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NIDA deputy director says shift tied to 'changes in the legal environment'
More people in the U.S. are using marijuana, as fewer perceive the drug to be harmful, researchers found.
In a study of data from the National Survey on Drug Use and Health (NSDUH), use of the drug rose from 10.4% in 2002 to 13.3% in 2014 (P<0.0001), Wilson Compton, MD, deputy director of the National Institute on Drug Abuse, and colleagues reported online in the Lancet Psychiatry.
At the same time, the proportion of people who perceived great risk of harm from smoking pot once or twice a week fell from about 50% to 33% during that time (P<0.0001), they reported.
When asked what may be causing the changes in risk perception, Compton cited "changes in the legal environment -- but we're not sure if it's because more people are using [marijuana] and voting for [its legalization] or if the legal changes are leading to more permissive attitudes."
He added that the link between increasing use and decreasing risk perception "suggests the need for education regarding the risk of smoking marijuana, and prevention messages."
Compton and colleagues examined data from 596,500 adults who participated in the NSDUH in 2002-2014. They observed that the decline in risk perception started in 2007, with significant differences from the early period of the study starting in 2011.
"By 2007, 12 U.S. states had legalized medical marijuana use, and the cumulative effects of these policy changes might have led to changes in marijuana use and risk perceptions in U.S. adults in 2006–2007," the researchers wrote.
Compton told MedPage Today that "more surprisingly and importantly," the number of users on a daily or near-daily basis more than doubled during the study period -- from an estimated 3.9 million in 2002 to 8.4 million in 2014 -- although the absolute increase was relatively small (from 1.9% to 3.5%).
Also, the frequency of disorders -- including abuse or dependence -- remained stable at about 1.5% between 2002 and 2014, and the prevalence of marijuana use disorders among users actually fell, from 14.8% to 11%, they found.
"We speculate that the many people who have recently (within the past year) started to use marijuana might be using the drug less intensely and have less psychopathology than people who have used marijuana for longer, which could decrease their risk of transition from use to use disorders," they wrote.
The study was limited by the fact that it excluded teenagers, as well as homeless and institutionalized people, which could lead to underestimates in drug use and drug use disorders. Also, associations between marijuana use and some psychiatric disorders couldn't be evaluated because these measures weren't included in NSDUH. And NSDUH is a self-reported survey subject to recall bias, the researchers warned.
Still, they concluded that "understanding patterns of marijuana use and dependence, and how these have changed over time, is essential for policy makers who continue to consider whether and how to modify laws related to marijuana and for healthcare practitioners who care for patients using marijuana."
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