Silins Edmund, Horwood L John, Patton George C, Fergusson David M, Olsson Craig A, Hutchinson Delyse M, Spry Elizabeth, Toumbourou John W, Degenhardt Louisa, Swift Wendy, Coffey Carolyn, Tait Robert J, Letcher Primrose, Copeland Jan, Mattick Richard P
National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia.
Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Lancet Psychiatry. 2014 Sep;1(4):286-93. doi: 10.1016/S2215-0366(14)70307-4. Epub 2014 Sep 10.
Debate continues about the consequences of adolescent cannabis use. Existing data are limited in statistical power to examine rarer outcomes and less common, heavier patterns of cannabis use than those already investigated; furthermore, evidence has a piecemeal approach to reporting of young adult sequelae. We aimed to provide a broad picture of the psychosocial sequelae of adolescent cannabis use.
We integrated participant-level data from three large, long-running longitudinal studies from Australia and New Zealand: the Australian Temperament Project, the Christchurch Health and Development Study, and the Victorian Adolescent Health Cohort Study. We investigated the association between the maximum frequency of cannabis use before age 17 years (never, less than monthly, monthly or more, weekly or more, or daily) and seven developmental outcomes assessed up to age 30 years (high-school completion, attainment of university degree, cannabis dependence, use of other illicit drugs, suicide attempt, depression, and welfare dependence). The number of participants varied by outcome (N=2537 to N=3765).
We recorded clear and consistent associations and dose-response relations between the frequency of adolescent cannabis use and all adverse young adult outcomes. After covariate adjustment, compared with individuals who had never used cannabis, those who were daily users before age 17 years had clear reductions in the odds of high-school completion (adjusted odds ratio 0·37, 95% CI 0·20-0·66) and degree attainment (0·38, 0·22-0·66), and substantially increased odds of later cannabis dependence (17·95, 9·44-34·12), use of other illicit drugs (7·80, 4·46-13·63), and suicide attempt (6·83, 2·04-22·90).
Adverse sequelae of adolescent cannabis use are wide ranging and extend into young adulthood. Prevention or delay of cannabis use in adolescence is likely to have broad health and social benefits. Efforts to reform cannabis legislation should be carefully assessed to ensure they reduce adolescent cannabis use and prevent potentially adverse developmental effects.
Australian Government National Health and Medical Research Council.
关于青少年使用大麻的后果仍存在争议。现有数据在统计效力方面存在局限，难以考察比已研究情况更为罕见的结果以及不那么常见的、更大量的大麻使用模式；此外，证据在报告青年期后遗症方面采用的是零散的方法。我们旨在全面了解青少年使用大麻的心理社会后遗症。
我们整合了来自澳大利亚和新西兰的三项大型、长期纵向研究的参与者层面数据：澳大利亚气质项目、克赖斯特彻奇健康与发展研究以及维多利亚青少年健康队列研究。我们调查了17岁之前大麻使用的最高频率（从不使用、少于每月一次、每月或更频繁、每周或更频繁、或每天使用）与30岁之前评估的七种发育结果（高中毕业、获得大学学位、大麻依赖、使用其他非法药物、自杀未遂、抑郁和福利依赖）之间的关联。参与者数量因结果而异（N = 2537至N = 3765）。
我们记录了青少年大麻使用频率与所有不良青年期结果之间清晰且一致的关联以及剂量反应关系。在进行协变量调整后，与从未使用过大麻的个体相比，17岁之前每天使用大麻的个体高中毕业的几率明显降低（调整后的优势比0·37，95%置信区间0·20 - 0·66）以及获得学位的几率降低（0·38，0·22 - 0·66），并且后期大麻依赖（17·95，9·44 - 34·12）、使用其他非法药物（7·80，4·46 - 13·63）和自杀未遂（6·83，2·04 - 直至22·90）的几率大幅增加。
青少年使用大麻的不良后遗症范围广泛，并会持续到青年期。预防或推迟青少年使用大麻可能会带来广泛的健康和社会效益。对大麻立法改革的努力应进行仔细评估，以确保它们能减少青少年使用大麻并防止潜在的不良发育影响。
澳大利亚政府国家卫生与医学研究委员会。
