Lopez-Quintero Catalina, Anthony James C
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan.
Ann N Y Acad Sci. 2015 Sep;1349:119-26. doi: 10.1111/nyas.12868.
As epidemiologists studying foodborne illness outbreaks, we do not ask luncheon attendees to say which food caused their illnesses. Instead, we use measurement and analysis methods to estimate food-specific risk variations. Here, we adapt the foodborne outbreak approach to develop new estimates of drug use disorder risk for single-drug and polydrug users, without attributing the syndrome to a specific drug when multiple drugs have been used. We estimate drug use disorder risk for cannabis-only users as a reference value. We then derive comparative relative risk estimates for users of other drug subtypes, including polydrug combinations. Data are from the 2002 to 2003 U.S. National Comorbidity Survey Replication, a nationally representative sample of household residents (18+ years), with standardized drug use and drug dependence assessments. Multiple logistic regression provides odds ratio estimates of relative risk. With this approach, for every 1000 cannabis-only users, an estimated 17 had become cases (1.7%). By comparison, polydrug users and cocaine-only users had much greater cumulative incidence (>10%), even with adjustment for covariates and local area matching (P < 0.001). Using this approach, we find exceptionally low risk for cannabis-only users and greater risk for polydrug and cocaine-only users.
作为研究食源性疾病暴发的流行病学家，我们不会要求午餐会参与者说出是哪种食物导致了他们生病。相反，我们使用测量和分析方法来估计特定食物的风险差异。在此，我们采用食源性疾病暴发的方法，为单一药物使用者和多药使用者开发药物使用障碍风险的新估计值，当使用多种药物时，不将该综合征归因于特定药物。我们将仅使用大麻的使用者的药物使用障碍风险估计值作为参考值。然后，我们得出其他药物亚型使用者（包括多药组合使用者）的比较相对风险估计值。数据来自2002年至2003年美国国家共病调查复制项目，这是一个具有全国代表性的家庭居民样本（18岁及以上），对药物使用和药物依赖进行了标准化评估。多元逻辑回归提供相对风险的比值比估计值。采用这种方法，每1000名仅使用大麻的使用者中，估计有17人成为病例（1.7%）。相比之下，多药使用者和仅使用可卡因的使用者的累积发病率要高得多（>10%），即使对协变量和局部区域匹配进行了调整（P<0.001）。使用这种方法，我们发现仅使用大麻的使用者风险极低，而多药使用者和仅使用可卡因的使用者风险更高。
