CTN-0065-Ot: Evaluation of Drug Screening Implementation in Primary Care
Katharine Bradley, MD, MPH
Group Health Research Institute
Recent trials of screening and brief intervention for drug use have no demonstrated benefit compared to screening alone. However, the value of screening for drug use, compared to no screening, has not been evaluated. Screening for drug use may identify patients with drug use disorders who might need more intensive treatments than brief intervention. In states where marijuana use is now legal for recreation, as well as medical uses, clinicians want to be aware of and assess risks of marijuana use. Further, little is known about the predictive validity of screens for marijuana and/or drug use/misuse for subsequent adverse health outcomes. To that end, this study seeks to evaluate implementation of drug screening in primary care to: 1) describe rates of drug and marijuana screening, and positive screens, as well as barriers and facilitators to population-based screening; 2) assess changes in rates of assessment and identification; and 3) assess whether drug and marijuana use is associated with increased subsequent urgent care, ED, and hospitalization.
Among patients who completed the cannabis use question (n=22,095; 74%of eligible patients)15.3% (14.8-15.8%) reported any past-year use: 12.2% (11.8-12.6%) less than daily, and 3.1% (2.9-3.3%) daily. Among 2,228 patients aged 18-29 years, 36% (34-38%) reported any cannabis use and 8.1% (7-9.3%) daily use. Daily cannabis use was common among men aged 18-29 years who used tobacco or screened positive for depression: 25.5% (18.8-32.1%) and 31.7% (23.3-40%), respectively. Cannabis use was common in adult primary care patients, especially among younger patients and those with behavioral health conditions. Results highlight the need for primary care approaches to address cannabis use.
Results Article: Lapham G, et al. Frequency of Cannabis Use among Primary Care Patients in Washington State. Journal of the American Board of Family Medicine 2017;30(6):795-805. [get article]
All Participating Nodes: