Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (LRS, MSC); Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA (AS, MT); Psychiatry, Virginia Commonwealth University, Richmond, VA (MT).
J Addict Med. 2020 Jul/Aug;14(4):e29-e36. doi: 10.1097/ADM.0000000000000586.
This study aims to evaluate changes in cannabis use patterns, referral sources, and admissions in adolescents and young adults (YAs). As the United States increasingly moves toward liberalization of cannabis laws, it is critical to have baseline information of use patterns in this population.
Data were drawn from Treatment Episode Data Set-Admissions (TEDS-A) for adolescents (12-17 years) and young adults (18-24 years) entering treatment from 1992 to 2016 for primary cannabis use (N = 3,794,213). Rao-Scott chi-square tests were used to test for significant changes in proportions of individuals admitted to treatment for primary cannabis use and between 4-year increments from 1992 to 2016 (N = 1,052,724). Logistic regression assessed odds of admissions for primary cannabis use versus other substances.
Treatment admissions for cannabis among adolescents/YAs rose 3-fold from 1992 (49,996) to 1996 (125,858). The majority of referrals came from the criminal justice system (56%). Cannabis is increasingly the sole substance of use, with polysubstance use decreasing from 89% in 1992 to 59% in 2016. While alcohol-related treatment admissions were most common in 1992, admissions for treatment of cannabis use (followed by heroin and alcohol) were highest (38%) by 2016. Being an adolescent (odds ratio [OR] 3.1, 95% confidence interval [CI] 3.1-3.2), non-Hispanic black (OR 6.2, 95% CI 6.2-6.3), male (female OR 0.6, 95% CI 0.6-0.6) with co-occurring alcohol use (OR 25.9, 95% CI 25.7-26.1) was associated with admission for treatment of primary cannabis use as compared with other substances.
Public health efforts will be needed to ensure ongoing access and referral to treatment as the legal status of cannabis continues to change. Prevention and treatment efforts should target co-occurring alcohol and cannabis use.
本研究旨在评估青少年和年轻人（YAs）中大麻使用模式、转介来源和入院情况的变化。随着美国越来越倾向于大麻合法化，了解该人群的使用模式基线信息至关重要。
数据来自 1992 年至 2016 年期间因初次大麻使用而接受治疗的青少年（12-17 岁）和年轻人（18-24 岁）的治疗情节数据集-入院（TEDS-A）（N=3,794,213）。使用 Rao-Scott 卡方检验来检验 1992 年至 2016 年期间每 4 年递增一次的因初次大麻使用而接受治疗的个体比例的显著变化（N=1,052,724）。逻辑回归评估初次大麻使用与其他物质的入院治疗几率。
青少年/年轻人因大麻而接受治疗的入院人数从 1992 年的 49,996 人增加到 1996 年的 125,858 人，增加了 3 倍。大多数转介来自刑事司法系统（56%）。大麻的使用越来越单一，多物质使用从 1992 年的 89%下降到 2016 年的 59%。虽然 1992 年酒精相关治疗入院人数最多，但 2016 年治疗大麻使用（其次是海洛因和酒精）的入院人数最高（38%）。与其他物质相比，青少年（优势比[OR]3.1，95%置信区间[CI]3.1-3.2）、非西班牙裔黑人（OR 6.2，95% CI 6.2-6.3）、男性（女性 OR 0.6，95% CI 0.6-0.6），同时伴有酒精使用（OR 25.9，95% CI 25.7-26.1）与初次大麻使用治疗入院有关。
随着大麻的法律地位继续变化，需要开展公共卫生工作，以确保持续获得和转介治疗。预防和治疗工作应针对同时存在的酒精和大麻使用。
