Association between cannabis use disorder symptom severity and probability of clinically-documented diagnosis and treatment in a primary care sample.
Drug Alcohol Depend
; 251: 110946, 2023 10 01.
Article
em En
| MEDLINE
| ID: mdl-37688980
ABSTRACT
BACKGROUND:
Brief cannabis screening followed by standardized assessment of symptoms may support diagnosis and treatment of cannabis use disorder (CUD). This study tested whether the probability of a medical provider diagnosing and treating CUD increased with the number of substance use disorder (SUD) symptoms documented in patients' EHRs.METHODS:
This observational study used EHR and claims data from an integrated healthcare system. Adult patients were included who reported daily cannabis use and completed the Substance Use Symptom Checklist, a scaled measure of DSM-5 SUD symptoms (0-11), during routine care 3/1/2015-3/1/2021. Logistic regression estimated associations between SUD symptom counts and 1) CUD diagnosis; 2) CUD treatment initiation; and 3) CUD treatment engagement, defined based on Healthcare Effectiveness Data and Information Set (HEDIS) ICD-codes and timelines. We tested moderation across age, gender, race, and ethnicity.RESULTS:
Patients (N=13,947) were predominantly middle-age, male, White, and non-Hispanic. Among patients reporting daily cannabis use without other drug use (N=12,568), the probability of CUD diagnosis, treatment initiation, and engagement increased with each 1-unit increase in Symptom Checklist score (p's<0.001). However, probabilities of diagnosis, treatment, and engagement were low, even among those reporting ≥2 symptoms consistent with SUD 14.0% diagnosed (95% CI 11.7-21.6), 16.6% initiated treatment among diagnosed (11.7-21.6), and 24.3% engaged in treatment among initiated (15.8-32.7). Only gender moderated associations between Symptom Checklist and diagnosis (p=0.047) and treatment initiation (p=0.012). Findings were similar for patients reporting daily cannabis use with other drug use (N=1379).CONCLUSION:
Despite documented symptoms, CUD was underdiagnosed and undertreated in medical settings.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Cannabis
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Abuso de Maconha
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Transtornos Relacionados ao Uso de Substâncias
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Alucinógenos
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article