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

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(8), P. e2328934 - e2328934

Published: Aug. 29, 2023

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

Language: Английский

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Psychometric Performance of a Substance Use Symptom Checklist to Help Clinicians Assess Substance Use Disorder in Primary Care

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(5), P. e2316283 - e2316283

Published: May 26, 2023

Substance use disorders (SUDs) are underrecognized in primary care, where structured clinical interviews often infeasible. A brief, standardized substance symptom checklist could help clinicians assess SUD.To evaluate the psychometric properties of Use Symptom Checklist (hereafter checklist) used care among patients reporting daily cannabis and/or other drug as part population-based screening and assessment.This cross-sectional study was conducted adult who completed during routine between March 1, 2015, 2020, at an integrated health system. Data analysis from June 2021, to May 2022.The included 11 items corresponding SUD criteria Diagnostic Statistical Manual for Mental Disorders (Fifth Edition) (DSM-5). Item response theory (IRT) analyses tested whether unidimensional reflected a continuum severity evaluated item characteristics (discrimination severity). Differential functioning examined performed similarly across age, sex, race, ethnicity. Analyses were stratified by use.A total 23 304 screens (mean [SD] 38.2 [5.6] years; 12 554 [53.9%] male patients; 17 439 [78.8%] White 20 393 [87.5%] non-Hispanic patients). Overall, 16 140 reported only, 4791 2373 both use. Among with or use, 4242 (26.3%), 1446 (30.2%), 1229 (51.8%), respectively, endorsed 2 more on checklist, consistent DSM-5 SUD. For all subsamples, IRT models supported unidimensionality discriminated higher lower levels severity. observed some sociodemographic subgroups but did not result meaningful change (<1 point difference) overall score (0-11).In this study, administered screening, expected well subgroups. Findings support utility complete assessment make diagnostic treatment decisions care.

Language: Английский

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Cannabis Use Reported by Patients Receiving Primary Care in a Large Health System

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(6), P. e2414809 - e2414809

Published: June 5, 2024

Importance Despite the changing legal status of cannabis and potential impact on health, few health systems routinely screen for use, data epidemiology especially medical use among primary care patients, are limited. Objective To describe prevalence of, factors associated with, reasons past–3 month reported by patients. Design, Setting, Participants This cross-sectional study used electronic record from patients aged 18 years older who had an annual wellness visit between January 2021 May 2023 a clinic within university-based system in Los Angeles, California. Exposures Factors interest included age, race ethnicity, sex, employment status, neighborhood Area Deprivation Index (ADI). Main Outcomes Measures Cannabis was assessed using Alcohol Substance Involvement Screening Test (ASSIST). Patients were also asked about symptoms which they cannabis, mode use. Results Among 175 734 screened, median (range) age 47 (18-102) years; 101 657 (58.0%) female; 25 278 (15.7%) Asian, 21 971 (13.7%) Hispanic, 51 063 (31.7%) White. 29 898 (17.0%), with 10 360 (34.7%) having ASSIST scores indicative moderate to high risk disorder (CUD). Prevalence higher male than female (14 939 [20.0%] vs 14 916 [14.7%]) younger (18-29 years, 7592 [31.0%]; ≥60 4200 [8.5%]), lower those lived most disadvantaged neighborhoods (ADI decile 9-10, 189 [13.8%]; ADI 1-2, 12 431 [17.4%]). The common modes edibles (18 201 [61.6%]), smoking (15 256 [51.7%]), vaporizing (8555 [29.0%]). While 4375 (15.6%) did so only, 986 (75.7%) manage including pain (9196 [31.7%]), stress 542 [50.2%]), sleep (16 221 [56.0%]). (IQR) number managed 2 (1-4), at CUD (4 [2-6] symptoms). Conclusions Relevance In this study, common, more three-quarters any doing health-related symptom. These findings suggest that integration information regarding symptom management could help provide crucial point-of-care opportunity clinicians understand their patients’ CUD.

Language: Английский

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Test-retest reliability of DSM-5 substance use symptom checklists used in primary care and mental health care settings

Drug and Alcohol Dependence, Journal Year: 2024, Volume and Issue: 256, P. 111108 - 111108

Published: Jan. 24, 2024

Language: Английский

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Depressive and Anxiety Symptoms Moderate Cannabis Use Disorder Treatment Effects: A Randomized Clinical Trial with Young Adults

International Journal of Mental Health and Addiction, Journal Year: 2025, Volume and Issue: unknown

Published: April 4, 2025

Language: Английский

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Improving alcohol-related care in small-medium primary care practices: An evaluation of an adaptation of the SPARC trial intervention for small-medium sized practices

Journal of Substance Use and Addiction Treatment, Journal Year: 2025, Volume and Issue: unknown, P. 209697 - 209697

Published: April 1, 2025

Language: Английский

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Identifying Alcohol Use Disorder and Problem Use in Adult Primary Care Patients: Comparison of the Tobacco, Alcohol, Prescription Medication and Other Substance (TAPS) Tool With the Alcohol Use Disorders Identification Test Consumption Items (AUDIT-C)

Substance Use &amp Addiction Journal, Journal Year: 2025, Volume and Issue: unknown

Published: May 5, 2025

Background: The Tobacco, Alcohol, Prescription Medication, and Other Substance (TAPS) tool is a screening brief assessment instrument to identify unhealthy tobacco, alcohol, drug use, prescription medication use in primary care patients. This secondary analysis compares the TAPS Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for alcohol screening. Methods: Adult patients (1124 female, 874 male) completed followed by AUDIT-C. Performance of each was evaluated against reference standard measure, modified World Mental Health Composite International Diagnostic Interview, problem disorder (AUD). Area under curve (AUC) appraised discrimination, sensitivity specificity were calculated Youden optimal score thresholds. Results: For identifying use: On AUDIT-C, AUC 0.90 (95% Confidence Interval: 0.86-0.92) females 0.91 (0.89-0.93) males. Sensitivity 0.89 (0.83-0.93) 0.78 (0.75-0.80), respectively, males 0.84 (0.79-0.88) 0.82 (0.79-0.85). tool, (0.79-0.86) 0.81 (0.78-0.84) (0.72-0.84) (0.75-0.81), 0.76 (0.71-0.81) (0.72-0.79). AUD: (0.88-0.93) both 0.83 (0.74-0.90) (0.80-0.85), while males, they (0.74-0.87) (0.81-0.87). (0.80-0.89) (0.78-0.86) 0.73 (0.63-0.81) 0.85 (0.83-0.88), 0.75 (0.68-0.81) (0.81-0.86). Conclusion: AUDIT-C performed somewhat better than However, had an acceptable level performance may be advantageous practice settings seeking other substance with single instrument.

Language: Английский

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Cannabis Use Among Older Adults

JAMA Network Open, Journal Year: 2025, Volume and Issue: 8(5), P. e2510173 - e2510173

Published: May 14, 2025

Importance Little is known about patterns (forms, frequency, and reasons) factors associated with cannabis use in older veterans (aged ≥65 years). Objective To examine past 30-day disorder (CUD) veterans. Design, Setting, Participants In this cross-sectional study, community-dwelling adults aged 65 to 84 years who used Veterans Health Administration care were interviewed between February 5, 2020, August 29, 2023. Exposure Sociodemographic, behavioral, health-related characteristics. Main Outcomes Measures Past (smoking, vaping, dabbing, or edibles) any CUD (≥2 criteria based on Diagnostic Statistical Manual of Mental Disorders [Fifth Edition]) assessed using weighted multivariable logistic regressions. Results Of the 4503 participants (weighted mean age, 73.3 [95% CI, 73.0-73.5 years]; 85.4% 83.6%-87.2%] men), 58.2% (95% 55.3%-61.0%) had ever cannabis, 28.9% 26.0%-31.8%) whom reported for medical reasons, most commonly pain (56.4%; 95% 50.9%-61.9%), mood mental health (18.4%; 14.7%-22.1%), sleep (16.0%; 11.9%-20.0%). More than 1 10 (10.3%; 8.9%-11.7%), 52.4% 45.4%-59.4%) these 20 days more; smoking (72.4%; 65.4%-79.3%) edibles (36.9%; 29.8%-43.9%) common forms use. Characteristics included younger age (65-75 years), economic hardship, tobacco illicit drug use, residing a state recreationally legal cannabis. Among those 36.3% 30.1%-42.6%) screened positive CUD, higher odds among respondents, reporting anxiety, more deficits activities daily living, frequent recreationally. inhaled compared only, was increased (adjusted ratio, 3.56; 1.12-11.26). Conclusions Relevance study veterans, common, one-third 30 CUD. The prevalence close prevalence, risk similar observed other populations. Frequent Routine screening clinical settings necessary identify

Language: Английский

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Young Adults Advancing Through the Stages of Change: A Mediational Analysis of Cannabis Use Disorder Treatment

Substance Use & Misuse, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 7

Published: May 18, 2025

The Stages of Change (SoC) model explains addictive behavior change through 5 stages: precontemplation, contemplation, preparation, action, and maintenance. Limited evidence exists from randomized controlled trials testing the SoC in Cannabis Use Disorder (CUD) treatments. aim this study was to test indirect effects Peer Network Counseling- text (PNC-txt), a text-message delivered motivational interviewing informed treatment for cannabis use disorder, advancing participants SoC. Design two-arm clinical trial CUD with 1078 U.S. young adults. Participants were allocated 4 wk PNC-txt or wait-list control condition followed 6 months. Urine drug tests presence THC metabolites self-reported days used past 30 outcome variables. measured Marijuana Ladder, as dichotomized mediator variable representing Cognitive stage (precontemplation, preparation = 0) Behavioral (action, maintenance 1). Mediation analysis showed Action/Maintenance at 1-month post baseline had 50% lower odds highest level metabolite (300 ng/ml) result reported using fewer compared controls Results suggest that increased motivation resulting SoC, explaining decreases use. Findings provide novel biological support modifiable mechanism when treating

Language: Английский

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Tools to implement measurement-based care (MBC) in the treatment of opioid use disorder (OUD): toward a consensus

Addiction Science & Clinical Practice, Journal Year: 2024, Volume and Issue: 19(1)

Published: Feb. 28, 2024

Abstract Background The prevalence and associated overdose death rates from opioid use disorder (OUD) have dramatically increased in the last decade. Despite more available treatments than 20 years ago, treatment access high discontinuation are challenges, as personalized medication dosing making timely changes when fail. In other fields such depression, brief measures to address these tasks combined with an action plan—so-called measurement-based care (MBC)—have been better outcomes. This workgroup aimed determine whether can be identified for using MBC optimizing or informing decisions OUD. Methods National Institute on Drug Abuse Center Clinical Trials Network (NIDA CCTN) 2022 convened a small develop consensus about clinically usable improve quality of delivery methods Two clinical were addressed: (1) identify optimal dose medications OUD each patient (2) estimate effectiveness particular once implemented, granular fashion binary categories early sustained remission no found Diagnostic Statistical Manual Mental Disorders, fifth edition (DSM-5). Discussion Five parameters recommended personalize adjustment: withdrawal symptoms, use, magnitude (severity duration) subjective effects opioids used, craving, side effects. A rating OUD-specific parameter adjust global assessment verbal question side-effects was viewed sufficient. Whether ratings produce outcomes (e.g., engagement retention) practice deserves study. There that core signs symptoms based some 5 DSM-5 domains withdrawal) should basis assessing outcome. No existing measure meet all recommendations. Next steps would select, adapt de novo items/brief scales inform decision-making effectiveness. Psychometric testing, acceptability produces symptom control, life (QoL), daily function prognosis compared usual investigation.

Language: Английский

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