Fuster Daniel, Cheng Debbie M, Allensworth-Davies Donald, Palfai Tibor P, Samet Jeffrey H, Saitz Richard
Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, 801 Massachusetts Avenue, 2nd floor (Room #2022C), Boston, MA, 02118, USA,
J Gen Intern Med. 2014 Jan;29(1):133-9. doi: 10.1007/s11606-013-2605-z. Epub 2013 Sep 19.
Marijuana is the most commonly used illicit drug, yet its impact on health and healthcare utilization has not been studied extensively.
To assess the cross-sectional association between frequency of marijuana use and healthcare utilization (emergency department and hospitalization) and health (comorbidity, health status), we studied patients in an urban primary care clinic who reported any recent (past 3-month) drug use (marijuana, opioids, cocaine, others) on screening. Frequency of marijuana use in the past 3 months was the main independent variable [daily/ almost daily, less than daily and no use (reference group)]. Outcomes assessed were past 3-month emergency department or hospital utilization, the presence of medical comorbidity (Charlson index ≥ 1), and health status with the EuroQol. We used separate multivariable regression models adjusting for age, sex, tobacco and other substance use.
All 589 participants reported recent drug use: marijuana 84 % (29 % daily, 55 % less than daily), cocaine 25 %, opioid 23 %, other drugs 8 %; 58 % reported exclusive marijuana use. Frequency of marijuana use was not significantly associated with emergency department use {adjusted odds ratio [AOR] 0.67, [95 % confidence interval (CI) 0.36, 1.24] for daily; AOR 0.69 [95 % CI 0.40,1.18] for less than daily versus no use}, hospitalization [AOR 0.79 (95 % CI 0.35, 1.81) for daily; AOR 1.23 (95 % CI 0.63, 2.40) for less than daily versus no use], any comorbidity [AOR 0.62, (95 % CI 0.33, 1.18) for daily; AOR 0.67 (95 % CI 0.38, 1.17) for less than daily versus no use] or health status (adjusted mean EuroQol 69.1, 67.8 and 68.0 for daily, less than daily and none, respectively, global p = 0.78).
Among adults in primary care who screen positive for any recent illicit or non-medical prescription drug use, we were unable to detect an association between frequency of marijuana use and health, emergency department use, or hospital utilization.
大麻是最常用的非法药物，但其对健康和医疗保健利用的影响尚未得到广泛研究。
为了评估大麻使用频率与医疗保健利用（急诊科就诊和住院）及健康状况（合并症、健康状态）之间的横断面关联，我们对一家城市初级保健诊所中筛查出近期（过去3个月）使用过任何药物（大麻、阿片类药物、可卡因、其他药物）的患者进行了研究。过去3个月内大麻的使用频率是主要自变量[每日/几乎每日、少于每日及未使用（参照组）]。评估的结果包括过去3个月内的急诊科就诊或住院情况、是否存在医疗合并症（查尔森指数≥1）以及使用欧洲五维度健康量表评估的健康状态。我们使用了单独的多变量回归模型，并对年龄、性别、烟草及其他物质使用情况进行了校正。
所有589名参与者均报告近期使用过药物：84%使用过大麻（29%每日使用，55%少于每日使用），25%使用过可卡因，23%使用过阿片类药物，8%使用过其他药物；58%报告仅使用过大麻。大麻使用频率与急诊科就诊无显著关联{每日使用的校正比值比[AOR]为0.67，[95%置信区间（CI）为0.36, 1.24]；少于每日使用与未使用者相比，AOR为0.69 [95% CI为0.40, 1.18]}，与住院情况也无显著关联[每日使用的AOR为0.79（95% CI为0.35, 1.81）；少于每日使用与未使用者相比，AOR为1.23（95% CI为0.63, 2.40）]；与任何合并症也无显著关联[每日使用的AOR为0.62，（95% CI为0.33, 1.18）；少于每日使用与未使用者相比，AOR为0.67（95% CI为0.38, 1.17）]，与健康状态也无关（每日、少于每日及未使用者的校正欧洲五维度健康量表平均分分别为69.1、67.8和68.0，总体p = 0.78）。
在初级保健中对近期任何非法或非医疗处方药物使用筛查呈阳性的成年人中，我们未能发现大麻使用频率与健康、急诊科就诊或住院利用之间存在关联。
