In Reply In support of the conclusion that the prevalence of marijuana use and marijuana use disorders have undergone large increases in recent years (131% and 93%, respectively), as suggested by National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) data,1 Hasin and Grant cite large increases in the prevalence of marijuana-related outcomes among several high-risk populations. These include veterans, emergency department patients, and traffic crash decedents. However, in each of the cited studies, factors other than marijuana use likely contributed to those large increases. For example, assessment and detection of marijuana use disorders has become more frequent in the Veterans Administration system, leading to a higher prevalence of diagnosed cases independently of changes in marijuana use patterns.2 Moreover, selection into each of those populations is likely associated with multiple other risk factors for marijuana use, potentially magnifying increases relative to those in the general population. While trends in these high-risk populations are clearly important, they do not necessarily reflect changes in the general population.
Grucza RA, Agrawal A, Bierut LJ. NESARC Findings on Increased Prevalence of Marijuana Use Disorders—Reply: Consistent With Other Sources of Information. JAMA Psychiatry. 2016;73(5):532–533. doi:10.1001/jamapsychiatry.2016.0244
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