Quantifying data-driven metrics of meaningful cannabis reduction

量化有意义的大麻减少的数据驱动指标

• 批准号: 10426065
• 负责人: Nathaniel Lee Baker
• 金额: $ 18.88万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10426065
• 关键词: Abstinence; Address; Adult; African American; Age; Alcohols; Area; Biochemical Markers; Biological Assay; Biological Markers; Cannabinoids; Cannabis; Common Data Element; Creatinine; Data; Data Pooling; Data Set; Development; Drug usage; Enrollment; Female; Future; Goals; Gold; Grant; Harm Reduction; Health Benefit; Hispanic; Individual; Knowledge; Latinx; Literature; Measures; Methods; Modeling; Opioid; Outcome; Outcome Study; Participant; Patient Self-Report; Pattern; Perception; Plants; Plasma; Prevalence; Procedures; Public Health; Research; Saliva; Standardization; Statutes and Laws; Stimulant; Substance of Abuse; Time; Tobacco; Treatment outcome; United States; Urine; Work; cannabis cessation; data de-identification; demographics; diaries; improved; infancy; marijuana legalization; marijuana use; marijuana use disorder; model development; prospective; public health priorities; secondary analysis; success; treatment strategy; treatment trial; urinary

PROJECT SUMMARY/ABSTRACT Rates of cannabis use among adults in the United States are increasing and the perception of harm associated with cannabis use continues to decline. As legislation shifts towards widespread legal cannabis access, there is the potential to see an even greater increase in use rates, increased prevalence of regular use, and the development of cannabis use disorder (CUD). While cannabis cessation remains an important milestone for many, there may be public health benefit to exploring harm reduction approaches to cannabis use. Harm reduction strategies have strong empirical support for alcohol and opioids, but harm reduction work for cannabis is still in its infancy. For example, it is currently unknown how best to implement harm reduction approaches for cannabis and, critically, how to detect and define reductions in cannabis use to determine if there are benefits associated with reduction. Given that there is no established definition of cannabis reduction in the literature, this R21 proposal aims to address this gap in the literature by conducting a secondary analysis of six cannabis treatment trials conducted within our research group (five completed, one currently enrolling; N=873 expected at the earliest grant start date; N=820 currently enrolled; ages 13-65; 28% female; 26% African American; 12% Hispanic/Latinx). We propose to use these existing, de-identified data to characterize the decay in urinary cannabinoids coinciding with significant reductions in self-reported cannabis use. By characterizing the average decay and prediction intervals of urinary cannabinoids from this comprehensive data set, we will have data- driven metrics to operationally define and biologically verify cannabis reduction in future harm reduction and treatment studies. Specifically, the aims of this proposal are to: 1) determine whether 50% or greater decreases in weekly self-reported cannabis use correlate with a corresponding decrease in creatinine-normalized urinary cannabinoids following five weeks of use reduction; and 2) characterize the decay in weekly creatinine- normalized urinary cannabinoids in participants who reduce cannabis use by at least 50% by week five of treatment. Harm reduction strategies for cannabis use may be a beneficial alternative to cessation for some regular users, but important cannabis harm reduction questions cannot be adequately and systemically answered without rigorous and data-driven metrics to define and detect reductions in use. Outcomes from this study have the potential to impact future work on CUD treatment by promoting a shift towards alternative, non- abstinence outcomes of treatment success and improving the rigor of cannabis harm reduction work by providing data-driven reduction metrics. Cannabis use and its consequences represent an area of public health priority and there is a need to explore strategies to reduce the harmful impact of cannabis in regular users.

项目摘要/摘要 美国成年人中大麻使用的速度正在增加和对伤害的看法 与大麻使用相关的人继续下降。随着立法转向广泛的法律大麻 访问，有可能看到使用率的增加，定期使用的患病率增加， 以及大麻使用障碍（CUD）的发展。而大麻停止仍然是一个重要的里程碑 对于许多人来说，探索减少大麻使用的危害方法可能会带来公共卫生的好处。伤害 减少策略对酒精和阿片类药物有强烈的经验支持，但减少大麻的危害工作 仍处于起步期。例如，目前尚不清楚如何最好地实施减少伤害的方法 大麻，批判性地检测和定义大麻使用的减少来确定是否有好处 与还原有关。鉴于在文献中尚无对减少大麻减少的定义 R21提案旨在通过对六个大麻进行二次分析来解决文献中的这一差距 在我们的研究小组内进行的治疗试验（五项完成，目前正在注册； n = 873期望 在最早的赠款开始日期； n = 820当前注册； 13-65岁；女性28％； 26％的非裔美国人； 12％ 西班牙裔/拉丁裔）。我们建议使用这些现有的，被识别的数据来表征尿液中的衰减 大麻素与自我报告的大麻使用大大减少相吻合。通过表征平均 从这个综合数据集中尿尿大麻素的衰减和预测间隔，我们将拥有数据 - 驱动的指标可以在操作上定义和生物学验证减少大麻的减少大麻，并 治疗研究。具体而言，该提案的目的是：1）确定50％或更高的减少 在每周自我报告的大麻中，使用与肌酐归一化尿液的相应降低相关 减少使用五周后，大麻素； 2）特征是每周肌酐的衰减 - 参与者中的归一化尿大麻素，他们在第五周将大麻使用的使用率降低至少50％ 治疗。减少大麻使用的危害策略可能是戒烟的有益替代方案 普通用户，但重要的大麻减少危害问题不能充分和系统地被充分 回答没有严格和数据驱动的指标，以定义和检测使用的减少。结果 研究有可能通过促进向替代性，非 - 禁止治疗成功的结果，并通过提供减少大麻伤害工作的严格性 数据驱动的还原指标。大麻使用及其后果代表了公共卫生优先事项 而且有必要探索减少大麻对常规用户的有害影响的策略。