Degenhardt Louisa, Lintzeris Nicholas, Campbell Gabrielle, Bruno Raimondo, Cohen Milton, Farrell Michael, Hall Wayne D
National Drug and Alcohol Research Centre, UNSW, Australia; School of Population and Global Health, University of Melbourne, Australia.
Discipline of Addiction Medicine, University of Sydney, Australia; The Langton Centre, South East Sydney Local Health District (SESLHD) Drug and Alcohol Services, Australia.
Drug Alcohol Depend. 2015 Feb 1;147:144-50. doi: 10.1016/j.drugalcdep.2014.11.031. Epub 2014 Dec 10.
There is increasing debate about cannabis use for medical purposes, including for symptomatic treatment of chronic pain. We investigated patterns and correlates of cannabis use in a large community sample of people who had been prescribed opioids for chronic non-cancer pain.
The POINT study included 1514 people in Australia who had been prescribed pharmaceutical opioids for chronic non-cancer pain. Data on cannabis use, ICD-10 cannabis use disorder and cannabis use for pain were collected. We explored associations between demographic, pain and other patient characteristics and cannabis use for pain.
One in six (16%) had used cannabis for pain relief, 6% in the previous month. A quarter reported that they would use it for pain relief if they had access. Those using cannabis for pain on average were younger, reported greater pain severity, greater interference from and poorer coping with pain, and more days out of role in the past year. They had been prescribed opioids for longer, were on higher opioid doses, and were more likely to be non-adherent with their opioid use. Those using cannabis for pain had higher pain interference after controlling for reported pain severity. Almost half (43%) of the sample had ever used cannabis for recreational purposes, and 12% of the entire cohort met criteria for an ICD-10 cannabis use disorder.
Cannabis use for pain relief purposes appears common among people living with chronic non-cancer pain, and users report greater pain relief in combination with opioids than when opioids are used alone.
关于将大麻用于医疗目的，包括用于慢性疼痛的症状治疗，争议日益增加。我们在一个因慢性非癌性疼痛而被开具阿片类药物的大型社区样本中，调查了大麻使用的模式及其相关因素。
POINT研究纳入了澳大利亚1514名因慢性非癌性疼痛而被开具药用阿片类药物的患者。收集了关于大麻使用、国际疾病分类第十版（ICD - 10）大麻使用障碍以及用于止痛的大麻使用情况的数据。我们探讨了人口统计学、疼痛及其他患者特征与用于止痛的大麻使用之间的关联。
六分之一（16%）的人曾使用大麻缓解疼痛，其中上月使用过的占6%。四分之一的人报告称，如果能够获取，他们会使用大麻缓解疼痛。平均而言，使用大麻止痛的人更年轻，报告的疼痛严重程度更高，疼痛造成的干扰更大，应对疼痛的能力更差，且在过去一年中因疼痛而无法正常工作的天数更多。他们被开具阿片类药物的时间更长，阿片类药物剂量更高，且更有可能不依从阿片类药物的使用。在控制了报告的疼痛严重程度后，使用大麻止痛的人疼痛干扰程度更高。几乎一半（43%） 的样本曾出于娱乐目的使用过大麻，整个队列中有12%符合ICD - 10大麻使用障碍的标准。
在慢性非癌性疼痛患者中，使用大麻缓解疼痛似乎很常见，而且使用者报告称，与单独使用阿片类药物相比，大麻与阿片类药物联合使用时疼痛缓解效果更好。
