Prevalence and Correlates of Cannabis Use and Cannabis Use Disorder Among U.S. Veterans: Results From the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III)
Abstract
Objective:
Methods:
Results:
Conclusions:
METHODS
Samples and Procedures
Assessments
Substance use and use disorders.
Sociodemographic characteristics.
Statistical Analysis
RESULTS
Demographic Characteristics and Prevalence of Cannabis Use and Cannabis Use Disorder
Characteristic | % | SE |
---|---|---|
Sex | ||
Male | 90.19 | 0.55 |
Female | 9.81 | 0.55 |
Age group | ||
18–29 years | 3.91 | 0.33 |
30–44 years | 14.93 | 0.80 |
45–64 years | 38.24 | 1.10 |
≥65 years | 42.92 | 1.24 |
Race/ethnicity | ||
Black | 10.42 | 0.78 |
Hispanic | 6.49 | 0.63 |
White | 79.53 | 1.04 |
Other | 3.55 | 0.45 |
Education | ||
<High school | 6.15 | 0.56 |
High school | 25.78 | 0.93 |
Some college or more | 68.07 | 0.99 |
Marital status | ||
Married or cohabiting | 67.62 | 0.92 |
Widowed, separated, or divorced | 24.98 | 0.80 |
Never married | 7.40 | 0.46 |
Employment | ||
Employed full-time | 33.88 | 1.31 |
Employed part-time | 8.24 | 0.56 |
Unemployed | 4.81 | 0.39 |
Other (e.g., retired, in school, disabled) | 53.07 | 1.43 |
Family income | ||
$0–$19,999 | 16.02 | 0.72 |
$20,000–$34,999 | 18.37 | 1.04 |
$35,000–$69,999 | 32.10 | 1.10 |
≥$70,000 | 33.50 | 1.24 |
Urbanicity | ||
Urban | 74.99 | 1.82 |
Rural | 25.01 | 1.82 |
Region | ||
Northeast | 15.89 | 0.89 |
Midwest | 22.69 | 0.98 |
South | 40.21 | 1.81 |
West | 21.20 | 1.50 |
Service Era | ||
WW2 or earlier (December 1946 or earlier) | 5.02 | 0.53 |
Korea and post-Korea (January 1947–February 1961) | 16.58 | 0.94 |
Vietnam era (March 1961–April 1975) | 33.05 | 1.12 |
Post-Vietnam (May 1975–July 1990) | 18.15 | 0.80 |
Gulf and post-Gulf (August 1990–August 2001) | 14.62 | 0.82 |
Post–9/11 (September 2001–present) | 12.60 | 0.77 |
Living in a state with medical marijuana laws by 2012 | 29.57 | 2.19 |
Cannabis Use | % | SE |
---|---|---|
Past 12 months | ||
Any use (N=272) | 7.26 | 0.54 |
Cannabis use disorder (N=60) | 1.77 | 0.29 |
Among past-12-month users | ||
Any medical use | 15.15 | 2.55 |
Any nonmedical use | 96.04 | 1.22 |
Both medical and nonmedical use | 11.20 | 2.10 |
Medical use only | 3.96 | 1.22 |
Nonmedical use only | 84.85 | 2.55 |
Daily or near daily nonmedical use | 24.68 | 3.12 |
Cannabis use disorder | 24.38 | 3.48 |
Lifetime | ||
Any use (N=1,102) | 32.46 | 1.12 |
Cannabis use disorder (N=191) | 5.69 | 0.51 |
Among lifetime users | ||
Any medical use | 4.54 | 0.87 |
Any nonmedical use | 99.44 | 0.17 |
Both medical and nonmedical use | 3.98 | 0.85 |
Medical use only | 0.56 | 0.17 |
Nonmedical use only | 95.46 | 0.87 |
Daily or near daily nonmedical use | 30.36 | 1.62 |
Cannabis use disorder | 17.42 | 1.43 |
Correlates of Past-12-Month Nonmedical Cannabis Use and Cannabis Use Disorder
Nonmedical Cannabis Use, Past 12 Months | Cannabis Use Disorder, Past 12 Months | |||||||
---|---|---|---|---|---|---|---|---|
Characteristic | %a | SE | Adjusted Odds Ratiob | 95% CI | %a | SE | Adjusted Odds Ratiob | 95% CI |
Sex | ||||||||
Male | 7.15 | 0.55 | 2.18 | 1.21, 3.93 | 1.93 | 0.32 | 10.63 | 2.69, 42.06 |
Female | 5.33 | 1.24 | Reference | 0.33 | 0.20 | Reference | ||
Age group | ||||||||
18–29 years | 17.96 | 3.50 | 9.02 | 4.08, 19.92 | 5.32 | 2.42 | 2.94 | 0.83, 10.37 |
30–44 years | 12.05 | 1.55 | 8.77 | 4.73, 16.27 | 3.82 | 0.94 | 2.79 | 1.29, 6.00 |
45–64 years | 9.18 | 0.87 | 4.94 | 2.96, 8.23 | 2.36 | 0.57 | Reference | |
≥65 years | 2.23 | 0.49 | Reference | 0.21 | 0.15 | —c | ||
Race/ethnicity | ||||||||
Black | 12.58 | 2.24 | 1.43 | 0.93, 2.19 | 3.69 | 1.43 | 1.39 | 0.62, 3.13 |
Hispanic | 8.89 | 1.77 | 0.99 | 0.58, 1.67 | 2.60 | 1.12 | 1.00 | 0.36, 2.77 |
Other | 11.32 | 2.61 | 1.25 | 0.64, 2.44 | 3.94 | 1.60 | 1.72 | 0.64, 4.62 |
White | 5.88 | 0.54 | Reference | 1.35 | 0.28 | Reference | ||
Education | ||||||||
<High school | 4.00 | 1.44 | 0.68 | 0.29, 1.60 | 1.19 | 1.06 | 1.02 | 0.13, 7.82 |
High school | 9.05 | 1.20 | 1.27 | 0.88, 1.85 | 2.78 | 0.75 | 1.57 | 0.80, 3.10 |
Some college | 6.45 | 0.55 | Reference | 1.44 | 0.27 | Reference | ||
Marital status | ||||||||
Married | 4.25 | 0.57 | Reference | 0.94 | 0.25 | Reference | ||
Widowed, separated, or divorced | 10.72 | 1.17 | 2.26 | 1.50, 3.41 | 3.29 | 0.78 | 2.75 | 1.51, 5.02 |
Not married | 19.14 | 2.19 | 2.70 | 1.69, 4.31 | 4.23 | 1.33 | 1.79 | 0.67, 4.79 |
Employment | ||||||||
Employed full-time | 6.99 | 0.79 | Reference | 1.91 | 0.44 | Reference | ||
Employed part-time | 10.22 | 1.88 | 1.62 | 0.86, 3.05 | 1.05 | 0.46 | 0.51 | 0.17, 1.58 |
Unemployed | 13.49 | 3.18 | 1.17 | 0.67, 2.03 | 2.67 | 1.10 | 0.65 | 0.27, 1.59 |
Other (e.g., retired, in school, disabled) | 5.86 | 0.73 | 1.54 | 0.97, 2.45 | 1.71 | 0.44 | 1.86 | 0.81, 4.28 |
Family income | ||||||||
$0–$19,999 | 13.79 | 1.85 | 2.35 | 1.26, 4.38 | 4.09 | 1.08 | 5.00 | 1.37, 18.21 |
$20,000–$34,999 | 8.68 | 1.52 | 1.82 | 1.02, 3.26 | 2.16 | 0.79 | 3.27 | 0.85, 12.56 |
$35,000–$69,999 | 5.99 | 0.72 | 1.34 | 0.78, 2.28 | 1.70 | 0.44 | 2.70 | 0.73, 9.92 |
≥$70,000 | 3.72 | 0.68 | Reference | 0.51 | 0.28 | Reference | ||
Urbanicity | ||||||||
Urban | 6.67 | 0.54 | 0.70 | 0.47, 1.04 | 1.87 | 0.33 | 1.16 | 0.54, 2.51 |
Rural | 7.86 | 1.25 | Reference | 1.46 | 0.51 | Reference | ||
Region | ||||||||
Northeast | 7.83 | 1.34 | 0.59 | 0.34, 1.04 | 2.65 | 1.13 | 1.33 | 0.53, 3.32 |
Midwest | 5.34 | 0.78 | 0.36 | 0.22, 0.59 | 1.65 | 0.44 | 0.71 | 0.34, 1.50 |
South | 4.93 | 0.66 | 0.30 | 0.18, 0.51 | 1.15 | 0.36 | 0.40 | 0.18, 0.89 |
West | 11.94 | 1.79 | Reference | 2.41 | 0.58 | Reference |
Nonmedical Cannabis Use, Past 12 Months | Cannabis Use Disorder, Past 12 Months | |||||||
---|---|---|---|---|---|---|---|---|
Disorder, Past 12 Months | %a | SE | Adjusted Odds Ratiob | 95% CI | %a | SE | Adjusted Odds Ratiob | 95% CI |
Alcohol use disorder | ||||||||
Yes | 22.80 | 2.38 | 3.37 | 2.37, 4.78 | 8.95 | 1.82 | 5.87 | 3.33, 10.34 |
No | 5.03 | 0.47 | Reference | 0.89 | 0.19 | Reference | ||
Opioid use disorderc | ||||||||
Yes | 30.63 | 10.29 | 4.73 | 2.02, 11.06 | 8.05 | 6.40 | 2.85 | 0.58,14.03 |
No | 6.79 | 0.52 | Reference | 1.72 | 0.28 | Reference | ||
Drug use disorderd | ||||||||
Yes | 57.18 | 10.51 | 12.64 | 4.44, 35.94 | 8.21 | 5.04 | 2.57 | 0.63,10.51 |
No | 6.66 | 0.51 | Reference | 1.73 | 0.29 | Reference | ||
Tobacco use disorder | ||||||||
Yes | 15.15 | 1.43 | 2.01 | 1.39, 2.90 | 4.69 | 0.89 | 2.09 | 1.12, 3.93 |
No | 4.84 | 0.56 | Reference | 1.01 | 0.24 | Reference | ||
Any mood disorder | ||||||||
Yes | 21.10 | 3.03 | 2.90 | 1.88, 4.48 | 8.04 | 2.01 | 4.37 | 2.16, 8.82 |
No | 5.40 | 0.47 | Reference | 1.07 | 0.22 | Reference | ||
Any anxiety disorder | ||||||||
Yes | 15.57 | 2.43 | 2.27 | 1.54, 3.34 | 5.32 | 1.54 | 2.99 | 1.52, 5.90 |
No | 6.00 | 0.46 | Reference | 1.37 | 0.25 | Reference | ||
PTSD | ||||||||
Yes | 16.70 | 3.93 | 1.66 | 0.94, 2.94 | 5.89 | 2.62 | 2.05 | 0.80, 5.27 |
No | 6.37 | 0.51 | Reference | 1.52 | 0.25 | Reference |
Correlates of Lifetime Nonmedical Cannabis Use and Cannabis Use Disorder
Past-12-month Cannabis Use and Cannabis Use Disorder by State Medical Marijuana Law Status
No Medical Marijuana Law by 2012 (N=2,164) | Medical Marijuana Law by 2012 (N=955) | |||||||
---|---|---|---|---|---|---|---|---|
Cannabis Variable, Past 12 Monthsa | %b | SE | %b | SE | Adjusted Odds Ratioc | 95% CI | Adjusted Odds Ratiod | 95% CI |
Any nonmedical use (N=260) | 5.51 | 0.52 | 10.44 | 1.35 | 2.41 | 1.64, 3.55 | 1.91 | 1.33, 2.75 |
Medical and nonmedical use (N=272) | 5.51 | 0.52 | 11.41 | 1.42 | 2.67 | 1.83, 3.92 | 2.09 | 1.45, 2.99 |
Nonmedical use only (N=227) | 5.31 | 0.51 | 8.17 | 1.05 | 1.80 | 1.27, 2.56 | 1.63 | 1.10, 2.42 |
Daily or near daily nonmedical use (N=73) | 0.99 | 0.22 | 3.47 | 0.62 | 4.39 | 2.24, 8.59 | 3.08 | 1.47, 6.44 |
Cannabis use disorder (N=60) | 1.39 | 0.32 | 2.66 | 0.58 | 2.37 | 1.29, 4.38 | 2.68 | 1.09, 6.60 |
DISCUSSION
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