MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON Canada.
Health Research Methodology Graduate Program, McMaster University, Hamilton, ON Canada.
Biol Sex Differ. 2017 Mar 30;8:8. doi: 10.1186/s13293-017-0130-1. eCollection 2017.
Cannabis will soon become legalized in Canada, and it is currently unclear how this will impact public health. Methadone maintenance treatment (MMT) is the most common pharmacological treatment for opioid use disorder (OUD), and despite its documented effectiveness, a large number of patients respond poorly and experience relapse to illicit opioids. Some studies implicate cannabis use as a risk factor for poor MMT response. Although it is well established that substance-use behaviors differ by sex, few of these studies have considered sex as a potential moderator. The current study aims to investigate sex differences in the association between cannabis use and illicit opioid use in a cohort of MMT patients.
This multicentre study recruited participants on MMT for OUD from Canadian Addiction Treatment Centre sites in Ontario, Canada. Sex differences in the association between any cannabis use and illicit opioid use were investigated using multivariable logistic regression. A secondary analysis was conducted to investigate the association with heaviness of cannabis use.
The study included 414 men and 363 women with OUD receiving MMT. Cannabis use was significantly associated with illicit opioid use in women only (OR = 1.82, 95% CI 1.18, 2.82, = 0.007). Heaviness of cannabis use was not associated with illicit opioid use in men or women.
This is the largest study to date examining the association between cannabis use and illicit opioid use. Cannabis use may be a sex-specific predictor of poor response to MMT, such that women are more likely to use illicit opioids if they also use cannabis during treatment. Women may show improved treatment outcomes if cannabis use is addressed during MMT.
大麻即将在加拿大合法化，目前尚不清楚这将如何影响公众健康。美沙酮维持治疗（MMT）是治疗阿片类药物使用障碍（OUD）最常用的药理学方法，尽管其有效性已被记录在案，但仍有大量患者反应不佳，复吸非法阿片类药物。一些研究表明，大麻的使用是 MMT 反应不佳的一个风险因素。尽管已经确定，性别的物质使用行为不同，但这些研究很少考虑到性别可能是一个潜在的调节因素。本研究旨在调查 MMT 患者队列中，大麻使用与非法阿片类药物使用之间的关联中是否存在性别差异。
这项多中心研究从加拿大安大略省的加拿大成瘾治疗中心招募了接受 MMT 治疗 OUD 的参与者。使用多变量逻辑回归研究大麻使用与非法阿片类药物使用之间的关联是否存在性别差异。还进行了二次分析，以研究与大麻使用量之间的关联。
该研究纳入了 414 名男性和 363 名女性 OUD 患者，他们正在接受 MMT。大麻的使用与女性中非法阿片类药物的使用显著相关（OR=1.82，95%CI 1.18，2.82， = 0.007）。大麻使用量与男性或女性的非法阿片类药物使用无关。
这是迄今为止研究大麻使用与非法阿片类药物使用之间关联的最大规模研究。大麻的使用可能是 MMT 反应不佳的一个性别特异性预测因素，即如果女性在治疗期间同时使用大麻，她们更有可能使用非法阿片类药物。如果在 MMT 期间解决大麻使用问题，女性的治疗效果可能会得到改善。
