Dataset Information

Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

ABSTRACT:

Background

Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs.

Methods

Data are from the World Mental Health Surveys Initiative and the National Latino and Asian American Study, with probability samples in Mexico (n = 4426), Colombia (n = 5,782) and the United States (USA; n = 8,228). The samples included 212 'cannabis only' users in Mexico, 260 in Colombia and 1,724 in the USA. Conditional GLM with GEE and 'exact' methods were used to estimate variation in the occurrence of clinically significant problems in cannabis only (CO) users across these surveyed populations.

Results

The experience of cannabis-related problems was quite infrequent among CO users in these countries, with weighted frequencies ranging from 1% to 5% across survey populations, and with no appreciable cross-national variation in general. CO users in Colombia proved to be an exception. As compared to CO users in the USA, the Colombia smokers were more likely to have experienced cannabis-associated 'social problems' (odds ratio, OR = 3.0; 95% CI = 1.4, 6.3; p = 0.004) and 'legal problems' (OR = 9.7; 95% CI = 2.7, 35.2; p = 0.001).

Conclusions

This study's most remarkable finding may be the similarity in occurrence of cannabis-related problems in this cross-national comparison within the Americas. Wide cross-national variations in estimated population-level cumulative incidence of cannabis use disorders may be traced to large differences in cannabis smoking prevalence, rather than qualitative differences in cannabis experiences. More research is needed to identify conditions that might make cannabis-related social and legal problems more frequent in Colombia than in the USA.

SUBMITTER: Fiestas F

PROVIDER: S-EPMC2863162 | biostudies-literature | 2010 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

Fiestas Fabian F Radovanovic Mirjana M Martins Silvia S SS Medina-Mora Maria E ME Posada-Villa Jose J Anthony James C JC

BMC public health 20100323

<h4>Background</h4>Epidemiological studies show wide variability in the occurrence of cannabis smoking and related disorders across countries. This study aims to estimate cross-national variation in cannabis users' experience of clinically significant cannabis-related problems in three countries of the Americas, with a focus on cannabis users who may have tried alcohol or tobacco, but who have not used cocaine, heroin, LSD, or other internationally regulated drugs.<h4>Methods</h4>Data are from t ...[more]

PMID: 20331880

Similar Datasets

Project description:BACKGROUND:Sleep disturbances are widespread among nursing home (NH) patients and associated with numerous negative consequences. Identifying and treating them should therefore be of high clinical priority. No prior studies have investigated the degree to which sleep disturbances as detected by actigraphy and by the sleep-related items in the Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory - Nursing Home version (NPI-NH) provide comparable results. Such knowledge is highly needed, since both questionnaires are used in clinical settings and studies use the NPI-NH sleep item to measure sleep disturbances. For this reason, insight into their relative (dis)advantages is valuable. METHOD:Cross-sectional study of 83 NH patients. Sleep was objectively measured with actigraphy for 7 days, and rated by NH staff with the sleep items in the CSDD and the NPI-NH, and results were compared. McNemar's tests were conducted to investigate whether there were significant differences between the pairs of relevant measures. Cohen's Kappa tests were used to investigate the degree of agreement between the pairs of relevant actigraphy, NPI-NH and CSDD measures. Sensitivity and specificity analyses were conducted for each of the pairs, and receiver operating characteristics (ROC) curves were designed as a plot of the true positive rate against the false positive rate for the diagnostic test. RESULTS:Proxy-raters reported sleep disturbances in 20.5% of patients assessed with NPI-NH and 18.1% (difficulty falling asleep), 43.4% (multiple awakenings) and 3.6% (early morning awakenings) of patients had sleep disturbances assessed with CSDD. Our results showed significant differences (p<0.001) between actigraphy measures and proxy-rated sleep by the NPI-NH and CSDD. Sensitivity and specificity analyses supported these results. CONCLUSIONS:Compared to actigraphy, proxy-raters clearly underreported NH patients' sleep disturbances as assessed by sleep items in NPI-NH and CSDD. The results suggest that the usefulness of proxy-rater measures of sleep may be questionable and further research is needed into their clinical value. The results highlight the need for NH staff to acquire and act on knowledge about sleep and sleep challenges among NH patients. TRIAL REGISTRATION:Registered at www.clinicaltrials.gov (registration number NCT02238652 ) on July 7th 2014 (6 months after study initiation).

Project description:BACKGROUND:The policy landscape regarding the legal status of cannabis (CAN) in the US and globally is changing rapidly. Research on CAN has lagged behind in many areas, none more so than in understanding how individuals suffering from the broad range of cannabis-related problems resolve those problems, and how their characteristics and problem resolution pathways are similar to or different from alcohol [ALC] or other drugs [OTH]. Greater knowledge could inform national policy debates as well as the nature and scope of any additional needed services as CAN population exposure increases. METHOD:National, probability-based, cross-sectional sample of the US non-institutionalized adult population was conducted July-August 2016. Sample consisted of those who responded "yes" to the screening question, "Did you used to have a problem with alcohol or drugs but no longer do?" (63.4% response rate from 39,809 screened adults). Final weighted sample (N?=?2002) was mostly male (60.0% [1.53%]), aged 25-49 (45.2% [1.63%]), non-Hispanic White (61.4% [1.64%]), employed (47.7% [1.61%]). Analyses compared CAN to ALC and OTH on demographic, clinical, treatment and recovery support services utilization, and quality of life (QOL) indices. RESULTS:9.1% of the US adult population reported resolving a significant substance problem, and of these, 10.97% were CAN. Compared to ALC (M?=?49.79) or OTH (M?=?43.80), CAN were significantly younger (M?=?39.41, p?<?0.01), had the earliest onset of regular use (CAN M?=?16.89, ALC M?=?19.02, OTH M?=?23.29, p?<?0.01), and resolved their problem significantly earlier (CAN M?=?28.87, ALC M?=?37.86, OTH M?=?33.06, p?<?0.01). Compared to both ALC and OTH, CAN were significantly less likely to report use of inpatient treatment and used substantially less outpatient treatment, overall (p?<?0.01), although CAN resolving problems more recently were more likely to have used outpatient treatment (p?<?0.01). Lifetime attendance at mutual-help meetings (e.g., AA) was similar, but CAN (M?=?1.67) had substantially lower recent attendance compared to ALC (M?=?7.70) and OTH (M?=?7.65). QOL indices were similar across groups. CONCLUSION:Approximately 2.4 million Americans have resolved a significant cannabis problem. Compared to ALC and OTH, the pattern of findings for CAN suggest similarities but also some notable differences in characteristics and problem resolution pathways particularly regarding earlier problem offset and less use of formal and informal services. Within a shifting policy landscape, research is needed to understand how increases in population exposure and potency may affect the nature and magnitude of differences observed in this preliminary study.

Dataset Information

Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

Background

Methods

Results

Conclusions

Publications

Cross-national differences in clinically significant cannabis problems: epidemiologic evidence from 'cannabis-only' smokers in the United States, Mexico, and Colombia.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure