be disrupted by conflicting harm reduction treatment messages. This commentary outlines the argument to maximize substance use intervention effectiveness and mental health promotion by increasing investment in abstinence-based substance use regulation and prevention and then restructuring treatment and recovery services to more deliberately integrate with this emphasis. The benefits of this approach are argued to include reduction of substance use harm and mental health burden.
The Addiction Conference Revelation: At the 2022 Australia and New Zealand Addiction Conference, Odyssey House presented findings that should have reverberated through every child protection agency: “Every Drug Rehabilitation programme must see drug use as Family Violence. These go together.”
