Choi Namkee G, Marti C Nathan, DiNitto Diana M, Choi Bryan Y
a University of Texas at Austin School of Social Work , Austin , TX , USA.
b Warren Alpert Medical School, Department of Emergency Medicine , Brown University , Providence , RI , USA.
Am J Drug Alcohol Abuse. 2018;44(2):215-223. doi: 10.1080/00952990.2017.1318891. Epub 2017 May 8.
Despite increasing marijuana use among older adults, little research has been done on marijuana's effects on their healthcare use.
To examine whether (1) marijuana use is associated with the likelihood of emergency department (ED) visits through increased injury risk, and (2) marijuana use patterns are associated with injury risk and ED visits among older adults.
Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Problems (N = 14,715 aged 50+; 6,379 men and 8,336 women), descriptive statistics were used to compare past-year marijuana users to nonusers on sociodemographic and physical/mental health characteristics. Structural equation modeling was used to simultaneously estimate whether injury mediates past-year marijuana use's association with ED visits. Logistic regression analysis was used to examine associations of marijuana use patterns with injury and ED visits.
Past-year injury rates were 18.9% for nonusers and 28.8% for users (3.9% of the 50+ age group), and past-year ED visit rates were 23.5% for nonusers and 30.9% for users (p < .001). Logistic regression models showed that marijuana use was associated with injury (OR = 1.48, 95% CI = 1.18-1.85), and injury was associated with ED visits (OR = 6.14, 95% CI = 1.70-1.93). Mediation analysis found significant indirect effect (z = 2.86, p = .004) and direct effect not significantly differing from zero (OR = 1.16, 95% CI = 0.90-1.50), indicating that marijuana use increases the likelihood of ED visits through increased injury risk. Marijuana use patterns were not associated with injuries or ED visits.
Healthcare providers should screen for marijuana and other substance use among older adults and provide education about associated injury risks.
尽管老年人使用大麻的情况日益增多,但关于大麻对其医疗保健使用的影响的研究却很少。
研究(1)大麻使用是否通过增加受伤风险与急诊就诊的可能性相关,以及(2)大麻使用模式是否与老年人的受伤风险和急诊就诊相关。
利用2012 - 2013年全国酒精及相关问题流行病学调查(N = 14715名年龄在50岁及以上;6379名男性和8336名女性),使用描述性统计方法比较过去一年中使用大麻者和未使用者在社会人口统计学和身体/心理健康特征方面的情况。采用结构方程模型同时估计受伤是否介导过去一年大麻使用与急诊就诊之间的关联。使用逻辑回归分析来研究大麻使用模式与受伤及急诊就诊之间的关联。
过去一年未使用者的受伤率为18.9%,使用者为28.8%(在50岁及以上年龄组中占3.9%),过去一年未使用者的急诊就诊率为23.5%,使用者为30.9%(p < 0.001)。逻辑回归模型显示,大麻使用与受伤相关(OR = 1.48,95%CI = 1.18 - 1.85),且受伤与急诊就诊相关(OR = 6.14,95%CI = 1.70 - 1.93)。中介分析发现显著的间接效应(z = 2.86,p = 0.004),直接效应与零无显著差异(OR = 1.16,95%CI = 0.90 - 1.50),表明大麻使用通过增加受伤风险增加了急诊就诊的可能性。大麻使用模式与受伤或急诊就诊无关。
医疗保健提供者应筛查老年人中的大麻及其他物质使用情况,并提供有关相关受伤风险的教育。