Symptoms—Not Frequency of Use—Predict Adverse Health Effects Associated with Cannabis Use in Young Men

Cannabis is the most commonly used illicit drug, and its health effects continue to be debated. This prospective cohort study examined cannabis use and self-reported health issues among 5084 men in their early twenties over an average of 15 months follow-up. Researchers used the Cannabis Use Disorder Identification Test (CUDIT) to measure symptoms of cannabis use disorder; the Major Depressive Inventory to measure depression; and the Short-Form Health Survey (SF-12) to measure physical and mental health. Health consequences included accident/injury, emergency department admission, suicide attempt, need for medical treatment, overnight hospitalization, and outpatient surgery.

• Of all participants, 62% reported no cannabis use; 23% had continuing use throughout the study; 8% initiated use during the follow-up period; and 7% had use at baseline and then stopped.
• Among the 1149 participants who continued cannabis use, 49% reported monthly use or less, and 16% daily or almost daily. They averaged 7 symptoms of cannabis use disorder on the CUDIT.
• In cross-lagged longitudinal models, the number of symptoms of cannabis use disorder—not the frequency of use—predicted depression, other mental health, and physical health consequences over follow-up.

Comments:

Without intervention, the pattern of cannabis use is stable among young men and daily use is common. In assessing the risk of developing health problems, a formal assessment of the number of symptoms of cannabis use disorder has greater prognostic value than the frequency or magnitude of cannabis use. Whether these findings generalize to women and more diverse populations, and how to use them in a targeted intervention, will require further study.

Peter D. Friedmann, MD, MPH

Reference:

Baggio S, N’Goran AA, Deline S, et al. Patterns of cannabis use and prospective associations with health issues among young males. Addiction. 2014;109(6):937–945.