Problem alcohol use and healthcare utilization among persons with cannabis use disorder in the United States

- 40% of persons with cannabis use disorder (CUD) reported past-year emergency department (ED) admission.
- Alcohol use disorder (AUD) among those with CUD increased odds of healthcare use.
- Current drinking patterns and CUD was not associated with increased healthcare use.
- Being male, Hispanic, ages 18-25, or having depression was associated with CUD + AUD.
- Other demographic subgroups with CUD also had increased odds of healthcare use.

BackgroundThe emergency department (ED) and hospital settings represent crucial opportunities for engaging treatment for cannabis use disorder (CUD). Thus, there is a need to identify factors associated with healthcare utilization among persons with CUD to improve screening and intervention approaches. Problematic alcohol use may be a salient risk factor.MethodsUsing data from the 2005-2013 National Surveys on Drug Use and Health, we determined factors, including different patterns of alcohol use, associated with past-year ED admission and inpatient hospitalization among persons aged 12 years or older meeting criteria for CUD in the past year (N = 16,757). We also determined the prevalence and correlates of problem alcohol use among persons with CUD to further inform its association with healthcare utilization.ResultsAmong persons with CUD, 40.15% and 10.04% reported past-year ED admission and inpatient hospitalization, respectively. Severe alcohol use disorder (AUD) (≥ 6 AUD symptoms), female sex, Black race, low income, major depressive episode (MDE), and other substance use disorders were associated with increased odds of healthcare utilization; current (i.e., last month) alcohol use patterns were not. Persons with CUD that were males, ages 18-25 (vs. ages 12-17), Hispanic (vs. White), and with low income, other drug use disorders, or MDE had increased odds of AUD.ConclusionsFindings suggest that screening and intervention efforts for improving treatment initiation or engagement for CUD may target cannabis-using women, blacks, low-income adults or those with severe AUD in the past year, another substance use disorder, or MDE.