Before I take you on a short journey a few caveats should be noted. I do not hold a PhD, I do call myself a scientist nor am I a statistician. However, I am very much a researcher both in my curiosity to explore and discover relationships in science. When possible, I share in some way with others (educate & inform). That said, the key purpose of this article is to underscore the need for everyone to look beyond the media and do not assume findings are a fact because a leading news company shares the story.
Details in science mean everything. Let me be clear, this is not about the scientists and journal as it appears they have precisely articulated their findings for what appear to be accurate. However, this information is not conveyed as they have reported. Let’s begin…
Before moving on to this topic in more detail, let’s first take a look at this very simple unassuming title of the story.
- The use of ‘’ immediately takes the discussion into a direction not that of a scientific perspective but one that is associated with controversy and misperception by any not coming from a perspective of truly understanding the scientific and implications.
- The use of the term ‘toking’, again takes us further down the path of a perception of clip from Dazed and Confused (a great throwback for it’s time). Nonetheless the connotation is hardly a positive image.
What is most meaningful and the reason for this short commentary is the last part of the title ‘doubles in 10 years’. Keep this in mind as I present additional information for you to decide and interpret this headline.
Now, on to the publication in more detail. I’m not going to get into the statistics and specific findings because that is not my purpose here. As mentioned this is intended to be an exercise in exploration.
In the recent JAMA Psychiatry publication, two very simple points will illustrate the importance of digging beyond the surface.
“MAIN OUTCOMES AND MEASURES Past-year use and DSM-IV use disorder (abuse or dependence).” (pg. 1)
“CONCLUSIONS AND RELEVANCE The prevalence of use more than doubled between 2001-2002 and 2012-2013, and there was a large increase in use disorders during that time. While not all users experience problems, nearly 3 of 10 users manifested a use disorder in 2012-2013. Because the risk for use disorder did not increase among users, the increase in prevalence of use disorder is owing to an increase in prevalence of users in the US adult population.” (pg. 1)
Regardless of the findings, let’s compare this to the title.
Does this intent of the paper in any way reflect the title of the CNN story?
Again, my purpose is not to dig into the details of the paper, because their findings and conclusions are not what are in question here.
“The National Institute on Alcohol Abuse and Alcoholism…” (pg 2)
Underscoring the value of independent scientific inquiry into cannabis. Again, it is not the intent to question the scientists or the integrity of the journal, but what is reasonable to question is to what extent the community of readers can believe the results are in fact independent of the perspectives of the funding agency.
“The prevalence of users remained stable…” (pg 2)
The findings of this study contrast with National Survey on Drug Use and Health (NSDUH) data suggesting that the prevalence of use increased only 12% from 2002 to 2012, and that the prevalence of use disorders did not increase (1.6% in 2002 (81) and 1.5% in 2012 (70)). The explanation of these different findings is not clear.” (pg 5)
The 10 year national trends on lifetime reported use of cannabis do not reflect statistically significant increases, and monthly and daily use has not shown 5-year trends to support as found by the NSDUH & MTF survey data (2014). Further, lifetime prevalence of cannabis showed a statistically significant DECLINE in 10 years.
In conclusion, the NSDUH is a 184 page document and the paper published by JAMA Psychiatry is more detailed than can be fully covered here. But, it is very important and a responsibility of all scientists, providers, and those in the cannabis industry that are committed to patient health to look beyond the highlights and headlines. The scientific and investigation of cannabis requires serious and honest dialogue to understand the best practices and how research findings can translate to improved patient outcomes and quality of life.
- Hasin DS, Saha TD, Kerridge BT, et al. Prevalence of Use Disorders in the United States Between 2001-2002 and 2012-2013. JAMA Psychiatry. Published online October 21, 2015. doi:10.1001/jamapsychiatry.2015.1858.
- Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.