The impact of cannabis use on patients enrolled in opioid agonist therapy in Ontario, Canada.
The impact of cannabis use on patients enrolled in opioid agonist therapy in Ontario, Canada.
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DOI：
10.1371/journal.pone.0187633
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Marsh DC
中科院分区：
文献类型：
--
作者：
Franklyn AM;Eibl JK;Gauthier GJ;Marsh DC
随着加拿大政府在2018年将大麻合法化，必须对某些人群（包括阿片类药物使用障碍患者）的潜在危害进行调查。大麻是从事阿片类药物使用障碍药物辅助治疗的患者最常用的物质之一，其影响在很大程度上是未知的。在这项研究中，我们检查了基线和持续使用大麻的影响，以及这些影响是否因性别而异。我们进行了一项回顾性队列研究，使用来自加拿大安大略省58家提供阿片类激动剂治疗的诊所的匿名电子医疗记录。一年的治疗保留是主要的研究结果，对在治疗的第一个月有大麻阳性尿样和没有大麻阳性尿样的患者进行测量，并作为整个治疗过程中大麻阳性尿样比例的函数。我们的队列包括644名患者，其中328名被认为是基线大麻使用者，256名被认为是重度使用者。基线使用大麻和重度使用大麻的患者退出的风险增加（分别为38.9%和48.1%）。在按性别评估这些趋势时，只有女性基线使用者和男性重度使用者有过早退出的风险增加。基线和大量使用大麻都预示着治疗保留率降低，性别之间确实存在差异。随着大麻在不久的将来合法化，医生应该密切监测使用大麻的患者，并在接受阿片类药物使用障碍治疗时提供有关使用大麻的潜在危害的教育。
With the Canadian government legalizing cannabis in the year 2018, the potential harms to certain populations—including those with opioid use disorder—must be investigated. Cannabis is one of the most commonly used substances by patients who are engaged in medication-assisted treatment for opioid use disorder, the effects of which are largely unknown. In this study, we examine the impact of baseline and ongoing cannabis use, and whether these are impacted differentially by gender. We conducted a retrospective cohort study using anonymized electronic medical records from 58 clinics offering opioid agonist therapy in Ontario, Canada. One-year treatment retention was the primary outcome of interest and was measured for patients who did and did not have a cannabis positive urine sample in their first month of treatment, and as a function of the proportion of cannabis-positive urine samples throughout treatment. Our cohort consisted of 644 patients, 328 of which were considered baseline cannabis users and 256 considered heavy users. Patients with baseline cannabis use and heavy cannabis use were at increased risk of dropout (38.9% and 48.1%, respectively). When evaluating these trends by gender, only female baseline users and male heavy users are at increased risk of premature dropout. Both baseline and heavy cannabis use are predictive of decreased treatment retention, and differences do exist between genders. With cannabis being legalized in the near future, physicians should closely monitor cannabis-using patients and provide education surrounding the potential harms of using cannabis while receiving treatment for opioid use disorder.
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DOI：
10.1056/nejmra1402309
发表时间：
2014-06-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Volkow ND;Baler RD;Compton WM;Weiss SR
通讯作者：
Weiss SR
影响因子：
39
作者：
Bachhuber, Marcus A.;Saloner, Brendan;Cunningham, Chinazo O.;Barry, Colleen L.
通讯作者：
Barry, Colleen L.
影响因子：
6.6
作者：
Peles, Einat;Schreiber, Shaul;Adelson, Miriam
通讯作者：
Adelson, Miriam
影响因子：
5.5
作者：
Davis, Jonathan M.;Mendelson, Bruce;Booth, Robert E.
通讯作者：
Booth, Robert E.
影响因子：
7.9
作者：
Bawor, Monica;Dennis, Brittany B.;Samaan, Zainab
通讯作者：
Samaan, Zainab