Socías M Eugenia, Kerr Thomas, Wood Evan, Dong Huiru, Lake Stephanie, Hayashi Kanna, DeBeck Kora, Jutras-Aswad Didier, Montaner Julio, Milloy M-J
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
Addict Behav. 2017 Sep;72:138-143. doi: 10.1016/j.addbeh.2017.04.006. Epub 2017 Apr 4.
No effective pharmacotherapies exist for the treatment of crack cocaine use disorders. Emerging data suggests that cannabinoids may play a role in reducing cocaine-related craving symptoms. This study investigated the intentional use of cannabis to reduce crack use among people who use illicit drugs (PWUD).
Data were drawn from three prospective cohorts of PWUD in Vancouver, Canada. Using data from participants reporting intentional cannabis use to control crack use, we used generalized linear mixed-effects modeling to estimate the independent effect of three pre-defined intentional cannabis use periods (i.e., before, during and after first reported intentional use to reduce crack use) on frequency of crack use.
Between 2012 and 2015, 122 participants reported using cannabis to reduce crack use, contributing a total of 620 observations. In adjusted analyses, compared to before periods, after periods were associated with reduced frequency of crack use (Adjusted Odds Ratio [AOR]=1.89, 95% Confidence Interval [CI]: 1.02-3.45), but not the intentional use periods (AOR=0.85, 95% CI: 0.51-1.41). Frequency of cannabis use in after periods was higher than in before periods (AOR=4.72, 95% CI: 2.47-8.99), and showed a tendency to lower frequency than in intentional cannabis use periods (AOR=0.56, 95% CI: 0.32-1.01).
A period of intentional cannabis use to reduce crack use was associated with decreased frequency of crack use in subsequent periods among PWUD. Further clinical research to assess the potential of cannabinoids for the treatment of crack use disorders is warranted.
目前尚无有效的药物疗法来治疗可卡因使用障碍。新出现的数据表明，大麻素可能在减轻与可卡因相关的渴望症状方面发挥作用。本研究调查了非法药物使用者（PWUD）有意使用大麻以减少快克可卡因使用的情况。
数据来自加拿大温哥华的三个非法药物使用者前瞻性队列。利用报告有意使用大麻来控制快克可卡因使用的参与者的数据，我们使用广义线性混合效应模型来估计三个预先定义的有意使用大麻时期（即首次报告有意使用大麻以减少快克可卡因使用之前、期间和之后）对快克可卡因使用频率的独立影响。
在2012年至2015年期间，122名参与者报告使用大麻来减少快克可卡因使用，共提供了620条观察数据。在调整分析中，与使用大麻之前的时期相比，使用大麻之后的时期与快克可卡因使用频率降低相关（调整后的优势比[AOR]=1.89，95%置信区间[CI]：1.02 - 3.45），但有意使用大麻的时期则不然（AOR=0.85，95%CI：0.51 - 1.41）。使用大麻之后的时期内大麻使用频率高于使用之前的时期（AOR=4.72，95%CI：2.47 - 8.99），且显示出比有意使用大麻时期频率更低的趋势（AOR=0.56，95%CI：0.32 - 1.01）。
非法药物使用者中，一段有意使用大麻以减少快克可卡因使用的时期与随后时期快克可卡因使用频率降低相关。有必要进行进一步的临床研究，以评估大麻素治疗快克可卡因使用障碍的潜力。
