Is it time for a cannabis harm reduction approach? Commentary on Sherman et al. (2022) and Borodovsky et al. (2022).
Is it time for a cannabis harm reduction approach? Commentary on Sherman et al. (2022) and Borodovsky et al. (2022).
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是时候采取减少大麻危害的方法了吗？
DOI：
10.1037/adb0000927
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Sherman,BrianJ
中科院分区：
文献类型：
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作者：
Stone,BryantM;Sherman,BrianJ
最近的研究表明，大麻衍生产品具有潜在的治疗益处，比其他非法物质的风险更低，并且减少使用会显着改善功能。同样，在大麻使用障碍（CUD）患者中，低戒烟率和低戒烟动机也是常态。因此，减少危害模型作为一种可行的替代方法在物质使用科学家和卫生保健专业人员中获得了牵引力。然而，到目前为止，没有正式的定义，大麻危害减少已被proposed.MethodWe回顾了文献，包括最近发表在成瘾行为心理学，谢尔曼等人的两篇实证论文。（2022）和Borodovsky et al.（2022），这表明损害减少足以实现功能改善。然后，我们提出并定义了一个减少危害的方法，大麻使用的研究和治疗，并认为为什么这种方法是一个及时的，必要的discussion.ResultsWe建议，大麻减少危害的方法包括治疗，研究和教育的举措，减少大麻使用的公共卫生负担。这种方法包括减少大麻的功能障碍和风险，减少或管理使用，有时但不一定是禁欲的干预措施。心理教育的治疗提供者，立法障碍，和研究建议也discussed.ConclusionsResearch和治疗CUD历来集中在大麻戒断。治疗试验很少产生持久的戒烟率，最近减少与功能改善有关。我们评论谢尔曼等人。（2022）和Borodovsky et al.（2022年），并提出转向减少大麻危害的方法。
ObjectiveRecent research suggests potential therapeutic benefits of cannabis-derived products, a lower risk profile than other illicit substances, and significant functional improvement from reduced use. Likewise, low abstinence rates and low motivation to achieve abstinence among those with cannabis use disorder (CUD) are the norm. As such, the harm reduction model has gained traction among substance use scientists and health care professionals as a viable alternative approach. Yet, to date no formal definition of cannabis harm reduction has been proposed.MethodWe reviewed the literature, including two recent empirical papers published in the Psychology of Addictive Behaviors, Sherman et al.(2022) and Borodovsky et al.(2022), which demonstrate that harm reduction is sufficient to achieve functional improvement. We then propose and define a harm reduction approach for cannabis use research and treatment, and argue why this approach is a timely, necessary discussion.ResultsWe suggest that a cannabis harm reduction approach includes treatment, research, and education initiatives that reduce the public health burden of cannabis use. This approach includes interventions that reduce functional impairment and risk from cannabis, reduced or managed use, and sometimes, but not necessarily, abstinence. Psychoeducation for treatment providers, legislative barriers, and research recommendations are also discussed.ConclusionsResearch and treatment for CUD has historically focused on cannabis abstinence. Treatment trials rarely yield durable abstinence rates, and reduction has recently been tied to functional improvement. We comment on Sherman et al.(2022) and Borodovsky et al.(2022) and propose a shift toward a cannabis harm reduction approach.