Escalation of drug use in early-onset cannabis users vs co-twin controls
Escalation of drug use in early-onset cannabis users vs co-twin controls
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DOI：
10.1001/jama.289.4.427
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发表时间：
2003-01-22
影响因子：
120.7
通讯作者：
Martin, NG
中科院分区：
文献类型：
--
作者：
Lynskey, MT;Heath, AC;Martin, NG
背景以前的研究报告说，早期开始使用大麻（大麻）使用是其他药物使用和药物相关问题的一个重要危险因素。目的研究在控制遗传和共同环境影响后，早期大麻使用和随后进展到使用其他药物和药物滥用/依赖之间的关联是否持续。设计1996年进行的横断面调查-2000年，在澳大利亚全国311名年轻成年志愿者中进行了抽样调查。（中位年龄，30岁）同卵和异卵同性双胞胎对早期大麻使用不一致主要结果测量自我报告的随后非医疗使用处方镇静剂、致幻剂、可卡因/其他兴奋剂和阿片类药物;滥用或依赖这些药物（包括大麻滥用/依赖）;结果17岁以前使用大麻的人有其他药物使用，酒精依赖，和药物滥用/依赖，比17岁之前没有使用大麻的孪生兄弟高2.1至5.2倍。控制已知的风险因素（早发性酒精或烟草使用，父母冲突/分离，儿童期性虐待，行为障碍，重度抑郁症和社交焦虑）对这些结果的影响可以忽略不计。这些协会之间没有显着差异单卵双胞胎和双卵twin.Conclusions早期大麻使用和后来的药物使用和滥用/依赖之间的关联不能仅仅解释共同的易感基因或共享的环境因素。这种关联可能是由于使用和获得大麻的同伴和社会背景的影响而产生的。特别是，抢先体验和使用大麻可减少对使用其他非法药物的感知障碍，并提供获得这些药物的机会。
Context Previous studies have reported that early initiation of cannabis (marijuana) use is a significant risk factor for other drug use and drug-related problems.Objective To examine whether the association between early cannabis use and subsequent progression to use of other drugs and drug abuse/dependence persists after controlling for genetic and shared environmental influences.Design Cross-sectional survey conducted in 1996-2000 among an Australian national volunteer sample of 311 young adult (median age, 30 years) monozygotic and dizygotic same-sex twin pairs discordant for early cannabis use (before age 17 years).Main Outcome Measures Self-reported subsequent nonmedical use of prescription sedatives, hallucinogens, cocaine/other stimulants, and opioids; abuse or dependence on these drugs (including cannabis abuse/dependence); and alcohol dependence.Results Individuals who used cannabis by age 17 years had odds of other drug use, alcohol dependence, and drug abuse/dependence that were 2.1 to 5.2 times higher than those of their co-twin, who did not use cannabis before age 17 years. Controlling for known risk factors (early-onset alcohol or tobacco use, parental conflict/separation, childhood sexual abuse, conduct disorder, major depression, and social anxiety) had only negligible effects on these results. These associations did not differ significantly between monozygotic and dizygotic twins.Conclusions Associations between early cannabis use and later drug use and abuse/dependence cannot solely be explained by common predisposing genetic or shared environmental factors. The association may arise from the effects of the peer and social context within which cannabis is used and obtained. In particular, early access to and use of cannabis may reduce perceived barriers against the use of other illegal drugs and provide access to these drugs.