Cannabis users: Screen systematically, treat individually. A descriptive study of participants in a randomized trial in primary care

English version

Autoři: Catherine Laporte ^aff001; Céline Lambert ^aff002; Bruno Pereira ^aff002; Olivier Blanc ^aff003; Nicolas Authier ^aff004; David Balayssac ^aff005; Georges Brousse ^aff003; Philippe Vorilhon ^aff006
Působiště autorů: Département de Médecine Générale, Equipe d’Accueil 7280, Unité de Formation et de Recherche de Médicine, Université Clermont Auvergne, Clermont-Ferrand, France ^aff001; Délégation à la recherche clinique et à l’innovation, Centre Hospitalier Universitaire Clermont-Ferrand,Clermont-Ferrand, France ^aff002; Equipe d’Accueil 7280, Unité de Formation et de Recherche de Médicine, Université Clermont Auvergne; Service de Psychiatrie B et d’addictologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France ^aff003; Inserm, Neuro-Dol, Université Clermont Auvergne; Service de Pharmacologie Médicale, Centres Addictovigilance / Pharmacovigilance, Centre Evaluation et Traitement de la Douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France ^aff004; Inserm U1107, NEURO-DOL, Unité de Formation et de Recherche de Pharmacie, Université Clermont Auvergne; Laboratoire de Toxicologie, Délégation à la recherche clinique et à l’innovation, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferran ^aff005; Université Clermont Auvergne, CNRS, SIGMA Clermont, Institut Pascal, France ^aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0224867

Souhrn

Purpose

The aim of the present study was to describe the profiles of a sample of young cannabis users not seeking care, for use in general practice in France.

Methods

In this cross-sectional study, baseline data were used from a previous clinical randomized trial, in which a brief intervention was tested. The participants were 262 cannabis users aged 15 to 25 years who smoked at least one joint per month. Assessment was undertaken both by the GP and via an anonymous self-reporting questionnaire. All statistical analyses were performed using Stata software and R. We used multiple correspondence analysis to determine the profiles of users.

Results

Among the 262 patients, 46.2% were daily users (more than 30 joints per month), 25.6% were regular users (from 10 to 29 joints per month), and 28.2% were recent users (fewer than 10 joints per month). The higher the frequency of use, the greater the incidence of unaccompanied use, daily use and week use (p from <0.001 to 0.01). The motivations of daily users were mostly self-treatment and habit (p <0.05). The cannabis abuse screening trial score revealed risky use for 87.5% of daily users and 34.4% for recent users. Factorial analysis identified 5 profiles according to age, risk, and motive for use. The reasons for consultation were equally distributed among users regardless of their level of use or their profile (p > 0.05).

Conclusions

The results provide support for the practice of asking young patients systematically about their cannabis use, allowing GPs to identify users who require medical care. GPs should consider the differences between participants according to their profile in order to determine the appropriate type of care.

Trial registration

Clinicaltrials.gov NCT01433692.

Klíčová slova:

Mental health and psychiatry – Habits – Cannabis – Adolescents – France – Primary care – Drug users – Cocaine

Zdroje

1. World Drug Report 2018. Global Overview of Drug Deman and Supply (2018).

2. European Drug Report. Trends and Developments. EMCDDA (European Monitoring Center for Drugs and Drug Addiction).2015.

3. Baromètre de santé 2014. INPES (Institut National de Prévention et d’Education pour la Santé).

4. Spilka S, Le Nézet O, Janssen E, Brissot A, Philippon A, Shah J, et al. Les drogues à 17 ans: analyse de l’enquête ESCAPAD 2017. OFDT. Tendance 123. Février 2018.

5. Richmond-Rakerd LS, Slutske WS, Wood PK. Age of initiation and substance use progression: A multivariate latent growth analysis. Psychol Addict Behav. sept 2017;31(6):664‑75. doi: 10.1037/adb0000304 28805408

6. Gobbi G, Atkin T, Zytynski T, Wang S, Askari S, Boruff J, et al. Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis. JAMA Psychiatry. 2019 fev 22. doi: 10.1001/jamapsychiatry.2018.4500 30758486

7. Marconi A, Di Forti M, Lewis CM, Murray RM, Vassos E. Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis. Schizophr Bull. sept 2016;42(5):1262‑9. doi: 10.1093/schbul/sbw003 26884547

8. Castellanos-Ryan N, Pingault J-B, Parent S, Vitaro F, Tremblay RE, Séguin JR. Adolescent cannabis use, change in neurocognitive function, and high-school graduation: A longitudinal study from early adolescence to young adulthood. Dev Psychopathol. oct 2017;29(4):1253‑66. doi: 10.1017/S0954579416001280 28031069

9. Orr C, Spechler P, Cao Z, Albaugh M, Chaarani B, Mackey S, et al. Grey Matter Volume Differences Associated with Extremely Low Levels of Cannabis Use in Adolescence. J Neurosci. 6 mars 2019;39(10):1817‑27.

10. Baromètre de santé 2010. INPES (Institut National de Prévention et d’Education pour la Santé).

11. Haller DM, Michaud P-A, Suris J-C, Jeannin A, Narring F. Opportunities for Prevention in Primary Care in a Country with Universal Insurance Coverage. J Adolesc Health. nov 2008;43(5):517‑9.

12. Beck F, Guignard R, Obradovic I, Gautier A, Karila L. [Increasing trends in screening for addictives behaviors among general practitioners in France]. Rev Dépidémiologie Santé Publique. oct 2011;59(5):285‑94.

13. Obradovic I.[Guide pratique des principaux outils de repérage de l’usage problématique de cannabis chez les adolescents.]. OFDT 2013.

14. Laporte C, Vaillant-Roussel H, Pereira B, Blanc O, Eschalier B, Kinouani S, et al. Cannabis and Young Users-A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care. Ann Fam Med. mars 2017;15(2):131‑9.

15. Miller WR, Sanchez V. C. Issues in Alcohol Use and Misuse in Young Adults. Howard G, editor. Notre Dame: University of Notre Dame Press; 1993. p. 55–82. Motivating young adults for treatment and lifestyle change.

16. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet Lond Engl. 20 oct 2007;370(9596):1453‑7.

17. Laporte C, Vaillant-Roussel H, Pereira B, Blanc O, Tanguy G, Frappé P, et al. CANABIC: CANnabis and Adolescents: effect of a Brief Intervention on their Consumption–study protocol for a randomized controlled trial. Trials. 2014;15(1):40.

18. https://www.insee.fr.

19. Bahadoor K, Rude M, Picard-Bernard V, Marty L, Vorilhon P, Laporte C. Adolescent consumers of cannabis and general practitioners: how to communicate? Eur J of Gen Pract2011;17:35–57.

20. Goodhines PA, Gellis LA, Kim J, Fucito LM, Park A. Self-Medication for Sleep in College Students: Concurrent and Prospective Associations With Sleep and Alcohol Behavior. Behav Sleep Med. 4 mai 2019;17(3):327‑41.

21. Legleye S, Piontek D, Kraus L. Psychometric properties of the Cannabis Abuse Screening Test (CAST) in a French sample of adolescents. Drug Alcohol Depend. 15 janv 2011;113(2‑3):229‑35.

22. Day S, Pedhazur EJ, Schmelkin LP. Measurement, Design and Analysis: An Integrated Approach. The Statistician. 1994;43(4):608.

23. Tabachnick BG, Fidell LS. Using multivariate statistics. 3rd ed. New York: Harper-Collins; 1996.

24. Lin LI. A concordance correlation coefficient to evaluate reproducibility. Biometrics. 1989 Mar;45(1):255–68. 2720055

25. Erlbaum L. Statistical power analysis for the behavioral sciences. 1988, 2nd ed. New Jersey.

26. Benard V, Rolland B, Messaadi N, Petit A, Cottencin O, Karila L. Consommation de cannabis: conduite à tenir en médecine générale Presse Med. 2015; 44: 707–715.

27. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.

28. Solowij N, Jones KA, Rozman ME, Davis SM, Ciarrochi J, Heaven PCL, et al. Verbal learning and memory in adolescent cannabis users, alcohol users and non-users. Psychopharmacology (Berl). juill 2011;216(1):131‑44.

29. Vorilhon P, Picard V, Marty L, Roussel HV, Llorca PM, Laporte C. Attitudes of family physicians towards adolescent cannabis users: A qualitative study in France. Fam Pract. oct 2014;31(5):585‑91. doi: 10.1093/fampra/cmu030 24939655

30. Tims FM, Dennis ML, Hamilton N, J. Buchan B, Diamond G, Funk R, et al. Characteristics and problems of 600 adolescent cannabis abusers in outpatient treatment. Addiction. déc 2002;97:46‑57. doi: 10.1046/j.1360-0443.97.s01.7.x 12460128

31. Copeland J, Swift W, Rees V. Clinical profile of participants in a brief intervention program for cannabis use disorder. J Subst Abuse Treat. janv 2001;20(1):45‑52.

32. Gilchrist G, Moskalewicz J, Slezakova S, Okruhlica L, Torrens M, Vajd R, et al. Staff regard towards working with substance users: a European multi-centre study: Staff regard towards substance users. Addiction. juin 2011;106(6):1114‑25.

33. Esmaeelzadeh S, Moraros J, Thorpe L, Bird Y. Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada—A Systematic Review and Meta-Analysis. J Clin Med. 13 déc 2018;7(12):543.

34. McCambridge J, Kypri K. Can Simply Answering Research Questions Change Behaviour? Systematic Review and Meta Analyses of Brief Alcohol Intervention Trials. McCulloch P, éditeur. PLoS ONE. 5 oct 2011;6(10):e23748. doi: 10.1371/journal.pone.0023748 21998626

35. Smelt AFH, van der Weele GM, Blom JW, Gussekloo J, Assendelft WJJ. How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials. Br J Gen Pract J R Coll Gen Pract. juill 2010;60(576):e305–318.

36. Pouchain D, Lièvre M, Huas D, Lebeau J-P, Renard V, Bruckert E, et al. Effects of a multifaceted intervention on cardiovascular risk factors in high-risk hypertensive patients: the ESCAPE trial, a pragmatic cluster randomized trial in general practice. Trials. 2013;14(1):318.