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      An exploratory study of cannabis use pattern and treatment seeking in patients attending an addiction treatment facility

      research-article
      , ,
      Indian Journal of Psychiatry
      Wolters Kluwer - Medknow
      Cannabis, diagnosis, treatment seeking

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          Abstract

          Background and Aims:

          Although cannabis is the most common illicit substance of use in India, it is often not the presenting complaint of patients with substance use disorders. The present study aimed to understand the profile of cannabis use disorders among patients at a substance abuse treatment facility in an Indian tertiary care center.

          Materials and Methods:

          This was a cross-sectional interview-based study which assessed adult patients with substance use disorders who had a history of cannabis use in the recent past. Participants were evaluated for cannabis use disorder as per the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and cannabis dependence as per the International Classification of Diseases, 10 th revision (ICD-10). They were assessed for cannabis withdrawal, and treatment-seeking behavior about cannabis use was explored.

          Results:

          Among the 100 male participants in the study, the use of smoked form ( charas, ganja, sulfa) was more common than oral form (bhang). Fifty-eight patients fulfilled the ICD-10 criteria of dependence, whereas 74 patients fulfilled the DSM-5 criteria of cannabis use disorder. Tolerance, craving, and withdrawal were the most common clinical features. Only 7 patients ever sought help for quitting cannabis, whereas 28 patients thought that generally treatment is required for quitting cannabis.

          Conclusion:

          More cannabis users seem to fulfill a diagnosis of cannabis use disorder as per DSM5 than cannabis dependence as per ICD-10. Treatment seeking for cannabis use disorders seems to be low among the substance using patients. Clinicians need to focus on cannabis use as well when they treat patients with substance use disorders.

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          Most cited references24

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          Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013.

          Laws and attitudes toward marijuana in the United States are becoming more permissive but little is known about whether the prevalence rates of marijuana use and marijuana use disorders have changed in the 21st century.
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            An improved brief measure of cannabis misuse: the Cannabis Use Disorders Identification Test-Revised (CUDIT-R).

            Cannabis is widely used and significant problems are associated with heavier consumption. When a cannabis misuse screening tool, the CUDIT, was originally published it was noted that although it performed well there was concern about individual items. 144 patients enrolled in a clinical trial for concurrent depression and substance misuse were administered an expanded CUDIT, containing the original 10 items and 11 candidate replacement items. All patients were assessed for a current cannabis use disorder with the SCID. A revised CUDIT-R was developed containing 8 items, two each from the domains of consumption, cannabis problems (abuse), dependence, and psychological features. Although the psychometric adequacy of the original CUDIT was confirmed, the CUDIT-R was shorter and had equivalent or superior psychometric properties. High sensitivity (91%) and specificity (90%) were achieved. The 8-item CUDIT-R has improved performance over the original scale and appears well suited to the task of screening for problematic cannabis use. It may also have potential as a brief routine outcome measure. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
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              Prevalence and Correlates of DSM-5 Cannabis Use Disorder, 2012-2013: Findings from the National Epidemiologic Survey on Alcohol and Related Conditions–III

              Objective Attitudes towards marijuana are changing, the prevalence of DSM-IV cannabis use disorder has increased, and DSM-5 modified the diagnostic criteria for cannabis use disorders. Therefore, updated information is needed on the prevalence, demographic characteristics, psychiatric comorbidity, disability and treatment for DSM-5 cannabis use disorders in the US adult population. Method In 2012–2013, a nationally representative sample of 36,309 participants ≥18 years were interviewed in the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). Psychiatric and substance use disorders were assessed using the Alcohol Use Disorders and Associated Disabilities Interview Schedule-5. Results Prevalence of 12-month and lifetime marijuana use disorder was 2.5% and 6.3%. Among those with 12-month and lifetime marijuana use disorder, marijuana use was frequent; mean days used per year was 225.3 (SE=5.69) and 274.2 (SE=3.76). Odds of 12-month and lifetime marijuana use disorder were higher for men, Native Americans, those unmarried, with low incomes, and young adults, (e.g., OR=7.2, 95% CI 5.5–9.5 for 12-month disorder among those 18–24 years compared to those ≥45 years). Marijuana use disorder was associated with other substance disorders, affective, anxiety and personality disorders. Twelve-month marijuana use disorder was associated with disability. As disorder severity increased, virtually all associations became stronger. Only 24.3% with lifetime marijuana use disorder participated in 12-step programs or professional treatment. Conclusions DSM-5 marijuana use disorder is prevalent, associated with comorbidity and disability, and often untreated. Findings suggest the need to improve prevention methods, and educate the public, professionals and policy makers about the harms associated with marijuana use disorders and available interventions.
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                Author and article information

                Journal
                Indian J Psychiatry
                Indian J Psychiatry
                IJPsy
                Indian Journal of Psychiatry
                Wolters Kluwer - Medknow (India )
                0019-5545
                1998-3794
                Mar-Apr 2020
                17 March 2020
                : 62
                : 2
                : 145-151
                Affiliations
                [1]Department of Psychiatry and NDDTC, AIIMS, New Delhi, India
                Author notes
                Address for correspondence: Dr. Siddharth Sarkar, Department of Psychiatry and NDDTC, AIIMS, New Delhi - 110 029, India. E-mail: sidsarkar22@ 123456gmail.com
                Article
                IJPsy-62-145
                10.4103/psychiatry.IndianJPsychiatry_132_19
                7197828
                32382173
                ba08d753-5ac2-48a6-abab-ca78064c61f6
                Copyright: © 2020 Indian Journal of Psychiatry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 02 March 2019
                : 14 May 2019
                : 08 February 2020
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                cannabis,diagnosis,treatment seeking
                Clinical Psychology & Psychiatry
                cannabis, diagnosis, treatment seeking

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