The prevalence of cannabis use in the general U.S. population more than doubled in the period between 2002 and 2011. In 2002, 4.5% of the adult population reported having used cannabis, whereas in 2011 this was the case for 9.5% of the population. One-third of all adults aged 18 to 34 have tried cannabis in their lifetimes.
Less known are the changes in cannabis use among medical patients. Given the increasingly widespread focus on the plant's medical properties, as well as concerns voiced over its safety, it is important to understand how the drug is affecting the health patient population.
To better understand this issue, Dr. Paris Charilaou and colleagues from the Rutgers/Saint Peter’s University Hospital in New Jersey dived into a gigantic clinical database and returned with a handful of interesting findings. Their report can be retrieved from the American Journal of Medicine.
The team analyzed information of nearly 300 million hospitalization cases spanning for over a decade, which represents faithfully about 95% of the U.S. population. They focused on cannabis-related diagnoses that were either the main condition or a secondary problem to another disease.
Between 2002 and 2011, a total of 2,833,567 (0.91%) adults admitted into a hospital were diagnosed with cannabis abuse or dependence. The proportion of patients with these conditions increased three times during this period (from 0.52% in 2002 to 1.34% in 2011).
As expected, the majority of the patients with cannabis-related diagnosis were male (62.5%). Interestingly, the sharpest increases were observed among the richest and poorest patients, whereas the middle class showed a steady decrease year after year. Ethnic prevalences were more or less stable, with the exception of a notable increase by Native Americans.
The conditions most commonly shared with cannabis abuse or dependence were alcoholism (28.1%), chronic lung disease (13.8%), psychosis (10.7%) and depression (10.2%). Of all associated conditions, only alcoholism decreased throughout the decade, possibly reflecting a substitution effect.
On the other hand, psychiatric comorbidities rose steadily among these patients. For instance, PTSD diagnosis associated with cannabis disorders jumped from 2.59% to 4.18%. It seems that a non-negligible share of the PTSD population is having problems with cannabis, maybe in an attempt at self-medication.
Cannabis use problems were also prevalent among chronic pain patients. The authors used chronic pancreatitis to illustrate this situation. Compared to other patients, those diagnosed with pancreatitis were 1.5 times more likely to also have a cannabis abuse or dependence problem. Interestingly, these patients also tended to leave the hospital sooner and save on health costs, which the authors argue is an evidence that cannabis is being used as a pain relief alternative.
Finally, the researchers discuss the associations between cannabis-related diagnoses and respiratory conditions. They detected a steep increase (1.7 times) in asthma prevalence among cannabis abusers from 2002 to 2011, that was exclusive to non-tobacco smokers. The authors make sense of these findings by arguing that the effect of cannabis smoke on respiratory conditions is significant but much less so than that of tobacco smoke. Overall, this finding aligns with an emerging awareness of cannabis’ potential allergenic properties.
The report succeeds in raising awareness for cannabis use problems among the health patient population. It is paramount that health policies are put in place to address these issues if cannabis is to continue its march into legalization and mainstream medicine.