Evidence map›Paper›PMID 38493111›Full record

ArticleJournal of cannabis research2024

A national study of clinical discussions about cannabis use among Veteran patients prescribed opioids.

Tauheed Zaman, Dawn M Bravata, Amy Byers, Erin Krebs, Samuel Leonard, Charles Austin, Friedhelm Sandbrink, Deborah S Hasin, Salomeh Keyhani

Erratum issuedAbstract read
In one paragraph

Article in Journal of cannabis research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Correction: Competing Interests.Journal of cannabis research · 2025
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Tauheed ZamanAddiction Recovery and Treatments Services, San Francisco VA Health Care System, 4150 Clement Street, #116F, San Francisco VA Medical Center, San Francisco, CA, 94121, USA. tauheed.zaman@ucsf.edu.
Dawn M BravataRichard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
Amy ByersDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA.
Erin KrebsCenter for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
Samuel LeonardMedical Service, San Francisco VA Health Care System, San Francisco, USA.
Charles AustinRichard L. Roudebush VA Medical Center, Indianapolis, IN, USA.
Friedhelm SandbrinkNational Pain Management, Opioid Safety and Prescription Drug Monitoring Program, Veterans Health Administration, Washington, DC, USA.
Deborah S HasinNew York State Psychiatric Institute, New York, NY, USA.
Salomeh KeyhaniMedical Service, San Francisco VA Health Care System, San Francisco, USA.

Funding

Risks of Cannabis Use Among Veterans on Long-term Opioid TherapyI01HX002737 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI KEYHANI, SALOMEH · 2020 to 2024
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Health Services Research and Development IIR 18-231-2HSRD VA I01 HX002737Tobacco-Related Disease Research Program T29IP0511
6 · The paper itself

Abstract

backgroundThe Veterans Health Administration tracks urine drug tests (UDTs) among patients on long-term opioid therapy (LTOT) and recommends discussing the health effects of cannabis use.

objectiveTo determine the occurrence of cannabis-related discussions between providers and patients on LTOT during six months following UDT positive for cannabis, and examine factors associated with documenting cannabis use.

designWe identified patients prescribed LTOT with a UDT positive for cannabis in 2019. We developed a text-processing tool to extract discussions around cannabis use from their charts. SUBJECTS: Twelve thousand seventy patients were included. Chart review was conducted on a random sample of 1,946 patients. MAIN MEASURES: The presence of a cannabis term in the chart suggesting documented cannabis use or cannabis-related discussions. Content of those discussions was extracted in a subset of patients. Logistic regression was used to examine the association between patient factors, including state of residence legal status, with documentation of cannabis use. KEY

resultsAmong the 12,070 patients, 65.8% (N = 7,948) had a cannabis term, whereas 34.1% (N = 4,122) of patients lacked a cannabis term, suggesting that no documentation of cannabis use or discussion between provider and patient took place. Among the subset of patients who had a discussion documented, 47% related to cannabis use for medical reasons, 35% related to a discussion of VA policy or legal issues, and 17% related to a discussion specific to medical risks or harm reduction strategies. In adjusted analyses, residents of states with legalized recreational cannabis were less likely to have any cannabis-related discussion compared to patients in non-legal states [OR 0.73, 95% CI 0.64-0.82].

conclusionsOne-third of LTOT patients did not have documentation of cannabis use in the chart in the 6 months following a positive UDT for cannabis. Discussions related to the medical risks of cannabis use or harm reduction strategies were uncommon.

Indexed as

And opioidsCannabisCannabis documentationCannabis for painCannabis use in Veterans

Identifiers

PMID38493111
PMCPMC10943860

What Socratic holds

Textmetadata
LicenceCC BY
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 Socratic graph.