Evaluating the relationship between marijuana use, aggressive behaviors, and victimization: an epidemiological study in colombian adolescents.

Objectives: This study aimed to examine the relationship between marijuana use and aggression and victimization among Colombian adolescents. We aimed to clarify marijuana's distinct role by comparing different categories of drug use and by considering the order of drug initiation.

Methods: We conducted a secondary analysis of nationally representative cross-sectional data collected from Colombian adolescents in 2016. The original sample included 80,018 students in Grades 7 to 11. Participants were categorized into marijuana-use groups - EXCLUSIVE (marijuana only), INITIAL (marijuana use before other drugs), and SUBSEQUENT (marijuana use following other drugs) - and non-marijuana-use groups - NON-DRUG (no use), ONE-DRUG (one other drug only), and MULTIPLE-DRUG (two or more other drugs).Aggressive behaviors (individual aggression, group aggression, harassment) and victimization were assessed based on self-reported involvement in the past 12 months. Logistic regression models examined associations between marijuana use patterns and these outcomes, controlling for sex, age, parental education, and grade repetition. For the SUBSEQUENT group, the total number of other drugs used was also controlled.

Results: Adolescents with no drug use had the lowest rates of all aggressive behaviors and victimization. As drug use increased, so did the prevalence of these outcomes, with MULTIPLE-DRUG users exhibiting the highest levels. Compared to NON-DRUG adolescents, each marijuana-use group (EXCLUSIVE, INITIAL, SUBSEQUENT) showed increased odds of some forms of aggression and victimization. For example, EXCLUSIVE users had higher odds of aggression compared to NON-DRUG users. However, the magnitude of these associations differed when comparing marijuana-use groups against each other and against ONE-DRUG and MULTIPLE-DRUG groups. INITIAL and SUBSEQUENT users often demonstrated greater odds of aggression than EXCLUSIVE users, suggesting that polydrug involvement and the sequence of drug initiation matter.

Conclusions: These findings underscore the importance of moving beyond binary classifications of marijuana use when examining aggression and victimization among adolescents. Marijuana use is associated with an increased risk of aggression and victimization, but other substance use patterns and the temporal order of drug initiation influence this relationship. Policymakers, educators, and clinicians should consider these when designing preventive interventions. Future research should employ longitudinal designs and incorporate additional contextual variables to further clarify the mechanisms linking marijuana use to aggression and victimization.