Trends in cannabis or cocaine-related dependence and alcoholdrug treatment in Argentina, Chile, and Uruguay.
In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabiscocaine-related dependence and treatment in Argentina, Chile, and Uruguay. Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 surveys, 2006-2017), Chile (7 surveys, 2006-2018), and Uruguay (4 surveys, 2006-2018) were harmonized. We estimated weighted prevalences of cannabis or cocaine-related (cocaine or cocaine paste) dependence, based on meeting 3 past-year ICD-10 dependence criteria. We estimated weighted prevalences of past-year alcoholdrug treatment use (Argentina, Chile) or useseeking (Uruguay) among people with past-year cannabiscocaine-related dependence. We tested model-based prevalence trends over time and described individual-level treatment correlates by country. Cannabiscocaine dependence prevalence increased in the region starting in 2010-2011, driven by cannabis dependence. Adjusted cannabis dependence prevalence increased from 0.7% in 2010 to 1.5% in 2017 in Argentina (aPD0.8, 95% CI 0.3, 1.2), from 0.8% in 2010 to 2.8% in 2018 in Chile (aPD2.0, 95% CI 1.4, 2.6), and from 1.4% in 2011 to 2.4% in 2018 in Uruguay (aPD0.9, 95% CI 0.2, 1.6). Cocaine-related dependence increased in Uruguay, decreased in Argentina, and remained stable in Chile. Among people with past-year cannabiscocaine dependence, average alcoholdrug treatment use prevalence was 15.3% in Argentina and 6.0% in Chile, while treatment useseeking was 14.7% in Uruguay. Alcoholdrug treatment prevalence was lower among people with cannabis dependence than cocaine-related dependence. Treatment correlates included older ages in all countries and male sex in Argentina only. Alcoholdrug treatment use among people with cannabiscocaine-related dependence remained low, signaling an ongoing treatment gap in the context of growing cannabis dependence prevalence in the region. Additional resources may be needed to increase treatment access and uptake. Future studies should assess contributors of low treatment use, including perceived need, stigma, and service availability.