Evidence map›Paper›PMID 37688980›Full record

Observational studyDrug and alcohol dependence2023

Association between cannabis use disorder symptom severity and probability of clinically-documented diagnosis and treatment in a primary care sample.

Theresa E Matson, Emily C Williams, Gwen T Lapham, Malia Oliver, Kevin A Hallgren, Katharine A Bradley

Open access · greenAbstract readObservational Study
In one paragraph

Observational study in Drug and alcohol dependence, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Youth Correlates of Genetic Liability to Substance Use Disorders.medRxiv : the preprint server for health sciences · 2025
    Article
  3. Cannabis Use Among Older Adults.JAMA network open · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Theresa E MatsonKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Health Services Research & Development (HSR&D) Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98101, USA. Electronic address: Theresa.E.Matson@kp.org.
Emily C WilliamsKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Health Services Research & Development (HSR&D) Center for Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA 98101, USA.
Gwen T LaphamKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA.
Malia OliverKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA.
Kevin A HallgrenKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
Katharine A BradleyKaiser Permanente Washington Health Research Institute, Seattle, WA 98101, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA; Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
Kaiser Permanente Washington Health Research Institute · US

Funding

Project-002UG1DA040314 · NIDA · KAISER FOUNDATION RESEARCH INSTITUTE · PI Ingrid A Binswanger, CYNTHIA I CAMPBELL · 2015 to 2026
$34.9M
NIDA NIH HHS UG1 DA040314
6 · The paper itself

Abstract

backgroundBrief cannabis screening followed by standardized assessment of symptoms may support diagnosis and treatment of cannabis use disorder (CUD). This study tested whether the probability of a medical provider diagnosing and treating CUD increased with the number of substance use disorder (SUD) symptoms documented in patients' EHRs.

methodsThis observational study used EHR and claims data from an integrated healthcare system. Adult patients were included who reported daily cannabis use and completed the Substance Use Symptom Checklist, a scaled measure of DSM-5 SUD symptoms (0-11), during routine care 3/1/2015-3/1/2021. Logistic regression estimated associations between SUD symptom counts and: 1) CUD diagnosis; 2) CUD treatment initiation; and 3) CUD treatment engagement, defined based on Healthcare Effectiveness Data and Information Set (HEDIS) ICD-codes and timelines. We tested moderation across age, gender, race, and ethnicity.

resultsPatients (N=13,947) were predominantly middle-age, male, White, and non-Hispanic. Among patients reporting daily cannabis use without other drug use (N=12,568), the probability of CUD diagnosis, treatment initiation, and engagement increased with each 1-unit increase in Symptom Checklist score (p's<0.001). However, probabilities of diagnosis, treatment, and engagement were low, even among those reporting ≥2 symptoms consistent with SUD: 14.0% diagnosed (95% CI: 11.7-21.6), 16.6% initiated treatment among diagnosed (11.7-21.6), and 24.3% engaged in treatment among initiated (15.8-32.7). Only gender moderated associations between Symptom Checklist and diagnosis (p=0.047) and treatment initiation (p=0.012). Findings were similar for patients reporting daily cannabis use with other drug use (N=1379).

conclusionDespite documented symptoms, CUD was underdiagnosed and undertreated in medical settings.

Indexed as

CannabisHallucinogensMarijuana AbuseSubstance-Related DisordersAdultFemaleHumansMaleMiddle AgedPrimary Health CareRisk FactorsHallucinogensCannabisCannabis use disorderDiagnosisPrimary careScreening and assessmentTreatment

Identifiers

PMID37688980
PMCPMC10655701
OpenAlexW4386101199

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.