Awards from the National Institute on Drug Abuse (UG1DA040314-01S1, UG1 DA01581) and the Agency for Healthcare Research and Quality (R18 HS023173) supported study implementation, analysis and manuscript preparation.
Journal of the American Board of Family Medicine
Primary health care, Medical screening, Cannabis
Background and Objectives—Over 12% of U.S. adults report past-year cannabis use, and among those who use daily, 25% or more have a cannabis use disorder. Use is increasing as legal access expands. Yet, cannabis use is not routinely assessed in primary care, and little is known about use among primary care patients and relevant demographic and behavioral health subgroups. This study describes the prevalence and frequency of past-year cannabis use among primary care patients assessed for use during a primary care visit.
Methods—This observational cohort study included adults who made a visit to primary care clinics with annual behavioral health screening, including a single-item question about frequency past-year cannabis use (March 2015-February 2016; n=29,857). Depression, alcohol and other drug use were also assessed by behavioral health screening. Screening results, tobacco use, and diagnoses for past-year behavioral health conditions (e.g., mental health and substance use disorders) were obtained from EHRs.
Results—Among patients who completed the cannabis use question (n=22,095; 74% of eligible patients), 15.3% (14.8–15.8%) reported any past-year use: 12.2% (11.8%–12.6%) less than daily and 3.1% (2.9%–3.3%) daily. Among 2,228 patients 18–29 years, 36.0% (34.0%–38.0%) reported any cannabis use and 8.1% (7.0%–9.3%) daily use. Daily cannabis use was common among men 18–29 who used tobacco or screened positive for depression: 25.5% (18.8%–32.1%) and 31.7% (23.3%–40.0%), respectively.
Conclusions—Cannabis use was common in adult primary care patients, especially among younger patients and those with behavioral health conditions. Results highlight the need for primary care approaches to address cannabis use.
Lapham, G. T., Lee, A. K., Caldeiro, R. M., McCarty, D., Browne, K. C., Walker, D. D., ... & Bradley, K. A. (2017). Frequency of Cannabis Use Among Primary Care Patients in Washington State. The Journal of the American Board of Family Medicine, 30(6), 795-805.