Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients
Medical cannabis access, use, and substitution for prescription opioids and other substances: A survey of authorized medical cannabis patients
复制标题
DOI：
10.1016/j.drugpo.2017.01.011
复制
发表时间：
2017-04-01
影响因子：
4.4
通讯作者：
Walsh, Zach
中科院分区：
文献类型：
--
作者：
Lucas, Philippe;Walsh, Zach
背景：2014年，加拿大卫生部以《医疗用途马里瓦纳条例》(MMPR)取代了《医疗准入条例》(MMAR)。新计划的主要变化之一是从一个获得许可的大麻生产商(LP)转移到多个获得许可的生产商。这是第一次对MMPR中登记的患者进行全面调查。方法：从联邦授权的MMPR内的特许生产商Tilray购买大麻的患者被邀请完成一项在线调查，包括107个关于人口统计学、使用模式和大麻替代效果的问题。调查由271名受访者完成。结果：大麻被认为是治疗各种疾病的有效方法，其中疼痛和心理健康是最突出的。研究结果包括大量自我报告使用大麻作为处方药的替代品(63%)，特别是药用阿片类药物(30%)、苯二氮卓类药物(16%)和抗抑郁药(12%)。患者还报告用大麻替代酒精(25%)、香烟/烟草(12%)和非法药物(3%)。很大一部分患者(42%)报告说除了通过有限合伙人获得大麻外，还从非法/不受管制的来源获得大麻，超过一半(55%)的患者被收取使用大麻的医疗建议费用，近25%的患者支付300美元或更多。结论：患者报告将大麻用作处方药替代品的发现支持了先前对医用大麻使用者的研究；然而，这项研究首次明确了大麻被用作替代大麻的处方药类别，并将这种替代与特定的诊断类别相匹配。一些获得授权的患者从不受监管的来源购买大麻，以及相当大比例的患者被收取医用大麻建议的费用，这一发现突显了这一联邦计划正在面临的政策挑战。(C)2017爱思唯尔B.V.保留所有权利。
Background: In 2014 Health Canada replaced the Marihuana for Medical Access Regulations (MMAR) with the Marihuana for Medical Purposes Regulations (MMPR). One of the primary changes in the new program has been to move from a single Licensed Producer (LP) of cannabis to multiple Licensed Producers. This is the first comprehensive survey of patients enrolled in the MMPR.Methods: Patients registered to purchase cannabis from Tilray, a federally authorized Licenced Producer (LP) within the MMPR, were invited to complete an online survey consisting of 107 questions on demographics, patterns of use, and cannabis substitution effect. The survey was completed by 271 respondents.Results: Cannabis is perceived to be an effective treatment for diverse conditions, with pain and mental health the most prominent. Findings include high self-reported use of cannabis as a substitute for prescription drugs (63%), particularly pharmaceutical opioids (30%), benzodiazepines (16%), and antidepressants (12%). Patients also reported substituting cannabis for alcohol (25%), cigarettes/tobacco (12%), and illicit drugs (3%). A significant percentage of patients (42%) reported accessing cannabis from illegal/unregulated sources in addition to access via LPs, and over half (55%) were charged to receive a medical recommendation to use cannabis, with nearly 25% paying $300 or more.Conclusion: The finding that patients report its use as a substitute for prescription drugs supports prior research on medical cannabis users; however, this study is the first to specify the classes of prescription drugs for which cannabis it is used as a substitute, and to match this substitution to specific diagnostic categories. The findings that some authorized patients purchase cannabis from unregulated sources and that a significant percentage of patients were charged for medical cannabis recommendations highlight ongoing policy challenges for this federal program. (C) 2017 Elsevier B.V. All rights reserved.