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美国总体和按社会人口统计学亚组的大麻使用和大麻使用障碍的时间趋势:叙述性评论和新发现。

Time trends in US cannabis use and cannabis use disorders overall and by sociodemographic subgroups: a narrative review and new findings.

机构信息

Department of Psychiatry, Columbia University Medical Center, Columbia University, New York, NY, USA.

Translational Epidemiology, New York State Psychiatric Institute, New York, NY, USA.

出版信息

Am J Drug Alcohol Abuse. 2019;45(6):623-643. doi: 10.1080/00952990.2019.1569668. Epub 2019 Mar 14.

Abstract

Due to significant comorbidity and impairment associated with cannabis use and cannabis use disorder, understanding time trends in cannabis use and cannabis use disorder is an important public health priority. To identify trends in cannabis use and cannabis use disorder overall, and by sociodemographic subgroup. Narrative review of published findings on trends in cannabis use and cannabis use disorders in data from repeated cross-sectional US general population surveys. In addition, in National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2002-2002) and NESARC-III (2012-2013) data, logistic regression was used to examine whether trends differed between subgroups of adults. The review showed that in adults, cannabis use increased over the past decade overall and within sociodemographic subgroups (gender, age, race/ethnicity, income, education, marital status, urbanicity, region, pregnancy status, disability status), with greater increases in men and disabled adults. Most sources also indicated significant increases in cannabis use disorders. New analysis showed significantly greater increases in adult cannabis use and cannabis use disorder in men ( ≤ .0001); young adults ( < .05); Blacks (vs. Whites, < .01); low income groups ( < .001); never-married ≤ .0001), and urban residents ( < .05). In adolescents, cannabis use generally decreased, although recent increases were observed in older and non-White adolescents. Cannabis use and cannabis use disorder are increasing in adults, with specific sociodemographic groups at higher risk, and may be increasing in some adolescent subgroups. Studies should determine mechanisms for differential trends to provide information to policymakers and enable informed decisions on cannabis legalization and service planning.

摘要

由于与大麻使用和大麻使用障碍相关的显著合并症和功能障碍,了解大麻使用和大麻使用障碍的时间趋势是一个重要的公共卫生优先事项。为了确定总体上以及按社会人口统计学亚组划分的大麻使用和大麻使用障碍的趋势。对来自美国重复横断面一般人群调查的数据中关于大麻使用和大麻使用障碍趋势的已发表研究结果进行叙述性综述。此外,在国家酒精流行病学调查和相关条件(NESARC;2002-2002 年)和 NESARC-III(2012-2013 年)数据中,使用逻辑回归检查趋势是否在成年亚组之间存在差异。综述结果表明,在过去十年中,总体上和在社会人口统计学亚组(性别、年龄、种族/民族、收入、教育、婚姻状况、城市、地区、妊娠状况、残疾状况)中,大麻使用呈上升趋势,男性和残疾成年人的增幅更大。大多数来源还表明大麻使用障碍显著增加。新分析显示,男性(≤.0001);年轻人(<.05);黑人(与白人相比,<.01);低收入群体(<.001);未婚者(≤.0001)和城市居民(<.05)的成年人大麻使用和大麻使用障碍增加幅度显著更大。在青少年中,大麻使用普遍减少,尽管最近观察到年龄较大和非白人青少年的使用有所增加。大麻使用和大麻使用障碍在成年人中呈上升趋势,特定社会人口统计学群体的风险更高,并且在某些青少年亚组中可能也在增加。研究应确定差异趋势的机制,为决策者提供信息,并为大麻合法化和服务规划做出明智决策提供依据。

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