title: Cannabis Use and Disorder From Childhood to Adulthood in a Longitudinal Community Sample With American Indians.
abstract: OBJECTIVE
  Recent changes in DSM criteria require new documentation of the prevalence and developmental sequences of cannabis use disorder (CUD). The goal of this study was to investigate the early course of DSM-5 CUD and its overlap with DSM-IV and consumption constructs in a community-representative sample of American Indians.
  
  
  METHODS
  Data came from the prospective, longitudinal, population-based Great Smoky Mountains Study in North Carolina (N = 1,420, including 349 American Indians). Cannabis use and disorder were assessed during yearly interviews from 9 to 16 years of age and at 19, 21, 26, and 30 years of age (up to 11 assessments per participant from 1993 through 2015).
  
  
  RESULTS
  By 30 years of age, approximately 70% of participants had used cannabis, 34% had used cannabis daily, and 18% had met criteria for DSM-5 CUD. Approximately 1 in 4 cannabis users met criteria for CUD at some point. Those who met criteria initiated use more than 2 years previously (at 13.3 years old) compared with other users. Despite higher risks from increased poverty, American Indians' patterns of use were similar to those of the rest of the sample. Concordance between DSM-5 CUD and DSM-IV abuse or dependence was substantial but was even higher between DSM-5 CUD and daily use.
  
  
  CONCLUSIONS
  It was common to have used cannabis daily or to have met criteria for DSM-5 CUD by adulthood. DSM-5 CUD was an improvement over DSM-IV diagnostic constructs by raising the threshold for diagnosis.
authors.affiliation: Duke University, Durham, NC. Electronic address: William.Copeland@duke.edu.
authors.forename: William E
authors.initials: WE
authors.lastname: Copeland
authors.affiliation: Duke University, Durham, NC.
authors.forename: Sherika
authors.initials: S
authors.lastname: Hill
authors.affiliation: Duke University, Durham, NC.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Costello
authors.affiliation: University of North Carolina, Chapel Hill.
authors.forename: Lilly
authors.initials: L
authors.lastname: Shanahan
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000208:ethnology*; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000208:ethnology*; D000074609:Marijuana Use / Q000208:ethnology*; D009657:North Carolina / Q000208:ethnology; D055815:Young Adult
keywords: American Indian; cannabis use; cannabis use disorder; epidemiology