Prevalence Of Cannabis Use Disorder Research Articles

Associations between state-level policy liberalism, cannabis use, and cannabis use disorder from 2004 to 2012: Looking beyond medical cannabis law status

BackgroundMedical cannabis laws (MCL) have received increased attention as potential drivers of cannabis use (CU), but little work has explored how the broader policy climate, independent of MCL, may impact CU outcomes. We explored the association between state-level policy liberalism and past-year cannabis use (CU) and cannabis use disorder (CUD). MethodsWe obtained state-level prevalence of past-year CU and CUD among past year cannabis users for ages 12–17, 18–25, and 26+ from the 2004–2006 and 2010–2012 National Surveys on Drug Use and Health. States were categorized as liberal, moderate, or conservative based on state-level policy liberalism rankings in 2005 and 2011. Linear models with random state effects examined the association between policy liberalism and past-year CU and CUD, adjusting for state-level social and economic covariates and medical cannabis laws. ResultsIn adjusted models, liberal states had higher average past-year CU than conservative states for ages 12–17 (+1.58 percentage points; p = 0.03) and 18–25 (+2.96 percentage points; p = 0.01) but not for 26+ (p = 0.19). CUD prevalence among past year users was significantly lower in liberal compared to conservative states for ages 12–17 (−2.87 percentage points; p = 0.045) and marginally lower for ages 26+ (-2.45 percentage points; p = 0.05). ConclusionLiberal states had higher past-year CU, but lower CUD prevalence among users, compared to conservative states. Researchers and policy makers should consider how the broader policy environment, independent of MCL, may contribute to CU outcomes.

Cannabis Use for Medicinal Purposes among Canadian University Students.

The study sought to describe a Canadian sample of university students' medicinal use of cannabis, including prevalence of cannabis use disorder (CUD) and replacement of traditional treatments with cannabis. A random sample of 4000 university students was asked to complete a cross-sectional web-based survey. The survey was completed by 2212 (average age 23.2 years, SD = 5.2 years), representing a 55.3% response rate. To be eligible, students had to be enrolled in a class on campus and were 18 years or older. Half (52%) of respondents used cannabis at least once in their lifetime, with ∼11% reporting medicinal cannabis use. Recreational motives to use cannabis were common among medicinal users (85%), several (38%) replaced traditional medication with cannabis, and more than a third received authorization by a health care provider. Of the medicinal users, 13.6% met the criteria for CUD. Common ailments for medicinal cannabis use were anxiety, sleep problems, depression, and pain. When mental health-related categories are combined, 78.2% of medicinal users used for at least 1 mental health condition. Medicinal cannabis use occurs among university students. None of the ailments listed by medicinal users meet the Canadian Family Physicians prescribing guidelines, and most are not among those viewed by the National Academies of Science, Engineering, and Medicine as having strong evidence for therapeutic value. The results raise concerns for health care providers who are authorizing or counselling patients' considering medicinal cannabis.

Time since first cannabis use and 12-month prevalence of cannabis use disorder among youth and emerging adults in the United States.

This study estimated whether and how the 12-month prevalence of cannabis use disorder among US youth aged 12-17 and emerging adults aged 18-25 varied by time since first cannabis use. Repeated cross-sectional survey data from the 2015-17 National Surveys on Drug Use and Health (NSDUH). United States. A total of 101 000 NSDUH participants aged 12-25. Past 12-month cannabis use disorder was assessed using DSM-IV criteria. Among youth, the life-time prevalence of cannabis use was 15.3% [95% confidence interval (CI)=14.86-15.65%]. Among emerging adults, the life-time prevalence of cannabis use was 52.4% (95% CI=51.77-53.01%). The adjusted 12-month prevalence of cannabis use disorder among youth with life-time cannabis use was 10.9% (95% CI=9.24-12.75%) in the first year after starting cannabis use, 15.3% (95% CI=13.68-17.12%) in the second year, 17.7% (95% CI=15.55-19.97%) in the third year and 20.6% (95% CI=18.23-23.17%) in the fourth year and beyond, which was consistently higher after the first year (linear trend only: P<0.0001). The adjusted 12-month prevalence of cannabis use disorder among emerging adults with life-time use ranged from 5.6% (95% CI=4.26-7.23%) in the first year after starting cannabis use, 7.7% (95% CI=6.45-9.17%) in the second year and 9.1% (95% CI=7.81-10.57%) in the third year to 10.5% (95% CI=9.87%-11.12%) in the fourth year and beyond, which was consistently higher after the first year (linear trend only: P<0.0001). Within each time-frame since first cannabis use, the adjusted 12-month prevalence of cannabis use disorder was higher among youth life-time users than their emerging adult counterparts. Among youth and emerging adults in the United States, the prevalence of cannabis use disorder appears to increase with time since initiation of use and is higher among youth than among emerging adults during each examined time-frame.

Has the Legalisation of Medical and Recreational Cannabis Use in the USA Affected the Prevalence of Cannabis Use and Cannabis Use Disorders?

Since California legalised medical use of cannabis in 1996, 29 other US states have done so. Eight US states have legalised the retail sale of cannabis to adults over the age of 21 years since 2012. Critics of these policy changes have suggested that they will increase the prevalence of cannabis use and cannabis use disorders. This paper (1) briefly describes the types of regulatory regimes for medical and recreational cannabis use in the USA, (2) describes possible effects of these policies on cannabis use and (3) assesses the impacts to date of the legalisation of medical and recreational cannabis use on the prevalence of cannabis use and cannabis use disorders in the US population. We (1) describe the regulatory regimes for medical and recreational cannabis use in the USA, (2) make predictions about their possible effects on the price and availability of cannabis, (3) conduct a review to summarise studies of the effects of legalising medical cannabis use in the USA on rates of cannabis use and cannabis use disorders and (4) assess early indications of the effects of legalising recreational cannabis use on cannabis use and cannabis use disorders. Liberal forms of medical cannabis regulation have probably reduced prices and increased the availability of cannabis. Analyses of survey data suggest that these changes have increased the prevalence and frequency of cannabis use among adults over the age of 21 years, but they have not to date increased rates of cannabis use among adolescents. Two series of epidemiological studies over a decade following the introduction of medical cannabis laws have produced inconsistent results on the effects of policy changes on the prevalence of cannabis use disorders in adults. One study found that the prevalence had increased; the other did not find an increase. An analysis of data on treatment seeking for cannabis use disorders showed an increase in states with medical cannabis laws in the number of adults seeking treatment who were not under legal coercion. There are major limitations with these studies, many of which have mistakenly assumed that all states with medical cannabis laws have similarly liberal policies. It may be a decade or more before we can fully assess the effects of liberalisation of cannabis policies on cannabis use and cannabis use disorders in the USA. It is critical that the effects of these policy changes are evaluated to ensure that cannabis is regulated in ways that minimise the harmful effects of its regular use, especially among young people.

Falling rates of marijuana dependence among heavy users

IntroductionMarijuana use has become increasingly popular in the United States since the turn of the century, and typical use patterns among past-month marijuana users have intensified, raising concerns for an increase in cannabis use disorders (CUDs). Yet the population prevalence of CUDs has mostly remained flat. We analyzed trends in DSM-IV marijuana dependence among Daily/Near-Daily (DND) users, both overall and by age and gender, and considered potential explanations. MethodsUsing data assembled from the National Survey on Drug Use and Health (2002–2016), rates of self-reported dependence and constituent symptoms are calculated for DND marijuana users; logistic regressions with pre- and post- periods (2002–2004, 2014–2016) and a Cochrane-Armitage trend test are applied to describe temporal changes. ResultsDependence among DND users fell by 39% (26.5%–16.1%; p < .001), with significant trend. No significant change is detected at the population level. Sub-group analysis shows a steep gradient for age but not for gender. Declines are robust to sub-group analysis, except for users over 50 years old. Among dependence symptoms, most showed significant declines: reducing important activities (p < .001); use despite emotional, mental, or physical problems (p < .001); failing attempts to cutback (p < .001); lots of time getting, using, or getting over marijuana (p < .01); and failing to keep limits set on use (p < .05). Reported tolerance showed no significant change. ConclusionsThough it is unclear why, the risk of dependence formation among heavy marijuana users appear to have declined since 2002. Further research is warranted regarding explanations related to state marijuana policies, product forms, or social context.

Trends in cannabis use disorder by cigarette smoking status in the United States, 2002–2016

BackgroundCannabis use is on the rise in the United States (US) and is disproportionately common among cigarette smokers. Cannabis use disorder (CUD) occurs among a small subset of cannabis users and may impact cigarette use. The objective of this study was to estimate trends in the prevalence of CUD among daily, non-daily, former, and never cigarette smokers from 2002 to 2016. MethodsData were drawn from cross-sectional, nationally representative samples of individuals ages 12 and older in the US that were collected annually. The prevalence of past 12-month CUD was estimated each year from 2002 to 2016 among daily, non-daily, former, and never cigarette smokers (total analytic N = 837,326). ResultsOverall, the prevalence of CUD decreased from 2002 to 2016. Yet, trends differed by cigarette smoking status. Adjusting for demographics, the prevalence of CUD increased significantly among non-daily smokers (aOR = 1.02; 95% CI = 1.01–1.03) from 2002 to 2016 and did not change among daily, former, or never smokers. CUD was significantly more common among non-daily (4.32%) and daily cigarette smokers (2.92%) compared with former (0.99%) and never smokers (1.11%) in 2016. Approximately one in five (18.11%–22.87%) youth ages 12–17 who smoke cigarettes met criteria for CUD in 2016, compared with approximately 2% of non-smoking youth. ConclusionsDespite downward trends in CUD observed at the general population level, the prevalence of CUD significantly increased among non-daily cigarette smokers from 2002 to 2016. In the US, CUD remains significantly higher among cigarette smokers relative to non-cigarette smokers.

Triple trajectories of alcohol use, tobacco use, and depressive symptoms as predictors of cannabis use disorders among urban adults.

Heavy cannabis use is associated with a wide array of physical, mental, and functional problems. Therefore, cannabis use disorders (CUDs) may be a major public health concern. Given the adverse health consequences of CUDs, the present study seeks to find possible precursors of CUDs. The current study consisted of 5 waves of data collection from the Harlem Longitudinal Development Study. Among 816 participants, about half are African Americans (52%), and the other half are Puerto Ricans (48%). We used Mplus to obtain the triple trajectories of alcohol use, tobacco use, and depressive symptoms. Logistic regression analyses were then conducted to examine the associations between the trajectory groups and CUDs. The 5 trajectory groups were (1) moderate alcohol use, high tobacco use, and high depressive symptoms (MHH; 12%); (2) moderate alcohol use, high tobacco use, and low depressive symptoms (MHL; 26%); (3) moderate alcohol use, low tobacco use, and low depressive symptoms (MLL; 18%); (4) low alcohol use, no tobacco use, and high depressive symptoms (LNH; 11%); and (5) low alcohol use, no tobacco use, and low depressive symptoms (LNL; 33%). The MHH, MHL, MLL, and LNH trajectory groups were associated with an increased likelihood of having CUDs compared to the LNL trajectory group after controlling for a number of confounding factors (e.g., CUDs in the late 20s). The findings of the current longitudinal study suggest that treatments designed to reduce or quit drinking as well as smoking and to relieve depressive symptoms may reduce the prevalence of CUDs. (PsycINFO Database Record

Is Cannabis Use Associated With the Worst Inpatient Outcomes in Attention Deficit Hyperactivity Disorder Adolescents?

ObjectiveTo determine the impact of cannabis use disorder (CUD) on the inpatient outcomes of attention deficit hyperactivity disorder (ADHD) in adolescentsBackgroundPrevious studies have evaluated the impact of CUD on the health-related quality of life in ADHD patients.MethodsWe used the nationwide inpatient sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2010­–2014. We identified ADHD and cannabis use (CU) as the primary and the other diagnosis, respectively, using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD­9–­CM) codes. We used the binomial logistic regression model to generate adjusted odds ratios (aOR).ResultsWe analyzed a total of 11,232 ADHD adolescent hospital admissions from years 2010–2014; of these, 1.79% had CUD. The mean age of adolescents was 14.1 years (SD = 1.79). The prevalence of CUD was highest in ADHD adolescents of 15-18 years (73%) and common in the white race (71%). A higher proportion of ADHD with CUD was transferred to acute care hospitals and skilled/other nursing facilities (5.4% and 7.4% vs. 1.1% and 2.6%, respectively, p-value < 0.001). CUD increases the risk of inpatient charges > $12,247 (median) by 0.6 times (aOR = 1.835; p-value = 0.002) and increases the risk of inpatient stay > 5 days (median) by 0.7 times (aOR = 2.099; p-value < 0.001). The utilization of psychotropic medications was reduced by 0.8 times in ADHD with CUD adolescents by 0.8 times (aOR = 0.448; p-value = 0.017), and the implication of behavioral therapy in the management of ADHD with CUD adolescents was reduced by 0.9 times (aOR = 0.412; p-value = 0.048). Also, there is a 2.8 times higher risk of comorbid alcohol abuse in ADHD with CUD adolescents (aOR = 17.141; p-value < 0.001).ConclusionThe increased risk of substance use is a long-term implication of ADHD in adolescents. It has been determined that comorbid CUD in patients with ADHD not only increases the risk of acute inpatient care but also prolongs the inpatient stay, thus increasing the healthcare cost. Surprisingly, comorbid CUD decreases the utilization of psychotropic medications and behavioral therapy in ADHD. Another major issue is the higher risk of comorbid alcohol abuse in ADHD with CUD adolescents. Further exploration with randomized controlled studies would be required to support and highlight the growing issue of cannabis use among adolescents with ADHD.

Prevalence of Cannabis Use Disorder and Associated Factors among Cannabis Young Adult Users at Shashemene Town, Oromia Region, Ethiopia, 2016.

Introduction Cannabis users are at high risk of developing cannabis use disorder which is a problematic pattern of cannabis use leading to clinically significant impairment or distress. Objective To assess the magnitude of cannabis use disorder and associated factors among young adults using cannabis at Shashemene Town, Oromia Region, Ethiopia. Methods A cross-sectional study was conducted at Shashemene Town, from May to June 2016. Young adults aged 18–25 who use cannabis and are permanent residents of Shashemene were included in the study. Using single proportion formula, 423 participants were selected using exponential discriminative snow ball sampling. Result This study revealed that the magnitude of cannabis use disorder was 42.2%. The most contributing factors that remained to be statistically significant with cannabis use disorder were common mental disorder (AOR = 2.125, 95% CI: 1.218, 3.708), current cigarette smoking (AOR = 6.118, 95% CI: 2.13, 17.575), and current use of shisha (AOR = 4.313, 95% CI: 2.427, 7.664). Conclusion The magnitude of cannabis use disorder among young adults using cannabis was high.

Psychosocial functioning among regular cannabis users with and without cannabis use disorder.

In the United States, cannabis accessibility has continued to rise as the perception of its harmfulness has decreased. Only about 30% of regular cannabis users develop cannabis use disorder (CUD), but it is unclear if individuals who use cannabis regularly without ever developing CUD experience notable psychosocial impairment across the lifespan. Therefore, psychosocial functioning was compared across regular cannabis users with or without CUD and a non-user control group during adolescence (age 17; early risk) and young adulthood (ages 18-25; peak CUD prevalence). Weekly cannabis users with CUD (n = 311), weekly users without CUD (n = 111), and non-users (n = 996) were identified in the Minnesota Twin Family Study. Groups were compared on alcohol and illicit drug use, psychiatric problems, personality, and social functioning at age 17 and from ages 18 to 25. Self-reported cannabis use and problem use were independently verified using co-twin informant report. In both adolescence and young adulthood, non-CUD users reported significantly higher levels of substance use problems and externalizing behaviors than non-users, but lower levels than CUD users. High agreement between self- and co-twin informant reports confirmed the validity of self-reported cannabis use problems. Even in the absence of CUD, regular cannabis use was associated with psychosocial impairment in adolescence and young adulthood. However, regular users with CUD endorsed especially high psychiatric comorbidity and psychosocial impairment. The need for early prevention and intervention - regardless of CUD status - was highlighted by the presence of these patterns in adolescence.

Predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime cannabis use disorder in the United States

ObjectiveTo present information on predictors of treatment utilization and barriers to treatment utilization among individuals with lifetime DSM-5 cannabis use disorder (CUD). MethodFace-to-face survey of a representative sample of the adult US general population (n=36,309). ResultsTreatment rates for CUD were low in this general population survey (13.7%). Severity of CUD and comorbidity of other lifetime drug use disorders were significant predictors of lifetime treatment utilization for CUD. Preference for self-reliance, minimizing problems, fear of stigma, and financial and structural issues were among the most frequently endorsed reasons for respondents not seeking treatment when they perceived the need for treatment among individuals with lifetime CUD, regardless of whether they eventually utilized treatment at some time in their lives. ConclusionsGiven the rising prevalence of CUD in the US over the past decade and currently low treatment rates for CUD, increased provision for services for CUD appears critically needed, especially those that screen for and treat, when present, other drug use disorders. Programs to reduce stigma and financial barriers are needed, as well as programs to increase awareness among the general public, health care professionals about the nature and seriousness of CUD, and the availability and effectiveness of treatment for this disorder.

Loose regulation of medical marijuana programs associated with higher rates of adult marijuana use but not cannabis use disorder.

Most US states have passed medical marijuana laws (MMLs), with great variation in program regulation impacting enrollment rates. We aimed to compare changes in rates of marijuana use, heavy use and cannabis use disorder across age groups while accounting for whether states enacted medicalized (highly regulated) or non-medical mml programs. Difference-in-differences estimates with time-varying state-level MML coded by program type (medicalized versus non-medical). Multi-level linear regression models adjusted for state-level random effects and covariates as well as historical trends in use. Nation-wide cross-sectional survey data from the US National Survey of Drug Use and Health (NSDUH) restricted use data portal aggregated at the state level. Participants comprised 2004-13 NSDUH respondents (n~67 500/year); age groups 12-17, 18-25 and 26+ years. States had implemented eight medicalized and 15 non-medical MML programs. Primary outcome measures included (1) active (past-month) marijuana use; (2) heavy use (>300days/year); and (3) cannabis use disorder diagnosis, based on DSM-IV criteria. Covariates included program type, age group and state-level characteristics throughout the study period. Adults 26+ years of age living in states with non-medical MML programs increased past-month marijuana use 1.46% (from 4.13 to 6.59%, P=0.01), skewing towards greater heavy marijuana by 2.36% (from 14.94 to 17.30, P=0.09) after MMLs were enacted. However, no associated increase in the prevalence of cannabis use disorder was found during the study period. Our findings do not show increases in prevalence of marijuana use among adults in states with medicalized MML programs. Additionally, there were no increases in adolescent or young adult marijuana outcomes following MML passage, irrespective of program type. Non-medical marijuana laws enacted in US states are associated with increased marijuana use, but only among adults aged 26+ years. Researchers and policymakers should consider program regulation and subgroup characteristics (i.e. demographics) when assessing for population level outcomes. Researchers and policymakers should consider program regulation and subgroup characteristics (i.e. demographics) when assessing for population level outcomes.

Differences in the Rates of Drug Polyconsumption and Psychiatric Comorbidity among Patients with Cocaine Use Disorders According to the Mental Health Service

ABSTRACTCocaine continues to be a worldwide public health concern in Europe. To improve prognosis and intervention, it is necessary to understand the characteristics of the patients who depend on the services where they receive care. The objective is to analyze the differences among patients who use cocaine and between ambulatory and residential resources to better adapt treatment. This is a descriptive, observational study of two populations of cocaine users in treatment: the ambulatory therapeutic community (ATC) and the therapeutic community (TC). The PRISM diagnostic interview was used for both groups. An analysis of both populations indicates a high prevalence of cocaine, heroin, cannabis, sedative, psychostimulant, and hallucinogen use disorders in the TC population compared to the ATC. In alcohol use disorder, differences between both mental health services were not observed. The degree of severity of cocaine use disorders (CUD) is greater in the TC population. The prevalence of psychiatric comorbidity is not statistically significant between the two populations, except for primary psychotic disorders, which are more prevalent in the TC population. This difference in the prevalence of psychotic disorders may be related to the high prevalence of cannabis use disorders in TC patients. Differences in the prevalence of substance use disorders, severity of CUD, and psychiatric comorbidity may limit the efficiency of mental health services involved in substance use disorder therapeutics. These results suggest the need for careful and extensive phenotyping of patients to improve intervention and prognosis in a clinical resource-dependent manner.

Overview of Current State-of-the-Art Treatments for Cannabis Use Disorders, and Future Directions

Background As policy responses to cannabis use and availability change internationally, the prevalence of cannabis use disorder (CUD) and the number of individuals seeking treatment for cannabis-related problems may increase.

Comparing adult cannabis treatment-seekers enrolled in a clinical trial with national samples of cannabis users in the United States

BackgroundCannabis use rates are increasing among adults in the United States (US) while the perception of harm is declining. This may result in an increased prevalence of cannabis use disorder and the need for more clinical trials to evaluate efficacious treatment strategies. Clinical trials are the gold standard for evaluating treatment, yet study samples are rarely representative of the target population. This finding has not yet been established for cannabis treatment trials. This study compared demographic and cannabis use characteristics of a cannabis cessation clinical trial sample (run through National Drug Abuse Treatment Clinical Trials Network) with three nationally representative datasets from the US; 1) National Survey on Drug Use and Health, 2) National Epidemiologic Survey on Alcohol and Related Conditions-III, and 3) Treatment: Episodes Data Set – Admissions. MethodsComparisons were made between the clinical trial sample and appropriate cannabis using sub-samples from the national datasets, and propensity scores were calculated to determine the degree of similarity between samples. Resultsshowed that the clinical trial sample was significantly different from all three national datasets, with the clinical trial sample having greater representation among older adults, African Americans, Hispanic/Latinos, adults with more education, non-tobacco users, and daily and almost daily cannabis users. ConclusionsThese results are consistent with previous studies of other substance use disorder populations and extend sample representation issues to a cannabis use disorder population. This illustrates the need to ensure representative samples within cannabis treatment clinical trials to improve the generalizability of promising findings.

Bipolar disorder and co-occurring cannabis use disorders

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The association between alcohol use trajectories from adolescence to adulthood and cannabis use disorder in adulthood: a 22-year longitudinal study

ABSTRACTBackground: Due to the increasing prevalence of cannabis use disorder (CUD), the impact of cannabis use on public health may be significant. Objective: The present study seeks the possible precursors (e.g., alcohol use) of CUD in order to minimize the potential negative consequences of CUD such as impaired coordination and performance. Method: The Harlem Longitudinal Development Study included 674 participants (53% African Americans, 47% Puerto Ricans), with 60% females (n=405) from a six wave survey. We used a growth mixture model to obtain the trajectories of alcohol use from the mean ages of 14 to 36. To examine the associations between alcohol use trajectories and CUD, we used logistic regression analyses with the indicator of CUD as the dependent variable and the indicator of membership in each trajectory group as the independent variables. Results: A three alcohol use trajectory group model was selected. Male gender, higher frequency of cannabis use in adolescence, and a lower educational level were associated with an increased likelihood of having CUD. Membership in the increasing alcohol use group (OR=27.44, p < .01; AOR=15.54, p < .01) and the moderate alcohol use group (OR=10.40, p < .05; AOR=8.63, p < .05) were associated with an increased likelihood of having CUD compared with the membership in the no or low alcohol use group. Conclusions: The findings of our study support the hypothesis that addressing alcohol use at an early age could impact later CUD.

Trends in cannabis use disorders among racial/ethnic population groups in the United States

BackgroundMinority groups generally experience more disparities than whites in behavioral healthcare use. The population of racial/ethnic groups is growing faster than whites. Given increased concerns of cannabis use (CU) and its associations with health conditions, we examined national trends in cannabis use disorder (CUD) among adults aged ≥18 by race/ethnicity. MethodsData were from the 2005–2013 National Surveys on Drug Use and Health (N=340,456). We compared CU patterns and the conditional prevalence of CUD among cannabis users by race/ethnicity to understand racial/ethnic variations in CUD. ResultsApproximately 1.5% of adults met criteria for a CUD in the past year. Regardless of survey year, cannabis dependence was more common than cannabis abuse, representing 66% of adults with a CUD. Across racial/ethnic groups, the prevalence of cannabis abuse and dependence remained stable during 2005–2013. In the total adult sample, the odds of weekly CU, monthly CU, and cannabis dependence were greater among blacks, native-Americans, and mixed-race adults than whites. Among cannabis users, the odds of cannabis abuse and dependence were greater among blacks, native-Americans, and Hispanics than whites. Logistic regression controlling for age, sex, education, and survey year indicated an increased trend in monthly CU and weekly CU in the total sample and among past-year cannabis users. Younger age, male sex, and low education were associated with increased odds of cannabis dependence. ConclusionsThe large sample provides robust information that indicates a need for research to monitor CUD and identify culturally appropriate interventions especially for targeting minority populations.

Comparing adults who use cannabis medically with those who use recreationally: Results from a national sample

ObjectivesCannabis has been legalized for medical use in almost half of the states in the U.S. Although laws in these states make the distinction between medical and recreational use of cannabis, the prevalence of people using medical cannabis and how distinct this group is from individuals using cannabis recreationally is unknown at a national level. MethodsData came from the 2013 National Survey on Drug Use and Health (NSDUH). All adults endorsing past year cannabis use who reported living in a state that had legalized medical cannabis were divided into recreational cannabis use only and medical cannabis use. Demographic and clinical characteristics were compared across these two groups. Results17% of adults who used cannabis in the past year used cannabis medically. There were no significant differences between those who used medically versus recreationally in race, education, past year depression and prevalence of cannabis use disorders. In adjusted analyses, those with medical cannabis use were more likely to have poorer health and lower levels of alcohol use disorders and non-cannabis drug use. A third of those who reported medical cannabis use endorsed daily cannabis use compared to 11% in those who reported recreational use exclusively. ConclusionsAdults who use medical and recreational cannabis shared some characteristics, but those who used medical cannabis had higher prevalence of poor health and daily cannabis use. As more states legalize cannabis for medical use, it is important to better understand similarities and differences between people who use cannabis medically and recreationally.

A clinical comparison of schizophrenia with and without pre-onset cannabis use disorder: a retrospective cohort study using categorical and dimensional approaches.

Background A high prevalence of cannabis use disorder has been reported in subjects suffering from schizophrenia, fuelling intense debate about whether schizophrenia with pre-onset cannabis use disorder may be a distinct entity with specific features or whether cannabis use disorder can precipitate schizophrenia in genetically vulnerable subjects.Methods We retrospectively assessed schizophrenia subjects with and without pre-onset cannabis use disorder on the basis of their clinical features, assessed categorically and dimensionally with the operational criteria checklist for psychotic illnesses (OCCPI). We also investigated whether the two groups could be differentiated on the basis of a history of psychiatric disorders in first-degree relatives. A principal component factor analysis of the OCCPI items was used to identify specific symptom dimensions. The relationships between symptom dimensions and cannabis status were analysed by point-biserial correlation analysis to control for sex and age at time of the assessment and illness duration.ResultsOne hundred and seventy-one subjects with a diagnosis of schizophrenia were included. Among them, forty-one patients (18.2 % of the sample) had a cannabis use disorder before or at the time of the onset of schizophrenia. We found similar results in symptoms patterns or family history between patients with and without pre-onset cannabis use disorder.ConclusionsOur results clearly argue against cannabis-associated schizophrenia being a relevant distinct clinical entity of schizophrenia with specific features.