Lau Nicholas, Sales Paloma, Averill Sheigla, Murphy Fiona, Sato Sye-Ok, Murphy Sheigla
Centre for Substance Abuse Studies, Institute for Scientific Analysis, San Francisco, USA.
Drug Alcohol Rev. 2015 Nov;34(6):654-9. doi: 10.1111/dar.12275. Epub 2015 Apr 28.
Substitution is operationalised as a conscious choice made by users to use one drug instead of, or in conjunction with another based on: perceived safety, level of addiction potential, effectiveness in relieving symptoms, access and level of acceptance. Harm reduction is a set of strategies that aim to minimise problems associated with drug use while recognising that for some users, abstinence may be neither a realistic nor a desirable goal. In this paper, we aim for deeper understandings of older adult cannabis users' beliefs and substitution practices as part of the harm reduction framework.
We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) marijuana users in the San Francisco Bay Area. Although the sample consisted of primary cannabis users, many had personal experience with other drugs throughout their lifetimes. Data collection consisted of an audio-recorded, semi-structured in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analysed to discover users' harm reduction beliefs and cannabis substitution practices.
Study participants described using cannabis as a safer alternative for alcohol, illicit drugs and pharmaceuticals based on their perceptions of less adverse side effects, low-risk for addiction and greater effectiveness at relieving symptoms, such as chronic pain.
Cannabis substitution can be an effective harm reduction method for those who are unable or unwilling to stop using drugs completely. More research is needed on cannabis as a safer alternative.
替代被定义为使用者基于以下因素做出的有意识选择，即使用一种药物替代另一种药物，或与另一种药物联合使用：感知到的安全性、成瘾潜力水平、缓解症状的有效性、可及性和接受程度。减少伤害是一套策略，旨在尽量减少与药物使用相关的问题，同时认识到对于一些使用者来说，戒除可能既不现实也不可取。在本文中，我们旨在更深入地了解老年大麻使用者的信念和替代行为，这是减少伤害框架的一部分。
我们展示了对旧金山湾区婴儿潮一代（出生于1946年至1964年）大麻使用者进行的定性研究的部分结果。尽管样本主要是大麻使用者，但许多人一生中对其他药物也有个人体验。数据收集包括一次录音的、半结构化的深入生活史访谈，随后进行问卷调查和健康调查。对定性访谈进行分析，以发现使用者的减少伤害信念和大麻替代行为。
研究参与者表示，基于他们对较少副作用、低成瘾风险以及在缓解慢性疼痛等症状方面更有效的认知，将大麻用作酒精、非法药物和药品的更安全替代品。
对于那些无法或不愿意完全停止使用药物的人来说，大麻替代可能是一种有效的减少伤害方法。需要对大麻作为更安全替代品进行更多研究。
