Cannabis Use and Health among VHA Primary Care Patients

VHA 初级保健患者的大麻使用和健康状况

• 批准号: 9907863
• 负责人: KIPLING M BOHNERT
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-05-01 至 2021-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9907863
• 关键词: Address; Age; Alcohol or Other Drugs use; Awareness; Cannabis; Certification; Clinical Practice Guideline; Data; District of Columbia; Health; Individual; Intervention; Interview; Laws; Legal; Link; Medical; Medical Marijuana; Medical center; Mental Health; Mental disorders; Methods; Michigan; Military Personnel; Monitor; Nature; Opioid; Outcome; Pain; Patient Care; Patients; Pattern; Pharmaceutical Preparations; Policies; Population; Post-Traumatic Stress Disorders; Primary Health Care; Provider; Qualifying; Reporting; Research; Rural Population; Sampling; Schedule; Services; Subgroup; Substance Use Disorder; Suburban Population; Symptoms; Time; United States; Urban Population; Veterans; Visit; chronic pain; cohort; comparison group; follow-up; health administration; health record; illicit drug use; innovation; marijuana use; marijuana use disorder; patient population; screening; service member; service utilization; sex; social

Background: Although more than 1 million Veterans regularly use cannabis (i.e., have used cannabis within the past month), only limited research has investigated cannabis use among Veterans Health Administration (VHA) patients. Furthermore, existing health records do not ascertain use that is below the threshold of a cannabis use disorder, suggesting that a substantial portion of patients who regularly use cannabis are not documented or monitored by their VHA providers. This absence of data is concerning given the links between cannabis use and adverse physical, mental health, and social outcomes. Such consequences may be even more pronounced among certain population subgroups, including those with psychiatric illnesses, which are overrepresented in the VHA patient population. Despite potential harms, some patients who use cannabis report that it is beneficial for the management of chronic pain, posttraumatic stress disorder (PTSD), and other illnesses, and 23 States and the District of Columbia have legalized the use of cannabis for individuals with qualifying medical conditions. Research is needed to characterize and understand patterns of cannabis use and how they relate to health, functioning, and service utilization among VHA primary care patients. Objectives: 1) To characterize cannabis use among a representative sample of VHA primary care patients; 2) To examine the extent to which cannabis use is associated with psychoactive medication use (e.g., opiates and other psychotropics), substance use, substance use disorder symptoms, mental health symptoms (e.g., PTSD), pain, functioning, and treatment utilization among a cross-sectional sample of patients with regular cannabis and those with no past-year use; 3) To identify cannabis use and cannabis use disorder symptom trajectories at 6- and 12-months following an initial primary care visit; 4) To longitudinally estimate associations between cannabis trajectory groups and psychoactive medication use (e.g., opiates and other psychotropics), substance use, substance use disorder symptoms, mental health symptoms (e.g., PTSD), pain, functioning, and treatment utilization. A secondary aim is to compare use, trajectories, and outcomes between those with and without State-issued medical cannabis certification to examine how patients with medical cannabis certification differ from those without it in the nature and extent of cannabis use and problems. Methods: To achieve these objectives, the proposed project will screen Veterans receiving primary care at 3 VAMCs in Michigan. Through screening the project will identify a group of 500 patients with regular cannabis use, defined as at least monthly use during the past year, and an age- and sex-matched comparison group of 500 Veterans without past-year cannabis use. Both groups will complete an in-depth cross-sectional baseline interview. Following screening and baseline, the 500 patients with regular cannabis use will comprise a cohort that will be re-assessed at 6- and 12-months follow-up to identify cannabis use and cannabis use disorder symptom trajectories and related health, functioning, and service utilization outcomes.

背景：虽然有100多万退伍军人经常使用大麻（即在美国境内使用过大麻）