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Trends in Cannabis Use Disorder Diagnoses in the U.S. Veterans Health Administration, 2005–2019
American Journal of Psychiatry ( IF 17.7 ) Pub Date : 2022-07-28 , DOI: 10.1176/appi.ajp.22010034
Deborah S Hasin 1 , Andrew J Saxon 1 , Carol Malte 1 , Mark Olfson 1 , Katherine M Keyes 1 , Jaimie L Gradus 1 , Magdalena Cerdá 1 , Charles C Maynard 1 , Salomeh Keyhani 1 , Silvia S Martins 1 , David S Fink 1 , Ofir Livne 1 , Zachary Mannes 1 , Melanie M Wall 1
Affiliation  

Objective:

In the United States, adult cannabis use has increased over time, but less information is available on time trends in cannabis use disorder. The authors used Veterans Health Administration (VHA) data to examine change over time in cannabis use disorder diagnoses among veterans, an important population subgroup, and whether such trends differ by age group (<35 years, 35–64 years, ≥65 years), sex, or race/ethnicity.

Methods:

VHA electronic health records from 2005 to 2019 (range of Ns per year, 4,403,027–5,797,240) were used to identify the percentage of VHA patients seen each year with a cannabis use disorder diagnosis (ICD-9-CM, January 1, 2005–September 30, 2015; ICD-10-CM, October 1, 2015–December 31, 2019). Trends in cannabis use disorder diagnoses were examined by age and by race/ethnicity and sex within age groups. Given the transition in ICD coding, differences in trends were tested within two periods: 2005–2014 (ICD-9-CM) and 2016–2019 (ICD-10-CM).

Results:

In 2005, the percentages of VHA patients diagnosed with cannabis use disorder in the <35, 35–64, and ≥65 year age groups were 1.70%, 1.59%, and 0.03%, respectively; by 2019, the percentages had increased to 4.84%, 2.86%, and 0.74%, respectively. Although the prevalence of cannabis use disorder was consistently higher among males than females, between 2016 and 2019, the prevalence increased more among females than males in the <35 year group. Black patients had a consistently higher prevalence of cannabis use disorder than other racial/ethnic groups, and increases were greater among Black than White patients in the <35 year group in both periods.

Conclusions:

Since 2005, diagnoses of cannabis use disorder have increased substantially among VHA patients, as they have in the general population and other patient populations. Possible explanations warranting investigation include decreasing perception of risk, changing laws, increasing cannabis potency, stressors related to growing socioeconomic inequality, and use of cannabis to self-treat pain. Clinicians and the public should be educated about the increases in cannabis use disorder in general in the United States, including among patients treated at the VHA.



中文翻译:

2005-2019 年美国退伍军人健康管理局大麻使用障碍诊断趋势

客观的:

在美国,成人大麻的使用随着时间的推移而增加,但关于大麻使用障碍的时间趋势的信息较少。作者使用退伍军人健康管理局 (VHA) 的数据来检查退伍军人(一个重要的人口亚群)中大麻使用障碍诊断随时间的变化,以及这种趋势是否因年龄组(<35 岁、35–64 岁、≥65 岁)而异、性别或种族/民族。

方法:

2005 年至 2019 年的 VHA 电子健康记录(每年 Ns 的范围,4,403,027–5,797,240)用于确定每年接受大麻使用障碍诊断的 VHA 患者的百分比(ICD-9-CM,2005 年 1 月 1 日至 9 月) 2015 年 30 日;ICD-10-CM,2015 年 10 月 1 日至 2019 年 12 月 31 日)。大麻使用障碍诊断的趋势按年龄和年龄组内的种族/族裔和性别进行了检查。鉴于 ICD 编码的转变,趋势差异在两个时期内进行了测试:2005-2014 (ICD-9-CM) 和 2016-2019 (ICD-10-CM)。

结果:

2005 年,<35 岁、35-64 岁和≥65 岁年龄组被诊断患有大麻使用障碍的 VHA 患者百分比分别为 1.70%、1.59% 和 0.03%;到 2019 年,该百分比分别增加到 4.84%、2.86% 和 0.74%。尽管大麻使用障碍的患病率在男性中一直高于女性,但在 2016 年至 2019 年期间,在 35 岁以下人群中,女性的患病率高于男性。与其他种族/族裔群体相比,黑人患者的大麻使用障碍患病率始终较高,并且在这两个时期内,<35 岁组的黑人患者患病率高于白人患者。

结论:

自 2005 年以来,大麻使用障碍的诊断在 VHA 患者中大幅增加,就像在普通人群和其他患者群体中一样。值得调查的可能解释包括降低对风险的认识、改变法律、增加大麻效力、与日益严重的社会经济不平等相关的压力源,以及使用大麻自我治疗疼痛。临床医生和公众应该了解美国总体上大麻使用障碍的增加,包括在 VHA 接受治疗的患者。

更新日期:2022-07-28
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