Cannabis legalization and cannabis use disorder in United States Veterans Health Administration patients with and without psychiatric disorders, 2005–2022: a repeated cross-sectional study

作者：Deborah S. Hasin, Carol A. Malte, Melanie M. Wall, Daniel M. Alschuler, Tracy L. Simpson, Mark Olfson, Ofir Livne, Zachary L. Mannes, David S. Fink, Katherine M. Keyes, Magdalena Cerdá, Charles Maynard, Salomeh Keyhani, Sílvia S. Martins, Scott E. Sherman, Andrew J. Saxon · 发表于：The Lancet Regional Health - Americas · 年份：2025 · DOI：10.1016/j.lana.2025.101155 · 被引用次数：5 · 研究领域：Cannabis and Cannabinoid Research、Substance Abuse Treatment and Outcomes、Psychedelics and Drug Studies

Background: We investigated whether the associations of state medical and recreational cannabis legalization (MCL, RCL enactment) with increasing prevalence of Cannabis Use Disorder (CUD) differed among patients in the United States (US) Veterans Health Administration (VHA) who did or did not have common psychiatric disorders. Methods: Electronic medical record data (2005-2022) were analyzed on patients aged 18-75 with ≥1 VHA primary care, emergency department, or mental health visit and no hospice/palliative care within a given year (sample sizes ranging from 3,234,382 in 2005 to 4,436,883 in 2022). Patients were predominantly male (>80%) and non-Hispanic White (>60%). Utilizing all 18 years of data, CUD prevalence increases attributable to MCL or RCL enactment were estimated among patients with affective, anxiety, psychotic-spectrum disorders, and Any Psychiatric Disorder (APD) using staggered difference-in-difference (DiD) models and 99% Confidence Intervals (CIs), testing differences between patient groups with and without psychiatric disorders via non-overlap in the 99% CIs of their DiD estimates. Findings: Among APD-negative patients, CUD prevalence was <1.0% in all years, while among APD-positive patients, CUD prevalence increased from 3.26% in 2005 to 5.68% in 2022 in no-CL states, from 3.51% to 6.35% in MCL-only states, and from 3.41% to 6.35% in MCL/RCL states. Among the APD group, DiD estimates of MCL-only and MCL/RCL effects were modest-sized, but the lower bound ...