Seventeen percent of patients in a large university-based health system in Los Angeles reported using cannabis in the past three months, according to a recent study published in JAMA Network Open. The study also found that 34.7% of these users had a moderate to high risk for cannabis use disorder.
The cross-sectional study included 175,734 patients aged 18 and older who had an annual wellness visit between January 2021 and May 2023. Among the patients screened, the median age was 47 years, and the majority were female (58.0%). Cannabis use was more prevalent among younger patients and those living in less socioeconomically disadvantaged neighborhoods.
Patients were assessed using the Alcohol Substance Involvement Screening Test (ASSIST). The findings indicated that 31.0% of patients aged 18-29 years reported cannabis use, compared to 8.5% of those aged ≥ 60 years. Additionally, male patients had a higher prevalence of use (20.0%) than female patients (14.7%).
The study also explored the reasons for cannabis use. Among those who reported using cannabis, 75.7% cited symptom management as their primary reason, including stress (50.2%), sleep issues (56.0%), and pain (31.7%). Despite the majority using cannabis for health-related reasons, only 15.6% identified as strictly medical users.
The modes of cannabis use varied, with edibles being the most common (61.6%), followed by smoking (51.7%) and vaporizing (29.0%). The data suggested that ingestion modes were as prevalent as inhalation, contrasting with non-clinical population studies where inhalation dominates.
The study highlighted the need for routine cannabis screening in primary care settings, especially given the high levels of use and risk of cannabis use disorder (CUD). Integrating cannabis use screening for symptom management could provide essential insights for clinicians to address patients' health needs more effectively.
On the importance of discussing cannabis use with patients, “Not asking patients about their cannabis use results in a missed opportunity for opening up doctor-patient communication regarding use of cannabis generally and for management of their symptoms," the lead author Dr. Lillian Gelberg noted in a statement.
The study had some limitations, including reliance on self-reported data and the potential influence of the COVID-19 pandemic on cannabis use rates. Despite these limitations, the researchers underscored the significance of their findings for improving patient care in primary health settings.
Full disclosures can be found in the analysis.