October 16, 2023 from Medscape
The enactment of medical and recreational cannabis laws in the United States has sparked a significant increase in the prevalence of cannabis use disorder (CUD), particularly among older adults experiencing chronic pain, according to a recent study involving US veterans.
Researchers aimed to investigate the reported surge in CUD prevalence among adults with chronic pain by assessing the impact of both medical cannabis laws (MCL) and recreational cannabis laws (RCL) on the US Veterans Health Administration (VHA).
The study analyzed 15 repeated cross-sectional VHA electronic health record datasets spanning from 2005 to 2019, with 3.2 to 4.6 million patients included each year. Patients were categorized based on chronic pain status using validated criteria.
Findings from the study revealed that the associations of MCL and RCL with CUD prevalence were more pronounced among patients with chronic pain compared to those without the condition. Enacting MCL resulted in a 0.135% absolute increase in CUD prevalence among patients with chronic pain, with 8.4% directly attributable to MCL.
Meanwhile, enacting RCL led to a 0.188% absolute increase in CUD prevalence among patients with chronic pain, and 11.5% of the total increase was due to RCL. Notably, the introduction of RCL had the most significant impact on CUD prevalence among patients aged 65–75 years with chronic pain.
The authors of the study underscored the importance of considering unintended consequences when developing cannabis legislation, especially the increased risk of cannabis use disorder in vulnerable populations like patients with chronic pain. The findings highlight a growing need, particularly within the Veterans Health Administration and beyond, to screen for cannabis use and offer evidence-based treatments for cannabis use disorder.
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