Prevalence of behavioral health conditions across frequency of cannabis use among adult primary care patients in Washington State.
Cannabis is the third most commonly used drug in the USA, after alcohol and tobacco, and the prevalence of cannabis use and cannabis use disorders (CUD) has doubled in the last decade, due in part to increasingly legalized access. Individuals who use cannabis have increased risk of behavioral health conditions, including depression, anxiety, and tobacco, alcohol, and other substance use disorders, but little is known about the association between frequency of cannabis use and behavioral health conditions among primary care patients. This population-based study of primary care patients reports on the prevalence of common behavioral health conditions across cannabis use frequency.
Using electronic health record data collected as part of CTN-0065 in a large health system in Washington State, Kaiser Permanente Washington, cannabis frequency was categories into three levels of past-year use: none, less than daily, and daily. Other behavioral health conditions identified through screening included depression symptoms, unhealthy alcohol use, and any illicit drug and/or medication misuse. Also assessed in the year prior to the screen were EHR-documented tobacco use and composite indicators for both mental health and substance use disorder diagnoses.
Analysis revealed a strong association between the frequency of cannabis use and tobacco use, depression symptoms, and other drug use, as well as diagnosed mental health and substance use disorders. Tobacco and unhealthy alcohol use were most common among young adult patients who reported daily and any past-year cannabis use, respectively. Among patients who used cannabis daily, nearly 50% reported depression symptoms and more than 35% had a past-year mental health disorder diagnosis.
Conclusions: Asking about the frequency of cannabis use as part of routine behavioral health screening primary care, in a state with legalized use, identifies patients at increased risk for substance use and mental health conditions.
Related protocols: CTN-0065