Center of Excellence in Substance Addiction Treatment and Education, Corporal Michael J. Crescenz VA Medical Center, Philadelphia (Browne, Saxon); Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Healthcare System, Seattle (Browne); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Browne, Saxon); New York State Psychiatric Institute, New York (Stohl, Fink, Olfson, Hasin); Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, and VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor (Bohnert); Department of Epidemiology, Columbia University Mailman School of Public Health, New York (Fink, Olfson, Martins, Hasin); Department of Psychiatry, Columbia University Medical Center, New York (Olfson, Hasin); Department of Population Health, New York University, New York (Cerda, Sherman); Department of Epidemiology, Boston University, Boston (Gradus).
Am J Psychiatry. 2022 Jan;179(1):26-35. doi: 10.1176/appi.ajp.2021.20081202. Epub 2021 Aug 19.
The authors sought to estimate the prevalence of past-12-month and lifetime cannabis use and cannabis use disorder among U.S. veterans; to describe demographic, substance use disorder, and psychiatric disorder correlates of nonmedical cannabis use and cannabis use disorder; and to explore differences in cannabis use and cannabis use disorder prevalence among veterans in states with and without medical marijuana laws.
Participants were 3,119 respondents in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) who identified as U.S. veterans. Weighted prevalences were calculated. Logistic regression analyses tested associations of nonmedical cannabis use and cannabis use disorder with demographic and clinical correlates and examined whether prevalence differed by state legalization status.
The prevalences of any past-12-month cannabis use and cannabis use disorder were 7.3% and 1.8%, respectively. Lifetime prevalences were 32.5% and 5.7%, respectively. Past-12-month and lifetime cannabis use disorder prevalence estimates among nonmedical cannabis users were 24.4% and 17.4%, respectively. Sociodemographic correlates of nonmedical cannabis use and use disorder included younger age, male gender, being unmarried, lower income, and residing in a state with medical marijuana laws. Nonmedical cannabis use and use disorder were associated with most psychiatric and substance use disorders examined.
Among veterans, the odds of nonmedical cannabis use and use disorder were elevated among vulnerable subgroups, including those with lower income or psychiatric disorders and among survey participants residing in states with medical marijuana laws. The study findings highlight the need for clinical attention (e.g., screening, assessment) and ongoing monitoring among veterans in the context of increasing legalization of cannabis.
作者旨在估计美国退伍军人过去 12 个月和终身大麻使用及大麻使用障碍的流行率；描述非医疗大麻使用和大麻使用障碍与人口统计学、物质使用障碍和精神障碍的相关性；并探讨有和没有医用大麻法律的州的退伍军人中，大麻使用和大麻使用障碍的流行率差异。
参与者为 2012-2013 年全国酒精相关情况流行病学调查-III（NESARC-III）中的 3119 名美国退伍军人。计算了加权流行率。逻辑回归分析测试了非医疗大麻使用和大麻使用障碍与人口统计学和临床相关性的关联，并检查了流行率是否因州合法化状况而有所不同。
任何过去 12 个月的大麻使用和大麻使用障碍的流行率分别为 7.3%和 1.8%。终身流行率分别为 32.5%和 5.7%。非医疗大麻使用者过去 12 个月和终身大麻使用障碍的患病率估计分别为 24.4%和 17.4%。非医疗大麻使用和使用障碍的社会人口统计学相关性包括年龄较小、男性、未婚、收入较低以及居住在有医用大麻法律的州。非医疗大麻使用和使用障碍与大多数检查的精神和物质使用障碍有关。
在退伍军人中，非医疗大麻使用和使用障碍的可能性在弱势群体中较高，包括收入较低或患有精神障碍的人群，以及居住在有医用大麻法律的州的调查参与者。研究结果强调了在大麻合法化不断增加的背景下，临床需要关注（例如，筛查、评估）和持续监测退伍军人。
