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Clinical Features of DSM-IV Cannabis Abuse in a Cross-National Context

Fabian Fiestas

Fiestas, Fabian, and Radovanovic, Mirjana, Michigan State University, United States; Medina-Mora, Maria Elena, Institute of Psychiatry, Mexico; Posada-Villa, Jose, Colegio Mayor de Cundinamarca University and the Social Protection Ministry, Colombia; Anthony, James C., Michigan State University, United States

Aims: Recent community surveys in Mexico and Colombia make it possible to estimate cumulative incidence of clinical features of DSM-IV cannabis abuse in these two countries, and to compare and contrast the experience of cannabis smokers (CS) in each place.

Methods: Study data are from the World Mental Health Surveys Initiative, with probability samples in Mexico (n=4,426) and Colombia (n=5,782). After excluding persons with a history of any other "illegal" drug use, the samples included 380 CS in Mexico and 413 CS in Colombia. Standardized diagnostic assessments were used to identify these CS, to implement exclusion rules, and to assess five manifestations of non-hierarchical DSM-IV cannabis abuse with respect to cannabis-associated social maladaptation or hazard-laden use (e.g., driving while intoxicated). Estimates and 95-percent confidence intervals were based on appropriate sample weighting and Taylor series variance estimation.

Results: After exclusion of polydrug users, an estimated one in eight to nine cannabis smokers attributed social problems to cannabis use (13% Colombia; 11% Mexico), whereas country-specific estimates for continuing to smoke despite social problems were 11 percent and 8 percent, respectively. Cannabis-associated work problems occurred somewhat less frequently: 9 percent in both Colombia and Mexico. In Colombia, an estimated 9 percent of cannabis smokers had engaged in hazard-laden cannabis use, versus 10 percent in Mexico. Cannabis-associated legal problems were experienced by 1 in 16 of the cannabis smokers in each country (i.e., ~6%).

Conclusions: This study's most remarkable finding is similarity in cumulative incidence of cannabis-associated problems among cannabis smokers in this cross-national comparison. Estimates derived separately indicate modestly greater hazard-laden CS among non-Hispanics in the United States, with modestly lower risk of legal problems for CS in the United States.

Abstract Year: 
Abstract Region: 
North America
Abstract Country: 
United States
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