Cannabis Use Disorder and Perioperative Complications

JAMA Surgery, Год журнала: 2023, Номер 158(9), С. 935 - 935

Опубликована: Июль 5, 2023

Cannabis use is growing in the US and increasingly perceived as harmless. However, perioperative impact of cannabis remains uncertain.

Язык: Английский

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State Cannabis Legalization and Cannabis Use Disorder in the US Veterans Health Administration, 2005 to 2019

JAMA Psychiatry, Год журнала: 2023, Номер 80(4), С. 380 - 380

Опубликована: Март 1, 2023

Cannabis use disorder (CUD) is increasing among US adults. Few national studies have addressed the role of medical cannabis laws (MCLs) and recreational (RCLs) in these increases, particularly patient populations with high rates CUD risk factors.To quantify MCL RCL enactment increases diagnosed prevalence Veterans Health Administration (VHA) patients from 2005 to 2019.Staggered-adoption difference-in-difference analyses were used estimate diagnoses, fitting a linear binomial regression model fixed effects for state, categorical year, time-varying law status, state-level sociodemographic covariates, age group, sex, race ethnicity. Patients aged 18 75 years 1 or more VHA primary care, emergency department, mental health visit no hospice/palliative care within given calendar year included. Time-varying yearly state control covariates state/year American Community Survey data: percentage male, Black, Hispanic, White, older, unemployed, income below poverty threshold, median household income. Analysis took place between February December 2022.As preplanned, International Classification Diseases, Clinical Modification, ninth tenth revisions, diagnoses electronic records analyzed.The number individuals analyzed ranged 3 234 382 4 579 994 2019. largely male (94.1% 89.0% 2019) White (75.0% 66.6% 2019), mean (SD) 57.0 [14.4] years. From 2019, adjusted prevalences increased 1.38% 2.25% states (no CLs), 2.54% MCL-only enacting states, 1.39% 2.56% RCL-enacting states. Difference-in-difference results indicated that was associated 0.05% (0.05-0.06) absolute increase prevalence, ie, 4.7% total could be attributed MCLs, while 1.12% (95% CI, 0.10-0.13) 9.8% RCLs. The greatest 65 years, an 0.15% 0.13-0.17) RCLs, 18.6% group.In this study patients, played significant overall older patients. However, consistent general population studies, effect sizes relatively small, suggesting cumulatively, affected attitudes diffusely across country other factors larger adult CUD. Results underscore need screen treat when it present.

Язык: Английский

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Increasing risk of cannabis use disorder among U.S. veterans with chronic pain: 2005-2019

Pain, Год журнала: 2023, Номер 164(9), С. 2093 - 2103

Опубликована: Май 8, 2023

Abstract In the United States, cannabis is increasingly used to manage chronic pain. Veterans Health Administration (VHA) patients are disproportionately affected by pain and may use for symptom management. Because increases risk of disorders (CUDs), we examined time trends in CUD among VHA with without pain, whether these differed age. From electronic health records from 2005 2019 (∼4.3-5.6 million yearly), extracted diagnoses conditions ( International Classification Diseases [ ICD ]- 9-CM , 2005-2014; ICD-10-CM 2016-2019). Differential prevalence overall age-stratified (<35, 35-64, or ≥65) were assessed any number (0, 1, ≥2). 2014, increased significantly more (1.11%-2.56%) than those (0.70%-1.26%). Cannabis disorder across all age groups was highest ≥2 conditions. 2016 2019, ≥65 (0.63%-1.01%) (0.28%-0.47%) Over time, has other patients, increase ≥65. Clinicians should monitor symptoms others who cannabis, consider noncannabis therapies, particularly because effectiveness management remains inconclusive.

Язык: Английский

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A critical assessment of the abuse, dependence and associated safety risks of naturally occurring and synthetic cannabinoids

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Июнь 10, 2024

Various countries and US States have legalized cannabis, the use of psychoactive

Язык: Английский

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Validating opioid use disorder diagnoses in administrative data: a commentary on existing evidence and future directions

Addiction Science & Clinical Practice, Год журнала: 2023, Номер 18(1)

Опубликована: Авг. 17, 2023

A valid opioid use disorder (OUD) identification algorithm for in administrative medical record data would enhance investigators' ability to study consequences of OUD, OUD treatment seeking and outcomes.Existing studies indicate ICD-9 ICD-10 codes abuse dependence do not accurately measure OUD. However, critical appraisal existing literature suggests alternative validation methods improve the validity algorithms data. Chart abstraction may be sufficient validate primary collection via structured diagnostic interviews might an ideal gold standard.Generating is research quality measurement real world health care settings.

Язык: Английский

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Chronic pain, cannabis legalisation, and cannabis use disorder among patients in the US Veterans Health Administration system, 2005 to 2019: a repeated, cross-sectional study

The Lancet Psychiatry, Год журнала: 2023, Номер 10(11), С. 877 - 886

Опубликована: Окт. 11, 2023

Язык: Английский

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Cannabis Use in HIV: Impact on Inflammation, Immunity and the Microbiome

Current HIV/AIDS Reports, Год журнала: 2025, Номер 22(1)

Опубликована: Фев. 22, 2025

Язык: Английский

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Improving diagnosis-based quality measures: an application of machine learning to the prediction of substance use disorder among outpatients

BMJ Open Quality, Год журнала: 2025, Номер 14(1), С. e003017 - e003017

Опубликована: Янв. 1, 2025

Objective Substance use disorder (SUD) is clinically under-detected and under-documented. We built validated machine learning (ML) models to estimate SUD prevalence from electronic health record (EHR) data assess variation in facility-level identification using documented diagnoses vs model-based estimated prevalence. Methods Predictors included demographics, SUD-related healthcare utilisation. The criterion outcome for model development was prevalent assessed via a patient survey across 30 geographically representative Veterans Health Administration (VA) sites (n=5989 patients). split the into training testing datasets series of ML cross-validation minimise over-fitting. selected final based on its performance predicting dataset. Using model, we at all sites. then compared facilities two alternative measures: diagnosis rate Results best-performing LASSO with n=61 predictors doubled sensitivity classifying relative only (0.682 0.331). Across sites, rates ranged 6.4%–13.9% predicted 9.7–16.0%. difference (observed minus prevalence) −7.2 +1.3 percentage points. Comparing facilities’ rank ordering prevalence, 16 out had ranking that changed by least quintile (ie, 6 places or more). Conclusions This analysis shows measures may help address measurement blind spots arise due differences diagnostic accuracy Although estimates better alone facility quality assessment, further improvements individual detection both require enhanced direct screening non-alcohol drug use.

Язык: Английский

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Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001–2019

Addiction, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Abstract Background and Aim Sedative, hypnotic or anxiolytic use disorders (SHA‐UD) are defined by significant impairment distress caused recurrent sedative, use. This study aimed to measure trends in the prevalence of SHA‐UD diagnoses adolescent young adult US Medicaid enrollees from 2001 2019. Design Annual, cross‐sectional study, 2001–2019. Setting Analytic eXtracts (MAX) Transformed Files (TAF) 42 states with complete data. Participants/Cases Adolescents (13–17 years) adults (18–29 ≥10 months enrollment calendar year; analytic sample contained 5.7 (2001) 13.2 (2019) million persons per year. Measurements Annual [defined as an inpatient outpatient ICD code (304.1x, 305.4x, F13.1x, F13.2x) year] was stratified sex, race/ethnicity, receipt a benzodiazepine, z‐hypnotic barbiturate prescription, selected mental health diagnoses. Absolute relative percent‐changes vs. 2019 were summarized. Secondary analyses restricted more consistent data capture. Findings The statistically significantly increased for adolescents (0.01% 0.04%) (0.05% 0.24%) Increasing observed sex race/ethnicity subgroups, greatest increases among Non‐Hispanic Black (624%) Hispanic (529%) adults. trend those without prescription; i.e. (2001 = 0.39% 1.77%) 0.03% 0.18%) prescription. Most (76%) (91%) diagnosis had comorbid substance disorder. Conclusions 3‐ 5‐fold between enrollees, remaining low adolescents. increase over two decades may be attributed changes availability, misuse medications detection, awareness diagnosing SHA‐UD.

Язык: Английский

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Cannabis Use and Self-Reported Bothersome Symptoms in People with HIV

Cannabis, Год журнала: 2025, Номер unknown

Опубликована: Янв. 24, 2025

Objective: While cannabis use is common among people with HIV (PWH), there have been few studies examining the association of health outcomes PWH. We aimed to evaluate between and bothersome physical mental symptoms using both self-report a direct biomarker for use. Method: The Medications, Alcohol Substance in Study (MASH) cross-cohort study focused on polypharmacy substance Participants were enrolled from October 2018 May 2022 Swiss Cohort (SHCS), Kaiser Permanente Northern California (KPNC) Cohort, 7 sites (Atlanta, GA; Bronx, NY; Washington, DC; Houston, TX; Los Angeles, CA; New York, Nashville, TN) Veterans Aging - (VACS-HIV). submitted self-reported information presence/absence prior 4 weeks, along level, Symptom Index, which comprised 20 commonly reported PWH, including fatigue, diarrhea, fever, anxiety, weight loss, others. Concurrent was also collected, participants provided nail clippings be tested used logistic regression models, adjusted age, sex, race/ethnicity, cohort, examine associations biomarker-identified symptoms. Results: analytic sample included 1,226 PWH who predominantly male (85%), non-white (64%), an average age 57 years; 20% positive use, 23% recent Agreement substantial (agreement 89%, kappa = 0.67). Put together, 27% either or positive. Of 19 more prevalent at level those compared without. In patterns remained biomarker-confirmed they particularly memory, depression, nausea. Conclusions: Cannabis associated number may treat loss appetite, nausea/vomiting, memory are concerning deserve investigation.

Язык: Английский

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