Is cannabis use associated with less opioid use among people who inject drugs?
Is cannabis use associated with less opioid use among people who inject drugs?
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DOI：
10.1016/j.drugalcdep.2015.05.014
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发表时间：
2015-08-01
影响因子：
4.2
通讯作者：
Bluthenthal RN
中科院分区：
文献类型：
--
作者：
Kral AH;Wenger L;Novak SP;Chu D;Corsi KF;Coffa D;Shapiro B;Bluthenthal RN
临床、实验和人种学研究表明，大麻可能被用来帮助止痛。人种学研究表明，一些人正在使用大麻来减少非法阿片类药物的使用。我们试图了解注射吸毒者中大麻使用和非医用阿片类药物使用频率之间是否存在关联(PWID)。2011-2013年，PWID是在洛杉矶和加利福尼亚州旧金山使用定向抽样方法招募的。我们将分析限于在过去30天内使用阿片类药物的人(N=653)。结果变量：在过去30天内非医学使用任何阿片类药物的次数。解释变量：在过去30天内使用任何大麻。统计学：使用对数变换的结果变量的多变量线性回归。约有一半的人报告在过去30天内使用了大麻。吸食大麻的人在过去30天内使用阿片类药物的平均次数和中位数显著低于不吸食大麻的人(平均次数：58.3vs.76.4倍；中位数：30次vs.60倍；p<；0.003)。在多变量分析中，使用大麻的人使用阿片类药物的频率低于不使用大麻的人(Beta：−0.346；95%可信区间：−0.575，−0.116；p<；0.003)。在PWID中，最近使用大麻与非医用阿片类药物使用频率较低之间存在统计关联。这可能表明PWID使用大麻来减轻他们的疼痛和/或非医疗用途的阿片类药物。然而，需要更多的研究，包括前瞻性的纵向研究，以确定这些发现的有效性。
Clinical, experimental, and ethnographic research suggests that cannabis may be used to help manage pain. Ethnographic research has revealed that some people are using cannabis to temper their illicit opioid use. We seek to learn if there is an association between cannabis use and the frequency of nonmedical opioid use among people who inject drugs (PWID). PWID were recruited using targeted sampling methods in Los Angeles and San Francisco, California, 2011–2013. We limited analysis to people who used opioids in past 30 days (N=653). Outcome variable: number of times used any opioids non-medically in past 30 days. Explanatory variable: any cannabis use past 30 days. Statistics: multivariable linear regression with a log-transformed outcome variable. About half reported cannabis use in the past 30 days. The mean and median number of times using opioids in past 30 days were significantly lower for people who used cannabis than those who did not use cannabis (mean: 58.3 vs. 76.4 times; median: 30 vs 60 times, respectively; p<0.003). In multivariable analysis, people who used cannabis used opioids less often than those who did not use cannabis (Beta: −0.346; 95% confidence interval: −0.575, −0.116; p<0.003). There is a statistical association between recent cannabis use and lower frequency of nonmedical opioid use among PWID. This may suggest that PWID use cannabis to reduce their pain and/or nonmedical use of opioids. However, more research, including prospective longitudinal studies, is needed to determine the validity of these findings.