Hyman Scott M, Sinha Rajita
Department of Psychiatry, Yale University School of Medicine, Substance Abuse Treatment Unit, 1 Long Wharf Drive, Box 18, New Haven, CT 06511, USA.
J Subst Abuse Treat. 2009 Jun;36(4):400-13. doi: 10.1016/j.jsat.2008.08.005. Epub 2008 Nov 11.
We examined the role of stress as a risk factor and motivation for cannabis use/misuse. A systematic review of studies gathered from PsychINFO and MEDLINE databases was conducted. Findings suggest that cannabis is commonly used as a stress-coping strategy. Negative life events, trauma, and maladaptive coping were all related to consumption. Cannabis use for stress-coping purposes was most evident when examining chronic as compared with experimental use. Although many individuals may be able to use cannabis without consequences, there appears to be a subset of individuals who experience greater life stress and who may be more likely to use for stress-coping purposes. These individuals may be at greatest risk for addiction. Chronic use may potentiate stress-related motivation to use/abuse cannabis and is associated with decision-making deficits and alterations in brain-stress pathways that may exacerbate compulsive drug seeking and sensitize individuals to stress-related drug use. Overall, stress-coping interventions and harm reduction focused on reducing the amount ingested may facilitate prevention and recovery efforts.
我们研究了压力作为大麻使用/滥用的风险因素和动机所起的作用。对从PsychINFO和MEDLINE数据库收集的研究进行了系统综述。研究结果表明,大麻通常被用作一种应对压力的策略。负面生活事件、创伤和适应不良的应对方式均与大麻消费有关。与实验性使用相比,在研究慢性使用时,将大麻用于应对压力的目的最为明显。尽管许多人使用大麻可能没有不良后果,但似乎有一部分人经历着更大的生活压力,并且可能更倾向于将大麻用于应对压力的目的。这些人可能成瘾风险最高。长期使用可能会增强与压力相关的使用/滥用大麻的动机,并与决策缺陷以及脑-压力通路的改变有关,这些改变可能会加剧强迫性觅药行为,并使个体对与压力相关的药物使用变得敏感。总体而言,专注于减少摄入量的应对压力干预措施和减少伤害措施可能有助于预防和康复工作。