Titre : | US adult illicit cannabis use, cannabis use disorder, and medical marijuana laws: 1991-1992 to 2012-2013 (2017) |
Auteurs : | D. S. HASIN ; A. L. SARVET ; M. CERDA ; K. M. KEYES ; M. STOHL ; S. GALEA ; M. M. WALL |
Type de document : | Article : Périodique |
Dans : | JAMA Psychiatry (Vol.74, n°6, June 2017) |
Article en page(s) : | 579-588 |
Langues: | Anglais |
Discipline : | EPI (Epidémiologie / Epidemiology) |
Mots-clés : |
Thésaurus géographique ETATS-UNISThésaurus mots-clés CANNABIS ; EVOLUTION ; LEGISLATION ; USAGE THERAPEUTIQUE ; PREVALENCE ; MORBIDITE ; FACTEUR DE RISQUE ; ADULTE |
Résumé : |
ENGLISH:
Importance: Over the last 25 years, illicit cannabis use and cannabis use disorders have increased among US adults, and 28 states have passed medical marijuana laws (MML). Little is known about MML and adult illicit cannabis use or cannabis use disorders considered over time. Objective: To present national data on state MML and degree of change in the prevalence of cannabis use and disorders. Design, Participants, and Setting: Differences in the degree of change between those living in MML states and other states were examined using 3 cross-sectional US adult surveys: the National Longitudinal Alcohol Epidemiologic Survey (NLAES; 1991-1992), the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; 2001-2002), and the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III; 2012-2013). Early-MML states passed MML between NLAES and NESARC ("earlier period"). Late-MML states passed MML between NESARC and NESARC-III ("later period"). Main Outcomes and Measures: Past-year illicit cannabis use and DSM-IV cannabis use disorder. Results: Overall, from 1991-1992 to 2012-2013, illicit cannabis use increased significantly more in states that passed MML than in other states (1.4-percentage point more; SE, 0.5; P = .004), as did cannabis use disorders (0.7-percentage point more; SE, 0.3; P = .03). In the earlier period, illicit cannabis use and disorders decreased similarly in non-MML states and in California (where prevalence was much higher to start with). In contrast, in remaining early-MML states, the prevalence of use and disorders increased. Remaining early-MML and non-MML states differed significantly for use (by 2.5 percentage points; SE, 0.9; P = .004) and disorder (1.1 percentage points; SE, 0.5; P = .02). In the later period, illicit use increased by the following percentage points: never-MML states, 3.5 (SE, 0.5); California, 5.3 (SE, 1.0); Colorado, 7.0 (SE, 1.6); other early-MML states, 2.6 (SE, 0.9); and late-MML states, 5.1 (SE, 0.8). Compared with never-MML states, increases in use were significantly greater in late-MML states (1.6-percentage point more; SE, 0.6; P = .01), California (1.8-percentage point more; SE, 0.9; P = .04), and Colorado (3.5-percentage point more; SE, 1.5; P = .03). Increases in cannabis use disorder, which was less prevalent, were smaller but followed similar patterns descriptively, with change greater than never-MML states in California (1.0-percentage point more; SE, 0.5; P = .06) and Colorado (1.6-percentage point more; SE, 0.8; P = .04). Conclusions and Relevance: Medical marijuana laws appear to have contributed to increased prevalence of illicit cannabis use and cannabis use disorders. State-specific policy changes may also have played a role. While medical marijuana may help some, cannabis-related health consequences associated with changes in state marijuana laws should receive consideration by health care professionals and the public. FRANÇAIS : Une légalisation autorisant l'usage médical de la marijuana pourrait favoriser son utilisation illicite. Une analyse des données provenant de trois enquêtes nationales aux États-Unis a révélé une augmentation plus importante de l'utilisation illégale de la marijuana dans les États qui avaient adopté les lois sur la marijuana médicale (MML) par rapport aux États qui n'avaient pas légalisé la marijuana médicale. L'augmentation de l'utilisation illicite de la marijuana et des troubles de l'utilisation de la marijuana était de 1,4 pour cent et 0,7 pour cent plus élevée, respectivement, dans les États qui avaient légalisé la marijuana médicale, par rapport aux états qui n'avaient pas de MML. Dans les États qui ont passé des MML, les médecins peuvent prescrire le médicament pour aider à traiter un certain nombre de pathologies, y compris la douleur, des nausées liées à la chimiothérapie, des troubles épileptiques et un manque d'appétit et de perte de poids en raison d'une maladie chronique. [Actualités des addictions, 15/05/2017] |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 85 |
Affiliation : | Department of Psychiatry, Columbia University Medical Center, New York, New York, USA |
Lien : | http://dx.doi.org/10.1001/jamapsychiatry.2017.0724 |
