• Gwen T Lapham, Amy K Lee, Ryan M Caldeiro, Dennis McCarty, Kendall C Browne, Denise D Walker, Daniel R Kivlahan, and Katharine A Bradley.
• From the Kaiser Permanent Washington Health Research Institute (formerly Group Health Research Institute) (GTL, AKL, KAB); Department of Health Services, University of Washington, Seattle, WA (GTL, KAB); Behavioral Health Support Services, Kaiser Permanente Washington (formerly Group Health Cooperative), Seattle (RMC); Oregon Health & Science University (OHSU) - Portland State University School of Public Health, OHSU, Portland, OR (DM); Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System, Seattle (KCB, DRK); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (KCB, DRK); Innovative Programs Research Group, School of Social Work, University of Washington, Seattle (DDW); Health Services Research & Development VA Puget Sound Health Care System, Center of Innovation for Veteran-Centered Value-Driven Care, Seattle (DRK); Department of Medicine, University of Washington, Seattle (KAB). lapham.g@ghc.org.
• J Am Board Fam Med. 2017 Nov 1; 30 (6): 795805795-805.

IntroductionOver 12% of US adults report past-year cannabis use, and among those who use daily, 25% or more have a cannabis use disorder. Use is increasing as legal access expands. Yet, cannabis use is not routinely assessed in primary care, and little is known about use among primary care patients and relevant demographic and behavioral health subgroups. This study describes the prevalence and frequency of past-year cannabis use among primary care patients assessed for use during a primary care visit.MethodsThis observational cohort study included adults who made a visit to primary care clinics with annual behavioral health screening, including a single-item question about frequency past-year cannabis use (March 2015 to February 2016; n = 29,857). Depression, alcohol and other drug use were also assessed by behavioral health screening. Screening results, tobacco use, and diagnoses for past-year behavioral health conditions (e.g., mental health and substance use disorders) were obtained from EHRs.ResultsAmong patients who completed the cannabis use question (n = 22,095; 74% of eligible patients), 15.3% (14.8% to 15.8%) reported any past-year use: 12.2% (11.8% to 12.6%) less than daily, and 3.1% (2.9%-3.3%) daily. Among 2228 patients age 18 to 29 years, 36.0% (34.0% to 38.0%) reported any cannabis use and 8.1% (7.0% to 9.3%) daily use. Daily cannabis use was common among men age 18 to 29 years who used tobacco or screened positive for depression or used tobacco: 25.5% (18.8% to 32.1%) and 31.7% (23.3% to 40.0%), respectively.ConclusionsCannabis use was common in adult primary care patients, especially among younger patients and those with behavioral health conditions. Results highlight the need for primary care approaches to address cannabis use.© Copyright 2017 by the American Board of Family Medicine.

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