一项关于青少年成年期曾用和现用大麻者的物质使用和心理健康结果的前瞻性研究。
A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users.
机构信息
National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia.
Australian Demographic and Social Research Institute, Australian National University, Canberra, Australia.
出版信息
Drug Alcohol Rev. 2017 Sep;36(5):618-625. doi: 10.1111/dar.12512. Epub 2017 Mar 20.
INTRODUCTION AND AIMS
The extent to which young adult former cannabis users fare better than infrequent users is unclear. We investigated the association between cannabis use status at age 23 and substance use and mental health outcomes at age 27.
DESIGN AND METHODS
Data were from the 20+ year cohort of the PATH Through Life Study. Lifetime cannabis users (n = 1410) at age 23 were classified as former/occasional/regular users. Multivariable logistic regression was used to estimate the association between cannabis use status at age 23 and six outcomes assessed at age 27.
RESULTS
Compared with occasional cannabis users: (i) former users had odds of subsequent tobacco use [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.52-0.85], illicit drug use (cannabis, OR = 0.22, 95% CI 0.17-0.28; other illicit drugs, OR = 0.29, 95% CI 0.22-0.39) and mental health impairment (OR = 0.71, 95% CI 0.55-0.92) that were 29-78% lower; and (ii) regular users had odds of subsequent frequent alcohol use (OR = 2.34, 95% CI 0.67-1.34), tobacco use (OR = 3.67, 95% CI 2.54-5.30), cannabis use (OR = 11.73, 95% CI 6.81-20.21) and dependence symptoms (OR = 12.60, 95% CI 8.38-18.94), and other illicit drug use (OR = 2.95, 95% CI 2.07-4.21) that were 2-13 times greater. Associations attenuated after covariate adjustment, and most remained significant.
DISCUSSION AND CONCLUSIONS
Clear associations exist between cannabis use status in young adulthood and subsequent mental health and substance use. While early intervention remains important to prevent regular cannabis use and the associated harms, experimentation with cannabis use in the years leading into young adulthood may not necessarily determine an immutable pathway to mental health problems and illicit substance use. [Silins E, Swift W, Slade T, Toson B, Rodgers B, Hutchinson DM. A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users. Drug Alcohol Rev 2017;00:000-000].
引言和目的
年轻成年前大麻使用者的情况是否优于非频繁使用者尚不清楚。我们调查了 23 岁时大麻使用状况与 27 岁时物质使用和心理健康结果之间的关联。
设计和方法
数据来自 PATH Through Life 研究的 20 岁以上队列。23 岁时的终生大麻使用者（n=1410）被分为前/偶尔/经常使用者。多变量逻辑回归用于估计 23 岁时的大麻使用状况与 27 岁时评估的六个结果之间的关联。
结果
与偶尔使用大麻的人相比：（i）前使用者随后使用烟草的几率[比值比（OR）=0.67，95%置信区间（CI）0.52-0.85]、非法药物使用（大麻，OR=0.22，95%CI 0.17-0.28；其他非法药物，OR=0.29，95%CI 0.22-0.39）和心理健康受损（OR=0.71，95%CI 0.55-0.92）的几率降低了 29%-78%；（ii）经常使用者随后频繁饮酒（OR=2.34，95%CI 0.67-1.34）、吸烟（OR=3.67，95%CI 2.54-5.30）、大麻使用（OR=11.73，95%CI 6.81-20.21）和依赖症状（OR=12.60，95%CI 8.38-18.94）以及其他非法药物使用（OR=2.95，95%CI 2.07-4.21）的几率增加了 2-13 倍。在调整协变量后，关联减弱，大多数仍然显著。
讨论和结论
年轻成年时的大麻使用状况与随后的心理健康和物质使用之间存在明显关联。虽然早期干预对于预防经常使用大麻和相关危害仍然很重要，但在进入年轻成年期之前，尝试使用大麻可能不一定会决定一个不可改变的途径，导致心理健康问题和非法药物使用。[Silins E、Swift W、Slade T、Toson B、Rodgers B、Hutchinson DM. 一项对年轻成年前和当前大麻使用者的物质使用和心理健康结果的前瞻性研究。药物和酒精评论 2017；00:000-000]。
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