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Cannabis Use Disorder More Prevalent in States With Legal Recreational Use
Findings from a study published this week in JAMA Network Open indicate that cannabis use disorder (CUD) is more common among primary care patients who reside in a state where cannabis use is legal.
“We wanted to conduct this study to help clinicians better understand whether it matters if patients report using cannabis for medical or nonmedical reasons, in terms of their risk for cannabis use disorder,” study lead author Gwen Lapham, PhD, MSW, MPH, assistant professor at Kaiser Permanente Tyson School of Medicine, said in a news release published by Kaiser Permanente Washington Health Research Institute.
For their study, researchers from Kaiser Permanente Washington Health Research Institute reviewed data from cannabis screenings of primary care patients in Washington, one of the first states in which recreational cannabis use was made legal. The screenings were conducted between March and September 2019. The screening contained a single question asking patients how often they used cannabis within the past year. Of the 1463 patients who said they had used cannabis recently, 21% reported symptoms of cannabis use disorder, with 6% reporting moderate to severe CUD.
Rates of patients showing symptoms of moderate to severe cannabis use disorder were significantly higher among individuals who reported any nonmedical cannabis use (7%) compared to those who used cannabis only for medical reasons (1%).
Cannabis use disorder was diagnosed when patients experience at least 2 of 11 symptoms, including cravings, withdrawal, and experiencing problems with work or relationships as a result of cannabis use. Experiencing 2-3 symptoms was considered mild cannabis use disorder, with 4-5 symptoms being considered moderate, and 6 or more as severe.
“In our sample, patients who use cannabis only for medical reasons, which was about 42% of survey respondents, had lower prevalence of moderate or severe cannabis use disorder,” Lapham said.
The study’s finding regarding the rate of CUD in a state with legal recreational use “underscores the importance of assessing patient cannabis use in clinical settings,” the researchers wrote. Conducting such assessments provides clinicians with an opportunity to discuss the risks and benefits of cannabis use, as well as treatment alternatives for patients using cannabis for medical reasons, the researchers added.
“Such knowledge can support engagement around symptoms, shared decision-making, and offering of treatment if desired, especially for patients with moderate to severe CUD who may benefit most from treatment,” Lapham and colleagues wrote.
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