Cannabis Use Disorder Among People With and Without HIV.

IF 3.2 3区医学 Q1 SUBSTANCE ABUSE

Journal of Addiction Medicine Pub Date : 2025-05-13 DOI:10.1097/ADM.0000000000001505

Danielle F Haley, Kaku So-Armah, Amy C Justice, Farah Kidwai-Khan, Ziming Xuan, Rachel Sayko Adams, Matthew P Fox, E Jennifer Edelman, Aleksandra Wrona, Michael J Silverberg, Derek D Satre, Adam Trickey, Suzanne M Ingle, Kathleen A McGinnis

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引用次数: 0

Abstract

Objectives: In the United States, adults aged 65 and older are the fastest-growing age group using cannabis. People living with HIV (PLWH) are an aging population with prevalent cannabis use exceeding the general population. We examined cannabis use disorder (CUD) diagnoses from 2000 to 2022, by age, race/ethnicity, sex, comorbidity, and HIV status.

Methods: This analysis (2000-2022) includes electronic health records from 185,372 individuals in the Veterans Aging Cohort Study-HIV, a national US cohort of PLWH matched 1:2 to people without HIV (PLWoH). Annual CUD diagnosis was determined by dividing the number with CUD International Classification of Diseases-Clinical Modification codes by total observations. We examined trends by age, race/ethnicity, sex, comorbidity, and HIV status graphically and with multivariable logistic models.

Results: Demographic characteristics were comparable for PLWH (n=58,959) versus PLWoH (n=126,413): 45% Black non-Hispanic (NH); 35% White NH; 7% Hispanic; 3% women, mean age 48 years. Twenty percent of PLWH had a CUD from 2000 to 2022. CUD increased in all subgroups and was consistently higher among PLWH (odds ratio=1.14 [95% CI=1.11-1.18]). Individuals 65 and older experienced the greatest relative increase: PLWH (0.9% vs. 4.0%) and PLWoH (0.03% vs. 3.15%).

Conclusions: CUD increased dramatically among all subgroups over time and was higher among PLWH. CUD increase among older PLWH and those with multimorbidity is especially concerning as cannabis interacts with many prescription medications. Universal screening and treatment advances are needed, as is research characterizing patterns and modalities of cannabis use, CUD, and potential harms and benefits in PLWH and PLWoH.

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艾滋病毒感染者和非艾滋病毒感染者的大麻使用障碍。

目的：在美国，65岁及以上的成年人是使用大麻增长最快的年龄组。艾滋病毒感染者是一个老龄化人口，其大麻使用普遍超过一般人口。我们根据年龄、种族/民族、性别、合并症和艾滋病毒状况检查了2000年至2022年大麻使用障碍（CUD）的诊断。方法：该分析（2000-2022）包括来自185,372名退伍军人衰老队列研究-HIV的电子健康记录，这是一项美国国家PLWH队列，与非HIV （PLWH）匹配1:2。年度CUD诊断是通过将CUD国际疾病分类-临床修改代码的数量除以总观察值来确定的。我们通过多变量逻辑模型，以图形方式检查了年龄、种族/民族、性别、合并症和艾滋病毒状况的趋势。结果：PLWH （n=58,959）与PLWH （n=126,413）的人口统计学特征具有可比性：45%的非西班牙裔黑人（NH）；35%白色NH；7%的西班牙裔;3%为女性，平均年龄48岁。从2000年到2022年，20%的PLWH有过CUD。CUD在所有亚组中均升高，在PLWH中持续升高（优势比=1.14 [95% CI=1.11-1.18]）。65岁及以上个体的相对增幅最大：PLWH（0.9%比4.0%）和PLWH（0.03%比3.15%）。结论：随着时间的推移，CUD在所有亚组中显著增加，在PLWH中更高。由于大麻与许多处方药相互作用，老年PLWH和多病患者的CUD增加尤其令人担忧。需要普遍的筛查和治疗进展，以及研究大麻使用的模式和方式、CUD以及PLWH和PLWH的潜在危害和益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Addiction Medicine 医学-药物滥用

CiteScore

6.10

自引率

9.10%

发文量

260

审稿时长

>12 weeks

期刊介绍： The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.