Identifying Risk Factors for Marijuana Use Among Veterans Affairs Patients

Abstract

Objectives Cannabis is the most widely used drug in the United States, and its use carries negative health consequences; however, universal screening for cannabis use is cumbersome. If data commonly collected in the primary care setting (eg, use of alcohol, smoking status, and depression symptoms) could predict cannabis use, then providers can implement targeted marijuana screening in high-risk groups. Methods We reviewed Behavioral Health Laboratory data collected between 2003 and 2006 from 5512 patients referred by Veterans Affairs primary care clinics for potential mental health needs. Logistic regression was used to determine the predictors of past year marijuana use. Results A total of 11.5% of the sample reported using marijuana in the past year. Age, gender, other drug use, presence of alcohol use disorders, smoking status, depressive disorders, posttraumatic stress disorder, anxiety disorders, and psychotic symptoms, individually, were associated with the patients’ use of marijuana during the past year. When controlling for age, race, and gender in a logistic regression analyses, only other drug use, alcohol use disorder, and smoking status were linked to past year marijuana use. Patients were 5.4 (95% confidence interval [CI] 4.3–6.7) times more likely to have used marijuana during the past year if they used another illicit drug during the past year. Those with alcohol use disorder diagnosis or current smokers were 2.3 (95% CI 1.9–2.8) and 1.5 times (95% CI 1.3–1.7), respectively, more likely to have used marijuana during the past year. Receiver operating characteristic curve (area under curve = 0.79) represents good sensitivity and specificity of the model, correctly classifying 88.4% of the past year marijuana users. Conclusion Identifying patients at high risk for cannabis use may facilitate targeted screening and provision of interventions in primary care. Patients who screen positive for cigarette use, alcohol abuse or dependence, or have evidence of other illicit drug use could be considered for cannabis screening.

Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.

“…Past six month prevalence rates in the current study (14.6%) were slightly higher than the past year prevalence found in previous research (11.5%; Goldman et al, 2010), which may be attributable to differences in the sample composition, including the exclusion of female participants, as well as the possibility that individuals presenting to a PTSD specialty clinic may show more severe anxiety and mood symptoms than those being referred from primary care. Further, a large percentage (27.6%) of participants who reported cannabis use in the present study reported daily use.…”

“…The purpose of the present study was to extend Goldman and colleagues’ (2010) findings by examining the prevalence of cannabis use and its psychological and functional correlates among a large sample of veterans seeking treatment at a VA PTSD specialty clinic.…”

“…Age, gender, other past year drug use, presence of alcohol use disorders, smoking status, depressive disorders, PTSD, anxiety disorders, and psychotic symptoms were each found to independently predict veterans’ cannabis use over the past year. After adjusting for demographic variables (age, race, and gender), only other substance use including past year drug use, alcohol use disorders, and cigarette use remained associated with past year cannabis use (Goldman et al, 2010). …”

Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans

“…Moreover, heavy cannabis use (i.e., cannabis use on 20 or more days during the past month) increased by nearly 60% in the U.S. from 2007 to 2013 (SAMHSA, 2014). Such findings are important because cannabis use has been associated with a wide range of health problems (e.g., Goldman et al, 2010; Joshi et al, 2014). To date, however, there has been only limited attention paid to the relationship between cannabis use and suicidal behavior.…”

Comparing adults who use cannabis medically with those who use recreationally: Results from a national sample

“…Prior studies have found a number of risk factors and correlates for cannabis use in general, including male gender, psychiatric conditions (4, 5) and other substance use (6). Nonetheless, there has only been limited research examining differences between those who use cannabis for medical versus recreational purposes.…”