Summary
Despite the changing legal status of cannabis and the potential impact on health, few health systems routinely screen for cannabis use. Data on the epidemiology of cannabis use, and especially medical cannabis use among primary care patients, are limited.
Researchers study the prevalence of, factors associated with, and reasons for past–3 month cannabis use reported by primary care patients. This study used electronic health record data from patients aged 18 years and older who had an annual wellness visit between January 2021 and May 2023 from a primary care clinic within a university-based health system in Los Angeles, California. Cannabis use was assessed using the Alcohol Substance Involvement Screening Test (ASSIST). Patients were also asked about reasons for use, symptoms for which they used cannabis, and mode of use.
Findings: Among the 175,734 patients screened, the median (range) age was 47 years; 58.0% were female; 15.7% were Asian, 13.7% were Hispanic, and 31.7% were white. Cannabis use was reported by 17.0% with 34.7% having ASSIST scores indicative of moderate to high risk for cannabis use disorder (CUD). Prevalence of cannabis use was higher among male patients than female patients and younger patients (18-29 years), and lower among those who lived in the most disadvantaged neighborhoods. The most common modes of use included edibles, smoking, and vaporizing. While 4,375 patients who reported using cannabis (15.6%) did so for medical reasons only, 75.7% of patients reported using cannabis to manage symptoms including pain (31.7%), stress (50.2%), and sleep (56.0%).
In this study, cannabis use and risk of CUD were common, and more than three-quarters of patients who reported any cannabis use reported doing so to manage a health-related symptom. These findings suggest that integration of information regarding cannabis use for symptom management could help provide a crucial point-of-care opportunity for clinicians to understand their patients’ risk for CUD.