Cannabis Legalization and Opioid Use Disorder in Veterans Health Administration Patients

作者：Zachary L. Mannes, Melanie M. Wall, Daniel M. Alschuler, Carol A. Malte, Mark Olfson, Ofir Livne, David S. Fink, Salomeh Keyhani, Katherine M. Keyes, Sílvia S. Martins, Magdalena Cerdá, Dana Sacco, Sarah Gutkind, Charles Maynard, Scott E. Sherman, Andrew J. Saxon, Deborah S. Hasin · 发表于：JAMA Health Forum · 年份：2025 · DOI：10.1001/jamahealthforum.2025.1369 · 被引用次数：2 · 研究领域：Cannabis and Cannabinoid Research、Opioid Use Disorder Treatment、Substance Abuse Treatment and Outcomes

Importance: In the context of the US opioid crisis, factors associated with the prevalence of opioid use disorder (OUD) must be identified to aid prevention and treatment. State medical cannabis laws (MCL) and recreational cannabis laws (RCL) are potential factors associated with OUD prevalence. Objective: To examine changes in OUD prevalence associated with MCL and RCL enactment among veterans treated at the Veterans Health Administration (VHA) and whether associations differed by age or chronic pain. Design, Setting, and Participants: Using VHA electronic health records from January 2005 to December 2022, adjusted yearly prevalences of OUD were calculated, controlling for sociodemographic characteristics, receipt of prescription opioids, other substance use disorders, and time-varying state covariates. Staggered-adoption difference-in-difference analyses were used for estimates and 95% CIs for the relationship between MCL and RCL enactment and OUD prevalence. The study included VHA patients aged 18 to 75 years. The data were analyzed in December 2023. Main Outcome and Measures: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) OUD diagnoses. Results: From 2005 to 2022, most patients were male (86.7.%-95.0%) and non-Hispanic White (70.3%-78.7%); the yearly mean age was 61.9 to 63.6 years (approximately 3.2 to 4.5 million patients...