Cherpitel Cheryl J, Ye Yu, Andreuccetti Gabriel, Stockwell Tim, Vallance Kate, Chow Clifton, Brubacher Jeffrey R
Alcohol Research Group, Emeryville, CA 94608, Canada; Centre for Addictions Research of BC, University of Victoria, Victoria, BC, V8W 2Y2, Canada.
Alcohol Research Group, Emeryville, CA 94608, Canada.
Drug Alcohol Depend. 2017 May 1;174:121-127. doi: 10.1016/j.drugalcdep.2017.01.019. Epub 2017 Mar 7.
Alcohol is known to be associated with injury, but little is known of combined use of alcohol and other drugs on injury; especially important for marijuana, given increasing legalization of use in the U.S. and Canada.
Probability samples of patients 18 and older were interviewed in the emergency department at two sites in Vancouver and one in Victoria, BC (n=1191 injured and 1613 non-injured patients). Case-control and case-crossover analyses were used to analyze risk of injury, based on self-reported alcohol and drug use (marijuana, stimulants, depressants) prior to injury.
Risk of injury was significantly elevated (p<0.001) for alcohol use alone in both case-control (OR=2.72) and case-crossover analyses (OR=2.80) but not for any of the three drug classes. The interaction of alcohol with each class of drug was tested, and marginally significant only for marijuana in case-control analysis (OR=4.42; p=0.088). The interaction of alcohol and two or more drugs was also significant in case-control analysis (OR=03; p=0.035). The volume of alcohol consumed prior to injury was greater for those also using drugs during this time and positively associated with the number of drugs reported.
Given the potential issues involved with both case-control and case-crossover study designs, the inconsistent findings suggest caution in reaching any definite conclusion regarding whether there is extra risk related to combined use of alcohol and marijuana, and is an important area for future research.
已知酒精与损伤有关，但对于酒精与其他药物联合使用对损伤的影响知之甚少；鉴于美国和加拿大对大麻使用的合法化程度不断提高，这一点对大麻尤为重要。
在温哥华的两个地点和不列颠哥伦比亚省维多利亚市的一个地点的急诊科，对18岁及以上患者的概率样本进行了访谈（n = 1191名受伤患者和1613名未受伤患者）。基于受伤前自我报告的酒精和药物使用情况（大麻、兴奋剂、抑制剂），采用病例对照和病例交叉分析来分析损伤风险。
在病例对照分析（OR = 2.72）和病例交叉分析（OR = 2.80）中，单独使用酒精时损伤风险显著升高（p < 0.001），但这三种药物类别中的任何一种均未出现这种情况。对酒精与每类药物的相互作用进行了测试，仅在病例对照分析中，酒精与大麻的相互作用具有边缘显著性（OR = 4.42；p = 0.088）。在病例对照分析中，酒精与两种或更多药物的相互作用也具有显著性（OR = 03；p = 0.035）。在受伤前同时使用药物的患者中，饮酒量更大，且与报告的药物数量呈正相关。
鉴于病例对照和病例交叉研究设计都存在潜在问题，这些不一致的研究结果表明，在就酒精和大麻联合使用是否存在额外风险得出任何明确结论时应谨慎，这是未来研究的一个重要领域。
