Prevalence Of Cannabis Use Disorder Research Articles

Divergence in Cannabis and Alcohol Use Disorder Prevalence Trends from 2002-2019

IntroductionDespite increases in availability, potency, and consumption of cannabis, epidemiological data suggest decreases in prevalence of cannabis use disorder (CUD) in some groups. Understanding mechanisms for these changes may help improve diagnostic tools for identifying disordered use. This analysis evaluates changes in CUD compared to a substance with comparably stable social and environmental context (alcohol use disorder [AUD]) as well as treatment engagement and need from 2002 to 2019. MethodsData were from the National Survey on Drug Use and Health. Outcomes included CUD and AUD symptoms, treatment engagement, and perceived need. Temporal trends and average annual rate of change [AARC] were computed. ResultsBetween 2002 and 2019, daily cannabis use prevalence increased by 94% (AARC=11.68%), whereas CUD prevalence among those using cannabis daily reduced by 47.9% (AARC=-10.30%). Daily alcohol use prevalence decreased by 10.86% (AARC=-1.90%), and AUD prevalence among those using alcohol daily reduced by 3.9% (AARC=-0.67%). Prevalence of individual 12-month CUD criteria among those using cannabis daily decreased (-13.4 to -59.6% change; AARC = -2.4% to -14%). Among those using cannabis daily, trends in prevalence of individual AUD criteria varied, with some criteria increasing in prevalence and others decreasing (-30.2% to 24.6% change; AARC = -5.82% to 3.7%). Treatment engagement and perceived need reduced for cannabis, whereas treatment engagement increased and perceived need decreased for alcohol. ConclusionThese results suggest that CUD and AUD criteria may be determined within the cultural context dictating the definition of harm which has changed for cannabis, but not alcohol, from 2002-2019.

Cannabis Use and Cannabis Use Disorder Among U.S. Adults with Psychiatric Disorders: 2001-2002 and 2012-2013

Background Rates of cannabis use disorder (CUD) have increased disproportionately among Veterans Administration (VA) patients with psychiatric disorders compared to patients with no disorder. However, VA patient samples are not representative of all U.S. adults, so results on disproportionate increases in CUD prevalence could have been biased. To address this concern, we investigated whether disproportionate increases in the prevalence of cannabis outcomes among those with psychiatric disorders would replicate in nationally representative samples of U.S. adults. Methods Data came from two national surveys conducted in 2001-2002 (n = 43,093) and 2012-2013 (n = 36,309). Outcomes were any past-year non-medical cannabis use, frequent non-medical use (≥3 times weekly), and DSM-IV CUD. Psychiatric disorders included mood, anxiety and antisocial personality disorders. Logistic regression was used to generate predicted prevalences of the outcomes, prevalence differences calculated and additive interactions compared differences between those with and without psychiatric disorders. Results Cannabis outcomes increased more among those with psychiatric disorders. The difference in prevalence differences included any past-year non-medical cannabis use, 2.45% (95%CI = 1.29-3.62); frequent non-medical cannabis use, 1.58% (95%CI = 0.83-2.33); CUD, 1.40% (95%CI = 0.58-2.21). For most specific disorders, prevalences increased more among those with the disorder. Conclusions In the U.S. general population, rates of cannabis use and CUD increased more among adults with psychiatric disorders than other adults, similar to findings from VA patient samples. Results suggest that although VA patients are not representative of all U.S. adults, findings from this important patient group can be informative. Greater clinical and policy attention to CUD is warranted for adults with psychiatric disorders.

Prevalence of Cannabis Use Disorder Among Primary Care Patients with Varying Frequency of Past-Year Cannabis Use.

Valid, single-item cannabis screens for the frequency of past-year use (SIS-C) can identify patients at risk for cannabis use disorder (CUD); however, the prevalence of CUD for patients who report varying frequencies of use in the clinical setting remains unexplored. Compare clinical responses about the frequency of past-year cannabis use to typical use and CUD severity reported on a confidential survey. Among adult patients in an integrated health system who completed the SIS-C as part of routine care (3/28/2019-9/12/2019; n = 108,950), 5000 were selected for a confidential survey using stratified random sampling. Among 1688 respondents (34% response rate), 1589 who reported past-year cannabis use on the SIS-C were included. We compared patients with varying frequency of cannabis use on the SIS-C (< monthly, monthly, weekly, daily) to survey responses on the Composite International Diagnostic Interview Substance Abuse Module for CUD (any and moderate-severe CUD) and cannabis exposure measures (typical use per-week, per-day). Adjusted multinomial (categorical) and logistic regression (binary), weighted for population estimates, estimated the prevalence of outcomes across frequencies. Patients were predominantly middle-aged (mean = 43.3years [SD = 16.9]), male (51.8%), white (78.2%), non-Hispanic (94.0%), and commercially insured (68.9%). The prevalence of any and moderate-severe CUD increased with greater frequency of past-year cannabis use reported on the SIS-C (p-values < 0.001) and ranged from 12.7% (6.3-19.2%) and 0.9% (0.0-2.7%) for < monthly to 44.6% (41.4-47.7%) and 20.3% (17.8-22.9%) for daily use, respectively. Greater frequency of use on the SIS-C in the clinical setting corresponded with greater per-week and per-day use on the confidential survey. Among patients who reported past-year cannabis use as part of routine screening, the prevalence of CUD and other cannabis exposure measures increased with greater frequency of cannabis use, underscoring the utility of brief cannabis screens for identifying patients at risk for CUD.

Cannabis use in adult population in Galicia: Prevalence and associated characteristics.

Cannabis is the most widely consumed illegal drug in Spain, with consumption concentrated mainly in adolescence and early adulthood. The objectives were to estimate the prevalence of cannabis use, cannabis use disorder (CUD) and dependent use in the Galician population aged 16 years and over, and to characterize cannabis users and cannabis dependent users. Data are from two cross-sectional studies from the Risk Behavior Information System conducted in 2017 (n = 7,841) and 2018 (n = 7,853). The Cannabis Abuse Screening Test (CAST) was used to identify users with CUD and/or dependent use. Prevalences were estimated and regression models were fitted to identify variables associated with cannabis use and dependent use. In 2017-2018, 2.7% (95% CI: 2.5-3.0) of the Galician population aged 16 years and over consumed cannabis at the time of the survey, with this prevalence being 9% in the 16-24 years age group. Prevalence decreased with age and was higher in males in all age groups. The prevalence of CUD in users was 69.5% (95% CI 61.1-78.1) and of dependent use it was 49.2% (95% CI 46.6-53.9). Tobacco use was the major determinant of being a cannabis user [OR = 19.8 (95% CI 13.8-28.4)] and daily cannabis use of being a dependent user [OR = 5.5 (95% CI 3.2-9.5)]. Cannabis use among the Galician population is high, especially among young people aged 16-24 years, who show the highest probability of dependent use. Prevention measures should be aimed especially at the younger population aged 16 years to curb its use and the development of consequences such as CUD and dependent use.

Validation of the Reasons for Quitting Smoking Cannabis Scale Among People with Cannabis Use Disorder

Background The prevalence of cannabis use disorder (CUD) has increased in the last ten years with medicinal and recreational legalization across the United States and increasing accessibility worldwide. Estimates suggest that 8-18% of individuals who use cannabis meet diagnostic criteria for CUD, leading to significant impairments across functioning. However, there are currently no measures that assess the reasons for quitting smoking cannabis to use in treatments with validation evidence in those with CUD. Method We validated the Reasons for Quitting Smoking Cannabis Scale (RQSCS) in adults (n = 133) who meet the diagnostic criteria for CUD as part of a laboratory-based clinical trial on transdermal nicotine patches for cannabis withdrawal symptoms (R01DA031006). We conducted standard psychometric testing, including exploratory factor analyses, estimating internal consistencies, exploring demographic variation, and testing construct validity. Results The RQSCS demonstrated a four-factor structure, including: (1) cognitive health, (2) social functioning, (3) health problems, (4) reputation, and a single item that assesses experimental incentive; λs > .410), with acceptable to high internal consistencies for each subscale (αs > .725). The scale demonstrated strong construct validity and minor demographic variation. Finally, all subscales were sensitive to detecting reasons for quitting cannabis and differentially predicted cannabis use 31 days after the study. Conclusion The RQSCS is a psychometrically robust, timely instrument for assessing the reasons for quitting smoking cannabis in individuals with CUD. The scale has the potential to provide useful information for clinicians attempting to help those with CUD reduce or cease their cannabis use, informing individualized treatment plans and enhancing motivation for change.

Discriminative validity of a substance use symptom checklist for moderate-severe DSM-5 cannabis use disorder (CUD) in primary care settings

BackgroundThe prevalence of cannabis use disorder (CUD) is increasing in the US and primary care providers need tools to identify patients with moderate-severe CUD to facilitate treatment. A single-item screen for cannabis (SIS-C) has outstanding discriminative validity for CUD. However, because the prevalence of moderate-severe CUD is typically low, the probability that an average patient who screens positive for daily cannabis has moderate-severe cannabis use disorder is low, making follow-up assessment important. MethodsThis study reports the discriminative validity of a DSM-5 Substance Use Symptom Checklist (“Checklist”) for moderate-severe CUD among 498 primary care patients who reported daily cannabis use on the SIS-C. We evaluated the performance of the Checklist (score 0–11) completed during routine care, compared to ≥4 DSM-5 CUD symptoms (moderate-severe CUD) on the Composite International Diagnostic Interview Substance Abuse Module from a confidential survey (reference standard). We estimated areas under receiver operating curve (AUROC), sensitivities, specificities, and post-test probabilities. ResultsOf 498 eligible patients, 17 % met diagnostic criteria for moderate-severe CUD. The Checklist’s AUROC for moderate-severe CUD was 0.77 (95 % CI: 0.71–0.83), and Checklist scores of 1–2 balanced sensitivity and specificity. Among patients from a population with average prevalence of CUD before screening (~6 % prevalence) and daily use on the SIS-C, a Checklist score of 3 indicated a post-test probability of 82.1 %. ConclusionOverall performance of the Checklist was good and the high specificity made it useful for identifying patients likely to have moderate-severe CUD among those at average risk.

W29 - Prevalence of Cannabis Use Disorder Among Primary Care Patients who Use Cannabis for Medical Only, Nonmedical Only, or Both Reasons

W29 - Prevalence of Cannabis Use Disorder Among Primary Care Patients who Use Cannabis for Medical Only, Nonmedical Only, or Both Reasons

S13 - Trends in Prevalence of Cannabis Use Disorders Among U.S. Veterans With Psychiatric Disorders Between 2005 and 2019

S13 - Trends in Prevalence of Cannabis Use Disorders Among U.S. Veterans With Psychiatric Disorders Between 2005 and 2019

Trends in Adolescent Comorbid Cannabis Use Disorder and Postoperative Complications.

Increasing legalization and widespread misinformation about the dangers of cannabis use have contributed to the rising prevalence of cannabis use disorder (CUD) among adolescents. Our objective was to determine the prevalence of CUD in adolescent surgical patients and evaluate its association with postoperative complications. We performed a retrospective, 1:1 propensity-matched cohort study of adolescents (aged 10-17 years) with and without CUD who underwent inpatient operations at US hospitals participating in the Pediatric Health Information System from 2009 to 2022. The primary outcome was the trend in prevalence of CUD. Secondary outcomes included postoperative complications. Using a Bonferroni correction, we considered a P value < .008 to be significant. Of 558 721 adolescents undergoing inpatient surgery from 2009 to 2022, 2604 (0.5%) were diagnosed with CUD (2483 were propensity matched). The prevalence of CUD increased from 0.4% in 2009 to 0.6% in 2022 (P < .001). The adjusted odds of respiratory complications, ICU admission, mechanical ventilation, and extended hospital stay were significantly higher in adolescents with CUD (respiratory complications: odds ratio [OR], 1.52; 95% confidence interval [CI], 1.16-2.00; P = .002; ICU admission: OR, 1.78; 95% CI, 1.61-1.98; P < .001; mechanical ventilation: OR, 2.41; 95% CI, 2.10-2.77; P < .001; extended hospital stay: OR, 1.96; 95% CI, 1.74-2.20; P < .001). The propensity score-adjusted odds of postoperative mortality or stroke for adolescents with CUD were not significantly increased (mortality: OR, 1.40; 95% CI, 0.87-2.25; P = .168; stroke: OR, 2.46; 95% CI, 1.13-5.36; P = .024). CUD is increasing among adolescents scheduled for surgery. Given its association with postoperative complications, it is crucial to screen adolescents for cannabis use to allow timely counseling and perioperative risk mitigation.

Cannabis use and cannabis use disorders and their treatment in the Europe.

This paper introduces the special issue on cannabis use in Europe. It describes data on the prevalence of cannabis use in Europe and the more limited data on the prevalence of cannabis use disorders, one of the most common forms of drug problem treated in many countries in Europe. It summarises what research has indicated about the adverse effects of acute and chronic cannabis use and discusses potential health system responses that may reduce some of these harms. These include public education about the risks of cannabis use; screening and brief interventions in primary medical settings; and specialist treatment for cannabis use disorders. It briefly indicates the special issues that may need to be addressed in dealing with the high rates of comorbidity between cannabis use disorders, other types of drug use disorders, and common mental disorders.

Association of Cannabis Use Disorder with Major Adverse Cardiac and Cerebrovascular Events in Older Non-Tobacco Users: A Population-Based Analysis.

Tobacco use disorder (TUD) adversely impacts older patients with established cardiovascular disease (CVD) risk. However, CVD risk in chronic habitual cannabis users without the confounding impact of TUD hasn't been explored. We aimed to determine the risk of major adverse cardiac and cerebrovascular events (MACCE) in older non-tobacco smokers with established CVD risk with vs. without cannabis use disorder (CUD). We queried the 2019 National Inpatient Sample for hospitalized non-tobacco smokers with established traditional CVD risk factors aged ≥65 years. Relevant ICD-10 codes were used to identify patients with vs. without CUD. Using multivariable logistic regression, we evaluated the odds of MACCE in CUD cohorts compared to non-CUD cohorts. Prevalence of CUD in the sample was 0.3% (28,535/10,708,815, median age 69), predominantly male, black, and non-electively admitted from urban teaching hospitals. Of the older patients with CVD risk with CUD, 13.9% reported MACCE. The CUD cohort reported higher odds of MACCE (OR 1.20, 95% CI 1.11-1.29, p < 0.001) compared to the non-CUD cohort. Comorbidities such as hypertension (OR 1.9) and hyperlipidemia (OR 1.3) predicted a higher risk of MACCE in the CUD cohort. The CUD cohort also had higher unadjusted rates of acute myocardial infarction (7.6% vs. 6%) and stroke (5.2% vs. 4.8%). Among older non tobacco smokers with known CVD risk, chronic cannabis use had a 20% higher likelihood of MACCE compared to those who did not use cannabis.

Prenatal cannabis use disorder and gastroschisis in California, 2007-19.

Gastroschisis is a congenital anomaly of the abdominal wall with an unknown aetiology. Recent trends in the prevalence of gastroschisis suggest that changing environmental or behavioural factors may contribute. We examined whether prenatal cannabis use disorder was associated with gastroschisis. The Study of Outcomes of Mothers and Infants is a population-based cohort compiled of California birth records that have been linked to Department of Health Care Access and Information hospitalization, emergency department and ambulatory surgery records. We included 2007-19 singleton live births (n = 5 774 656). Cannabis use disorder was measured by diagnosis codes at any visit during pregnancy or at birth. Gastroschisis was measured by diagnosis or surgical repair procedure codes at birth or during the first year of life. The prevalence of cannabis use disorder was about 1%. The prevalence of gastroschisis was 0.14% and 0.06% among those with and without cannabis use disorder, respectively. There were positive associations between cannabis use disorder and gastroschisis when using a multivariable model [adjusted risk ratio (aRR) = 1.3, 95% confidence interval (CI) 1.0, 1.7) and a matched sample approach (aRR = 1.5, 95% CI 1.1, 2.1). The association varied by maternal age and was largest among people aged >34 years (aRR = 2.5, 95% CI 1.0, 5.8). We confirm findings of a positive association between cannabis exposure and gastroschisis and add that it is strongest when maternal age is greater than 34 years. More investigation into whether the association is causal, and why the association varies by maternal age, is encouraged.

Prevalence of cannabis use disorder and perioperative outcomes in adult colectomy patients: A propensity score-matched analysis.

The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004-2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50years). Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p=0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p=0.601), hospital lengths of stay (CUD: 5days, IQR 4-7 vs. No CUD: 5days, IQR 4-7) (p=0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50years in the subgroup analysis. Though the prevalence of CUD has increased drastically over the past 15years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.

Abstract WP235: Cannabis Use Disorder in Elderly Stroke Survivors (≥65 Years) Elevates the Risk of Stroke Recurrence: An Analysis From the National Inpatient Sample (2016-2019)

Introduction: Amid the rising prevalence of cannabis use disorder (CUD) in older adults and with surveys reporting ~85% of overlapping use for medicinal and recreational purposes in American cannabis users, the link between CUD and stroke is paramount. This study explores the risk of recurrent acute ischemic stroke (AIS) or hemorrhagic stroke (HS) in CUD while also evaluating the effects of coexisting substance abuse and mental health conditions. Methods: Elderly (age &gt;65 years) stroke survivors were identified using ICD-10 codes from the National Inpatient Sample (2016-2019) and categorized based on the presence or absence of CUD and recurrent AIS or HS. Multivariable statistical methods assessed demographics, comorbidities, and temporal trends. Results: Out of 5,284,119 elderly stroke survivors, 16,820 (0.3%) had CUD and presented younger (median age: 69 vs. 79), predominantly male (68.8% vs. 45.1%), with a larger representation of black individuals (30.8% vs. 12.8%), and higher prevalence in the lowest income quartile (39.7% vs. 28.4%). Comorbidities like diabetes, hyperlipidemia, obesity, and hypothyroidism were less common in CUD patients, but substance abuse and mental health disorders were more prevalent. From 2016 to 2019, CUD among stroke survivors rose from 0.24% to 0.37%. The uptrend was observed across genders, racial groups (except Asians and Native Americans), income quartiles, hospital regions, and in cohorts with and without anxiety, depression, alcohol abuse, and tobacco use. Additionally, the recurrence of AIS decreased from 5.32% to 5.13% in the non-CUD group. After adjustment, the odds of recurrent AIS in the CUD cohort was 1.56 (95% CI:1.35-1.79), and for any stroke type (AIS or HS) 1.44 (95% CI:1.26-1.65). Conclusion: Elderly stroke survivors with concurrent CUD have a 56% increased risk of recurrent AIS and a 44% heightened risk for AIS or HS. The growing prevalence of CUD in this demographic underscores it's escalating clinical significance.

Results of a randomized controlled trial of the cannabis eCHECKUP TO GO personalized normative feedback intervention on reducing cannabis use, cannabis consequences, and descriptive norms

BackgroundThe prevalence of cannabis use disorder and its negative consequences among young adults has highlighted the need for prevention and early intervention programs. However, low treatment prevalence persists due to factors such as lack of perceived need, concerns about stigma, and limited access to treatment. To address these barriers, web-based cannabis interventions have been developed, but their efficacy remain limited. This study aims to evaluate the cross-site efficacy of the Cannabis eCHECKUP TO GO program, a web-based Personalized Normative Feedback and Protective Behavioral Strategies intervention for reducing cannabis use frequency and consequences in college students with willingness to change. MethodsParticipants were 781 students from three universities (two in Canada, one in the US) who reported using cannabis in the past month and expressed interest in reducing or engaging in safer cannabis use. The study randomly assigned them to either an experimental group that received personalized normative feedback or a control group that received information on healthy stress management. The study collected follow-up data 4 weeks after the initial intervention and measured participants' frequency of cannabis use, number of cannabis consequences, descriptive and injunctive norms at both time points. ResultsThe results showed no significant reductions in cannabis use or negative consequences of use. However, students who received personalized normative feedback experienced a significant reduction in descriptive norms related to cannabis use, to be more in line with actual use. ConclusionThis study suggests that more targeted interventions may be necessary for university students who are already using and seeking help to reduce their use.

Veterans with psychiatric disorders more prone to cannabis use disorder

Newly published data indicates that within a military veteran population that has seen a rise in the prevalence of cannabis use disorder, individuals with comorbid psychiatric disorders are experiencing even greater increases. The most recent numbers show that older veterans have recently become more susceptible to cannabis use disorder than younger groups, reflecting broader national trends in cannabis use among the elderly.

Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019.

Cannabis use disorder diagnoses are increasing among U.S. adults and are more prevalent among people with comorbid psychiatric disorders. Recent changes in cannabis laws, increasing cannabis availability, and higher-potency cannabis may have placed people with cannabis use and psychiatric disorders at disproportionately increasing risk for cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine whether trends in cannabis use disorder prevalence among VHA patients differ by whether they have psychiatric disorders. VHA electronic health records from 2005 to 2019 (N range, 4,332,165-5,657,277) were used to identify overall and age-group-specific (<35, 35-64, and ≥65 years) trends in prevalence of cannabis use disorder diagnoses among patients with depressive, anxiety, posttraumatic stress, bipolar, or psychotic spectrum disorders and to compare these to corresponding trends among patients without any of these disorders. Given transitions in ICD coding, differences in trends were tested within two periods: 2005-2014 (ICD-9-CM) and 2016-2019 (ICD-10-CM). Greater increases in prevalence of cannabis use disorder diagnoses were observed among patients with psychiatric disorders compared to those without (difference in prevalence change, 2005-2014: 1.91%, 95% CI=1.87-1.96; 2016-2019: 0.34%, 95% CI=0.29-0.38). Disproportionate increases in cannabis use disorder prevalence among patients with psychiatric disorders were greatest among those under age 35 between 2005 and 2014, and among those age 65 or older between 2016 and 2019. Among patients with psychiatric disorders, the greatest increases in cannabis use disorder prevalences were observed among those with bipolar and psychotic spectrum disorders. The findings highlight disproportionately increasing disparities in risk of cannabis use disorder among VHA patients with common psychiatric disorders. Greater public health and clinical efforts are needed to monitor, prevent, and treat cannabis use disorder in this population.

Prevalence of Cannabis Use Disorder and Its Association with Major Adverse Cardiac Events in Patients with Sickle Cell Crisis: Insights from the National Inpatient Sample

Background: Cannabis use has grown in popularity, with the possible therapeutic advantages being widely debated, one of which is in Sickle Cell Crisis (SCC). With increasing surveys reporting overlapping use of recreational and medicinal cannabis and high addiction potential, the aim of this nationwide study is to investigate the relationship between cannabis use disorder (CUD) in SCC patients. Methods: Using ICD-10 codes, the National Inpatient Sample-2020 was utilized to identify adult (&amp;gt;18 years) hospitalized patients due to SCD with and without crisis and further divided into patients with SCC with CUD (SCC+CUD+) and patients with SCC without CUD (SCC+CUD-). The prevalence of CUD in SCC and Major Adverse Cardiac Events [MACE, Acute Myocardial Infarction (AMI); Atrial Fibrillation (AFib) and cardiac arrest] were the primary outcomes; other associated comorbidities, Length of Stay (LOS), and hospitalization costs were secondary outcomes. After examining the baseline features on descriptive analysis, to compare the variables, Pearson's chi-squared test and Mann- Whitney U test were used to compare categorical and continuous data, respectively. Multivariable analyses were performed, controlling covariates, to assess the odds of MACE in the CUD+ vs. CUD- cohort. Results: Out of a total of 77,610 SCC adult hospitalizations, 4,535 (5.8%, p&amp;lt;0.001) had CUD. The median age of hospitalization for the CUD+ cohort was lower (28 years) than for the CUD- cohort (31 years). They were often of black ethnicity (95.8% vs. 95.3%, p=0.03), Medicaid enrollees (55.3% vs. 46.3%, p&amp;lt;0.001), and were hospitalized as non-electively (98.6% vs. 97.5%, p&amp;lt;0.001) to urban teaching hospitals (87% vs. 85.5%, p&amp;lt;0.001) in the Southern (47.7% vs. 53.7%, p&amp;lt;0.001) region. Chronic Pulmonary diseases (29.3% vs. 24.1%, p&amp;lt;0.001), prior venous thromboembolism (21.1% vs. 25.3%, p&amp;lt;0.001), hypertension (17.3% vs. 23.3%, p&amp;lt;0.001) and depression (16.3% vs 13.5%, p&amp;lt;0.001) were the majorly associated comorbidities in both (SCC+CUD+) and (SCC+CUD-) cohorts. On analysis of MACE in SCD patients with crisis; AMI (0.6% vs 0.7%, p=0.28), AFib (0.3% for both, p&amp;lt;0.001), cardiac arrest (0.3% for both, p = 0.89) were comparable in both SCC cohorts with and without CUD, suggesting no significant difference in MACE between these patient groups except for AFib. However, after adjusting for confounders, on multivariable analysis, none of the MACE (AMI: OR=0.85, CI= 0.35-2.05, p=0.71; AFib: OR=0.81, CI= 0.39-1.69, p= 0.57; cardiac arrest: OR = 1.23, CI= 0.39-3.86, p= 0.71) were found to be significant, p&amp;gt;0.05 for all. In (SCC+CUD+) and (SCC+CUD-) patients, there was no difference observed in LOS (4 days in both) and hospitalization costs (USD 29,216 vs. USD 31,604). Conclusion: Our study evaluated the prevalence and association between CUD and its cardiovascular effects during SCC, bringing light on an essential and understudied association in SCC patients while adjusting for other major concomitant mixed substance abuses like tobacco and alcohol. The observed disparities in MACE require further exploration via prospective research to better understand the possible recreational and therapeutic implications of cannabis use in patients with SCC.

Risk for Cannabis Use Disorder in People Who Use Cannabis to Cope with Internalizing Disorders: Implications for Policy and Practice

The prevalence of Cannabis Use Disorder (CUD) is increasing in the United States, likely related to increasing cultural and legal acceptance of cannabis. While most cannabis users will not develop a CUD, certain behaviors may increase risk. For example, smoking to cope with anxiety or depressive disorders is associated with higher rates of cannabis use. Users who smoke to cope with these internalizing disorders (anxiety, depression) increase the addictive potential of cannabis. Systems that potentially maintain problematic use in people with internalizing disorders include the reward processing and the stress responsivity systems. Both exhibit neurobiological changes after chronic heavy cannabis use and are affected across internalizing disorders. The shared importance of these systems may warrant several recommendations for policy and practice. Some reexamine cannabis-related policy, invest in local communities, and improve cannabis education.

Prevalence of Cannabis Use Disorder and Reasons for Use Among Adults in a US State Where Recreational Cannabis Use Is Legal.

Medical and nonmedical cannabis use and cannabis use disorders (CUD) have increased with increasing cannabis legalization. However, the prevalence of CUD among primary care patients who use cannabis for medical or nonmedical reasons is unknown for patients in states with legal recreational use. To estimate the prevalence and severity of CUD among patients who report medical use only, nonmedical use only, and both reasons for cannabis use in a state with legal recreational use. This cross-sectional survey study took place at an integrated health system in Washington State. Among 108 950 adult patients who completed routine cannabis screening from March 2019 to September 2019, 5000 were selected for a confidential cannabis survey using stratified random sampling for frequency of past-year cannabis use and race and ethnicity. Among 1688 respondents, 1463 reporting past 30-day cannabis use were included in the study. Patient survey-reported reason for cannabis use in the past 30 days: medical use only, nonmedical use only, and both reasons. Patient responses to the Composite International Diagnostic Interview-Substance Abuse Module for CUD, corresponding to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition CUD severity (0-11 symptoms) were categorized as any CUD (≥2 symptoms) and moderate to severe CUD (≥4 symptoms). Adjusted analyses were weighted for survey stratification and nonresponse for primary care population estimates and compared prevalence of CUD across reasons for cannabis use. Of 1463 included primary care patients (weighted mean [SD] age, 47.4 [16.8] years; 748 [weighted proportion, 61.9%] female) who used cannabis, 42.4% (95% CI, 31.2%-54.3%) reported medical use only, 25.1% (95% CI, 17.8%-34.2%) nonmedical use only, and 32.5% (95% CI, 25.3%-40.8%) both reasons for use. The prevalence of CUD was 21.3% (95% CI, 15.4%-28.6%) and did not vary across groups. The prevalence of moderate to severe CUD was 6.5% (95% CI, 5.0%-8.6%) and differed across groups: 1.3% (95% CI, 0.0%-2.8%) for medical use, 7.2% (95% CI, 3.9%-10.4%) for nonmedical use, and 7.5% (95% CI, 5.7%-9.4%) for both reasons for use (P = .01). In this cross-sectional study of primary care patients in a state with legal recreational cannabis use, CUD was common among patients who used cannabis. Moderate to severe CUD was more prevalent among patients who reported any nonmedical use. These results underscore the importance of assessing patient cannabis use and CUD symptoms in medical settings.