After medical and recreational marijuana was legalized in Washington, it’s not surprising tolearn that the use of the substance is on the rise in theEvergreen State. And so is the potential for “cannabis usedisorder” -- i.e., addiction, which can exacerbate depression and anxiety, according to a study byKaiser Permanente researchers in Seattle.

About one in seven adult primary care patients visiting medicaloffices in Washington reported having used marijuana at least oncein the past year, according to an analysis of 22,000 patientrecords by researchers at the Washington Health Research Institute,whose findings werepublished in the Journal of the American Board of FamilyMedicine.

In young adults, that rate was higher: nearly two in five. Youngadults — especially men age 18-29 who had depression or usedtobacco — were also much more likely than others to use marijuanaevery day.

“Some groups of patients are more likely to use cannabis dailyand be at higher risk for complications such as cannabis usedisorder — as well as some harms that are not yet completelyunderstood,” Kaiser research associate Gwen T. Lapham writes on Kaiser blog post.

In recent years, the concentration of tetrahydrocannabinol, orTHC, the main psychoactive and addictive component, has increasedin cannabis plants from 3 percent to 12 percent, Dr. Lapham says.And new products — like concentrated hash oil and syntheticcannabinoids — are raising the potency and risk for addiction.

Among patients who reported using marijuana, about half used itat least monthly — and about one in five used it daily, theresearchers found. From a quarter to half of people who use dailyare estimated to develop a cannabis use disorder, where patientscan’t cut down on their use despite accumulating use-relatedproblems.

“Widespread daily use in young men with depression isconcerning, because using cannabis can worsen depression andanxiety,” Dr. Lapham writes.

Doctors should routinely ask their patients during medicalvisits about the use of marijuana as part of “whole-person care” –and then start a dialogue with them, writes the study’s principalinvestigator, Katharine A. Bradley, a senior investigator at KPWHRIand internal medicine physician with Washington Permanente MedicalGroup.

“Our findings highlight the need for primary care clinicians tobe aware of the benefits and harms that patients may beexperiencing due to their cannabis use — and initiating aconversation is only the start in that process,” Dr. Bradleywrites.

These conversations can help providers assess the intensity ofpatients’ use, perceived risks and benefits and reasons whypatients are using marijuana, for instance possibly for symptoms ofa treatable condition.

Such conversations will most likely increase, considering thenumber of users is projected to grow during the next decade as morestates legalize the use of recreational marijuana, particularly forrecreational use, the researchers add.