Article Figures & Data
Figures
- Figure 1.
The prevalence of past-year cannabis use among patients in age and gender subgroups (A) and among those with a documented condition, diagnosis, or behavioral health screen (B). Note, any use is the summed total of monthly/monthly/weekly use and daily use. Documented conditions and diagnoses were in the year before the clinic visit. PHQ-2, Patient Health Questionnaire.
- Figure 2.
Among young patients 18 to 29 years old with a documented condition, diagnosis, or positive behavioral health screen, the prevalence and frequency of past-year cannabis Use. PHQ-2, Patient Health Questionnaire.
Tables
- Table 1.
Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5) Criteria for a Cannabis Use Disorder
A problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within a 12-month period Cannabis is often taken in larger amounts or over a longer period than was intended
There is a persistent desire or unsuccessful efforts to cut down or control cannabis use
A great deal of time is spent in activities necessary to obtain cannabis, use cannabis, or recover from its effects
Craving, or a strong desire or urge to use cannabis
Recurrent cannabis use resulting in a failure to fulfill major role obligations at work, school, or home
Continued cannabis use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of cannabis
Important social, occupational, or recreational activities are given up or reduced because of cannabis use
Recurrent cannabis use in situations in which it is physically hazardous
Cannabis use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by cannabis
Tolerance, as defined by either a (1) need for markedly increased cannabis to achieve intoxication or desired effect, or (2) markedly diminished effect with continued use of the same amount of cannabis
Withdrawal, as manifested by either (1) the characteristic withdrawal syndrome for cannabis, or (2) cannabis is taken to relieve or avoid withdrawal symptoms
Note: The severity of a cannabis use disorder is defined as: mild (2 or 3 symptoms), moderate (4 or 5), and severe (6 or more). Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013. All Rights Reserved.
- Table 2.
Primary Care Adult Patients Who Attended Pilot Sites and Were Screened for Past-Year Cannabis Use (n = 22,095)
N % Sex Women 13,182 59.7 Men 8913 40.3 Age categories (years) 18 to 29 2228 10.1 30 to 49 5194 23.5 50 to 64 6774 30.7 ≥65 7899 35.8 Race/ethnicity Black 490 2.2 Hispanic 997 4.5 Other 1972 8.9 White 17,993 81.4 Unknown 643 2.9 Tobacco use* 2133 9.7 Diagnoses in prior year* Major depression 3323 15.0 Anxiety disorder 2994 13.6 Serious mental illness† 704 3.2 Alcohol use disorder 396 1.8 Cannabis use disorder 109 0.5 Other drug use disorder 200 0.9 Behavioral health screens Depression (PHQ-2)** 3582 16.3 Unhealthy alcohol use** 5863 26.6 Any illicit drug use/Rx drug misuse** 363 1.7 ↵* Assessed in the year prior to clinic visit.
↵† Includes diagnoses for bipolar disorder, psychosis, and schizophrenia.
↵** Total N varies due to some patients not completing items of Behavioral Health screen: PHQ-2 (n = 22,081), AUDIT-C (n = 22,034), drug screen (n = 21,945).
PHQ-2, Patient Health Questionnaire; AUDIT, Alcohol Use Disorders Identification Test–Consumption.
Any Use Daily Use Adjusted OR 95% CI Adjusted OR 95% CI Sex Women† — — — — Men 1.68 (1.55 to 1.83)§ 1.87 (1.59 to 2.21)§ Age categories (years) 18 to 29 7.34 (6.42 to 8.40)§ 4.82 (3.67 to 6.31)§ 30 to 49 3.26 (2.90 to 3.68)§ 2.75 (2.13 to 3.53)§ 50 to 64 2.61 (2.33 to 2.93)§ 1.92 (1.49 to 2.48)§ ≥65† — — — — — Race Black 0.68 (0.51 to 0.91)¶ 0.75 (0.43 to 1.32) Hispanic 0.92 (0.76 to 1.11) 1.09 (0.76 to 1.57) Other 0.71 (0.61 to 0.83)§ 0.70 (0.52 to 0.96)¶ White† — — — — Unknown 1.00 (0.80 to 1.25) 1.34 (0.91 to 1.97) Current tobacco use‡ 2.00 (1.79 to 2.23)§ 2.92 (2.43 to 3.52)§ Diagnoses in prior year‡ Major depression 1.35 (1.20 to 1.52)§ 1.20 (0.96 to 1.49) Anxiety disorder 1.23 (1.09 to 1.38)¶ 1.23 (0.98 to 1.55) Serious mental illness 1.45 (1.18 to 1.79)§ 1.51 (1.05 to 2.17)¶ Alcohol use disorder 0.89 (0.69 to 1.16) 0.94 (0.61 to 1.46) Other drug use disorder 1.41 (0.98 to 2.04) 0.94 (0.54 to 1.62) Behavioral health screens Depression (PHQ-2) 1.77 (1.61 to 1.96)§ 3.89 (3.28 to 4.60)§ Unhealthy alcohol use 2.76 (2.54 to 3.00)§ 1.47 (1.24 to 1.74)§ Any illicit drug use/Rx drug misuse 5.19 (4.05 to 6.66)§ 2.86 (2.08 to 3.95)§ Constant 0.03 (0.03 to 0.03)§ 0.00 (0.00 to 0.01)§ - Appendix.
The Prevalence and Frequency of Past-Year Cannabis Use among Patient Demographic and Behavioral Health Subgroups
Conditions/Diagnoses in Prior Year Behavioral Health Screens Tobacco Use Major Depression Anxiety Serious Mental Illness Alcohol Use Disorder Other Drug Use Disorder Depression (PHQ2) Unhealthy Alcohol Use Illicit Drug Use/Rx Misuse % 95% CI % 95% CI % 95% CI % 95% CI % 95% CI % 95% CI % 95% CI % 95% CI % 95% CI Age 30 to 49 years Women (n = 371) (n = 554) (n = 634) (n = 123) (n = 48) (n = 32) (n = 527) (n = 881) (n = 48) Any use 29.9 (25.3 to 34.6) 21.8 (18.4 to 25.3) 22.2 (19.0 to 25.5) 30.1 (21.9 to 38.2) 25 (12.6 to 37.4) 34.4 (17.7 to 51.1) 28.5 (24.6 to 32.3) 28.6 (25.6 to 31.6) 47.9 (33.6 to 62.2) Frequency of use None 70.1 (65.4 to 74.8) 78.2 (74.7 to 81.6) 77.8 (74.5 to 81.0) 69.9 (61.8 to 78.1) 75 (62.6 to 87.4) 65.6 (48.9 to 82.4) 71.5 (67.7 to 75.4) 71.4 (68.4 to 74.4) 52.1 (37.8 to 66.4) >Daily 19.7 (15.6 to 23.7) 17 (13.8 to 20.1) 16.4 (13.5 to 19.3) 22.8 (15.3 to 30.2) 18.8 (7.6 to 29.9) 28.1 (12.3 to 44.0) 19.5 (16.2 to 22.9) 25 (22.1 to 27.8) 37.5 (23.7 to 51.4) Daily 10.2 (7.2 to 13.3) 4.9 (3.1 to 6.7) 5.8 (4.0 to 7.7) 7.3 (2.7 to 11.9) 6.3 (−0.7 to 13.2) 6.3 (−2.3 to 14.8) 8.9 (6.5 to 11.4) 3.6 (2.4 to 4.9) 10.4 (1.7 to 9.2) Men (n = 323) (n = 05) (n = 233) (n = 52) (n = 54) (n = 33) (n = 335) (n = 609) (n = 39) Any use 36.5 (31.3 to 41.8) 33.7 (27.2 to 40.2) 28.8 (22.9 to 34.6) 36.5 (23.3 to 49.8) 38.9 (25.8 to 52.0) 45.5 (28.2 to 62.7) 37.6 (32.4 to 42.8) 38.6 (34.7 to 42.5) 71.8 (57.5 to 86.1) Frequency of use None 63.5 (58.2 to 68.7) 66.3 (59.9 to 72.8) 71.2 (65.4 to 77.1) 63.5 (50.2 to 76.7) 61.1 (48.0 to 74.2) 54.6 (37.3 to 71.8) 62.4 (57.2 to 67.6) 61.4 (57.5 to 65.3) 28.2 (13.9 to 42.5) >Daily 24.8 (20.1 to 29.5) 22.4 (16.7 to 28.2) 19.3 (14.2 to 24.4) 23.1 (11.5 to 34.7) 29.6 (17.3 to 41.9) 21.2 (7.0 to 35.4) 20.6 (16.3 to 24.9) 29.4 (25.8 to 33.0) 41 (25.4 to 56.7) Daily 11.8 (8.2 to 15.3) 11.2 (6.9 to 15.6) 9.4 (5.7 to 13.2) 13.5 (4.1 to 22.8) 9.3 (1.5 to 17.1) 24.2 (9.4 to 39.1) 17 (13.0 to 21.1) 9.2 (6.9 to 11.5) 30.8 (16.1 to 45.5) Age ≥50 years Women (n = 628) (n = 1627) (n = 1274) (n = 293) (n = 100) (n = 51) (n = 1306) (n = 2056) (n = 60) Any use 19.8 (16.6 to 22.9) 12.9 (11.3 to 14.5) 13 (11.1 to 14.8) 11.3 (7.6 to 14.9) 21 (13.0 to 29.0) 19.6 (8.6 to 30.6) 14.9 (12.9 to 16.8) 14.1 (12.6 to 15.6) 41.7 (29.1 to 54.3) Frequency of use None 80.3 (77.1 to 83.4) 87.1 (85.5 to 88.7) 87.1 (85.2 to 88.9) 88.7 (85.1 to 92.4) 79 (71.0 to 87.0) 80.4 (69.4 to 91.4) 85.2 (83.2 to 87.1) 85.9 (84.4 to 87.4) 58.3 (45.8 to 70.9) >Daily 14.7 (11.9 to 17.4) 10 (8.5 to 11.4) 10.2 (8.5 to 11.9) 7.2 (4.2 to 10.1) 16 (8.8 to 23.2) 15.7 (5.6 to 25.8) 9.8 (8.2 to 11.4) 12.3 (10.8 to 13.7) 28.3 (16.8 to 39.8) Daily 5.1 (3.4 to 6.8) 3 (2.1 to 3.8) 2.8 (1.9 to 3.7) 4.1 (1.8 to 6.4) 5 (0.7 to 9.3) 3.9 -(1.5 to 9.3) 5.1 (3.9 to 6.2) 1.9 (1.3 to 2.4) 13.3 (4.7 to 22.0) Men (n = 512) (n = 616) (n = 502) (n = 152) (n = 155) (n = 40) (n = 920) (n = 1553) (n = 71) Any use 27.3 (23.5 to 31.2) 18.3 (15.3 to 21.4) 19.5 (16.1 to 23.0) 19.1 (12.8 to 25.4) 23.9 (17.1 to 30.6) 30.0 (15.6 to 44.4) 20.5 (17.9 to 23.2) 24.0 (21.9 to 26.1) 50.7 (39.0 to 62.4) Frequency of use None 72.7 (68.8 to 76.5) 81.7 (78.6 to 84.7) 80.5 (77.0 to 84.0) 80.9 (74.7 to 87.2) 76.1 (69.4 to 82.9) 70.0 (55.6 to 84.4) 79.5 (76.8 to 82.1) 76.0 (73.9 to 78.1) 49.3 (37.6 to 61.0) >Daily 21.1 (17.6 to 24.6) 14.8 (12.0 to 17.6) 15.5 (12.4 to 18.7) 14.5 (8.9 to 20.1) 19.4 (13.1 to 25.6) 25.0 (11.4 to 38.6) 13.3 (11.1 to 15.5) 20.2 (18.2 to 22.2) 36.6 (25.3 to 47.9) Daily 6.3 (4.2 to 8.4) 3.6 (2.1 to 5.0) 4.0 (2.3 to 5.7) 4.6 (1.3 to 8.0) 4.5 (1.2 to 7.8) 5.0 (−1.8 to 11.8) 7.3 (5.6 to 9.0) 3.8 (2.9 to 4.8) 14.1 (5.9 to 22.2) CI, confidential interval; PHQ-2, Patient Health Questionnaire.
