Cannabis use disorders among adults in the United States during a time of increasing use of cannabis
Cannabis use disorders among adults in the United States during a time of increasing use of cannabis
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DOI：
10.1016/j.drugalcdep.2019.05.008
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发表时间：
2019-11-01
影响因子：
4.2
通讯作者：
Blanco, Carlos
中科院分区：
文献类型：
--
作者：
Compton, Wilson M.;Han, Beth;Blanco, Carlos
背景：研究人员利用美国国家药物使用和健康调查（NSDUH）数据发现，近年来成年人大麻使用流行率有所增加，但 DSM-IV 大麻使用障碍（CUD）流行率保持稳定。检查所有个人 CUD 标准和 CUD 严重程度的趋势可能会阐明 CUD 缺乏增加的原因。方法：数据来自参加 2002-2017 年 NSDUH 的 749,500 名 18 岁或以上的人。应用描述性分析和逻辑回归。结果：在2002-2017年的成年人中，过去一年DSM-IV CUD的患病率稳定在1.5%至1.4%，但大麻使用从10.4%增加到15.3%，每天/接近每天使用从1.9%增加到4.2%，轻度DSM-5 CUD从1.4%增加到1.9%。在成年大麻使用者中，去年 DSM-IV CUD 患病率从 14.8% 下降至 9.3%，每日/近每日使用率从 18.0% 上升至 27.2%，DSM-5 中度（4-5 标准）和重度（6+ 标准） CUD 分别从 4.3% 下降至 3.1% 和从 2.4% 下降至 1.3%。对 2002 年至 2017 年成人个人 CUD 标准趋势的审查总体显示，两项标准（耐受性；花费大量时间获取/使用大麻或克服大麻效应）有所增加，而其他标准则有所减少/没有变化；在成年大麻使用者中，一项标准（耐受性）没有变化，其他标准有所下降。结论：DSM-5 的单一维度 CUD 测量可能比单独的 DSM-IV 大麻依赖和滥用类别对诊断患病率变化更敏感。未来评估 CUD 的诊断方法可能会受益于定量标准。
Background: Using U.S. National Surveys on Drug Use and Health (NSDUH) data, researchers found that prevalence of cannabis use among adults increased in recent years, but prevalence of DSM-IV cannabis use disorder (CUD) was stable. Examining trends of all individual CUD criteria and of CUD severity may elucidate reasons for the lack of increases in CUD.Methods: Data were from 749,500 persons aged 18 or older who participated in the 2002-2017 NSDUH. Descriptive analyses and logistic regressions were applied.Results: Among adults during 2002-2017, past-year prevalence of DSM-IV CUD remained stable at 1.5% to 1.4%, but cannabis use increased from 10.4% to 15.3%, daily/near daily use increased from 1.9% to 4.2%, and mild DSM-5 CUD increased from 1.4% to 1.9%. Among adult cannabis users, past-year prevalence of DSM-IV CUD decreased from 14.8% to 9.3%, daily/near daily use increased from 18.0% to 27.2%, and DSM-5 moderate (4-5 criteria) and severe (6+ criteria) CUD decreased from 4.3% to 3.1% and from 2.4% to 1.3%, respectively. Examining trends in individual CUD criteria during 2002-2017 among adults overall revealed increases in two criteria (tolerance; spending a lot of time getting/using cannabis or getting over cannabis effects) and decreases/no changes in other criteria; among adult cannabis users, there was no change in one criterion (tolerance) and decreases in other criteria.Conclusions: DSM-5's single dimension CUD measure may be more sensitive to diagnosis prevalence changes than the separate DSM-IV cannabis dependence and abuse categories. Future diagnostic approaches to assessing CUD may benefit from quantitatively oriented criteria.