Department of Neuroscience, Farber Institute for Neurosciences, Thomas Jefferson University, Philadelphia, PA, USA.
Am J Addict. 2013 Jul-Aug;22(4):344-51. doi: 10.1111/j.1521-0391.2013.12044.x.
Illicit drug use, particularly of cannabis, is common among opiate-dependent individuals and has the potential to impact treatment in a negative manner.
To examine this, patterns of cannabis use prior to and during methadone maintenance treatment (MMT) were examined to assess possible cannabis-related effects on MMT, particularly during methadone stabilization. Retrospective chart analysis was used to examine outpatient records of patients undergoing MMT (n = 91), focusing specifically on past and present cannabis use and its association with opiate abstinence, methadone dose stabilization, and treatment compliance.
Objective rates of cannabis use were high during methadone induction, dropping significantly following dose stabilization. History of cannabis use correlated with cannabis use during MMT but did not negatively impact the methadone induction process. Pilot data also suggested that objective ratings of opiate withdrawal decrease in MMT patients using cannabis during stabilization.
The present findings may point to novel interventions to be employed during treatment for opiate dependence that specifically target cannabinoid-opioid system interactions.
阿片类药物依赖者普遍存在非法药物使用,特别是大麻,这可能会对治疗产生负面影响。
为了研究这一问题,我们检查了阿片类药物依赖者在美沙酮维持治疗(MMT)之前和期间的大麻使用模式,以评估大麻对 MMT 的可能影响,特别是在美沙酮稳定期。回顾性图表分析用于检查接受 MMT 的门诊患者(n=91)的记录,重点关注过去和现在的大麻使用情况及其与阿片类药物戒断、美沙酮剂量稳定和治疗依从性的关系。
美沙酮诱导期的客观大麻使用率较高,剂量稳定后显著下降。大麻使用史与 MMT 期间的大麻使用相关,但不会对美沙酮诱导过程产生负面影响。初步数据还表明,在稳定期使用大麻的 MMT 患者中,阿片类药物戒断的客观评分降低。
目前的发现可能指向在阿片类药物依赖治疗中使用的新干预措施,这些措施专门针对大麻素-阿片系统相互作用。