Choi Namkee G, DiNitto Diana M, Marti Carl Nathan
University of Texas at Austin School of Social Work, 1925 San Jacinto Blvd, Austin, Texas.
Am J Addict. 2017 Oct;26(7):697-706. doi: 10.1111/ajad.12598. Epub 2017 Aug 18.
Given that 29 U.S. states now have laws allowing medical marijuana use, this study examined mental and physical health correlates of medical versus nonmedical marijuana use among three age groups of adults (18-29, 30-49, and 50+).
Data came from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309 respondents aged 18+). Logistic regression models were used to examine age group differences in associations of substance use and mental disorders and health conditions with medical versus nonmedical marijuana use.
Of all respondents, 9.74% (N = 3,784) reported past-year marijuana use. Of all past-year marijuana users, 11.03% (n = 445) reported medical use. Medical marijuana use rates were higher among the 50-64 age group (17.95%) than younger adults, and 32.88% of medical users, compared to 25.25% of nonmedical users, had past-year marijuana use disorder. The odds of medical marijuana use were higher among those with marijuana use disorder (OR = 1.87, 95% CI = 1.40-2.50) and personality disorder (OR = 1.42, 95% CI = 1.03-1.94), with no age group differences. However, older adults with alcohol use disorder and sleep problems and middle-age adults with arthritis had diminished odds of having used medical marijuana relative to young adults.
Given the high rates of marijuana use disorder among medical users, physicians should exercise caution in recommending marijuana for medical purposes, especially for younger adults. More research is needed on medical marijuana's safety and efficacy for patients at risk of marijuana use disorder. (Am J Addict 2017;26:697-706).
鉴于美国目前有29个州制定了允许使用医用大麻的法律，本研究调查了三个年龄组（18 - 29岁、30 - 49岁和50岁及以上）成年人中使用医用大麻与非医用大麻在身心健康方面的关联。
数据来自2012 - 2013年全国酒精及相关疾病流行病学调查（N = 36309名18岁及以上受访者）。采用逻辑回归模型来检验在物质使用、精神障碍和健康状况与使用医用大麻和非医用大麻之间的关联上年龄组的差异。
在所有受访者中，9.74%（N = 3784）报告过去一年使用过大麻。在所有过去一年使用过大麻的人中，11.03%（n = 445）报告使用过医用大麻。50 - 64岁年龄组的医用大麻使用率（17.95%）高于年轻成年人，并且在过去一年中，32.88%的医用大麻使用者患有大麻使用障碍，而非医用大麻使用者的这一比例为25.25%。在患有大麻使用障碍（OR = 1.87，95% CI = 1.40 - 2.50）和人格障碍（OR = 1.42，95% CI = 1.03 - 1.94）的人群中，使用医用大麻的几率更高，且不存在年龄组差异。然而，与年轻成年人相比，患有酒精使用障碍和睡眠问题的老年人以及患有关节炎的中年成年人使用医用大麻的几率降低。
鉴于医用大麻使用者中大麻使用障碍的高发生率，医生在推荐医用大麻时应谨慎，尤其是对于年轻成年人。对于有大麻使用障碍风险的患者，需要对医用大麻的安全性和有效性进行更多研究。（《美国成瘾杂志》2017年；26:697 - 706）
