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青少年大麻使用者在 28 天的监测禁欲中,大麻使用症状和情绪功能的变化。

Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users.

机构信息

Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.

Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.

出版信息

Psychopharmacology (Berl). 2017 Dec;234(23-24):3431-3442. doi: 10.1007/s00213-017-4725-3. Epub 2017 Sep 12.

Abstract

RATIONALE

Advancing marijuana prevention and intervention efforts are important given the decreasing perception of harm among adolescents and increasing marijuana legalization.

OBJECTIVES

This study evaluates how a monitored abstinence protocol may contribute to emotional functioning and changes in marijuana problems that can enhance successful outcomes for non-treatment-seeking adolescent marijuana users.

METHODS

Adolescent marijuana users (n = 26) and demographically matched controls (n = 30) completed 28 days of monitored abstinence confirmed by biweekly urine toxicology. Participants were given measures of emotional functioning, marijuana use symptoms, and reward sensitivity during monitored abstinence.

RESULTS

All participants (n = 56) completed the protocol, and 69% of marijuana users (n = 18 of 26) were confirmed abstinent for 28 days, with all users showing decreasing marijuana use. Reductions in subsyndromal depression, positive marijuana use expectancies, and poor sleep quality were observed by the end of the monitored abstinence period (n = 26, p values < .05). Marijuana users also reported more attentional impulsivity and less responsiveness to reward stimuli during the second week of abstinence compared to controls. Later age of onset of regular marijuana use and more cumulative lifetime use were associated with a greater degree of emotional change and increased recognition of the negative effects of marijuana use.

CONCLUSIONS

Monitored abstinence programs may be beneficial in reducing marijuana use, subsyndromal emotional distress symptoms, and changing beliefs about marijuana use. Future prevention and intervention efforts may consider targeting reward sensitivity and impulsivity, in addition to marijuana use, expectancies, and emotional functioning.

摘要

背景

鉴于青少年对大麻危害的认知度下降以及大麻合法化程度提高,推进大麻预防和干预工作十分重要。

目的

本研究评估了监测禁欲方案如何有助于改善情绪功能和大麻问题的变化,从而增强非治疗性青少年大麻使用者的成功治疗效果。

方法

大麻使用者青少年(n=26)和年龄匹配的对照者(n=30)完成了 28 天的监测禁欲,由每两周进行一次尿液毒理学检测来确认禁欲情况。在监测禁欲期间,参与者接受了情绪功能、大麻使用症状和奖励敏感性的评估。

结果

所有参与者(n=56)均完成了方案,28 天内有 69%的大麻使用者(n=26/26)确认禁欲,所有使用者的大麻使用量均减少。在监测禁欲期结束时,观察到亚综合征性抑郁、积极的大麻使用预期和较差的睡眠质量均有所下降(n=26,p 值均<.05)。与对照组相比,在禁欲的第二周,大麻使用者报告了更多的注意力冲动和对奖励刺激的反应减少。大麻使用的首发年龄较晚和累计终生使用量更多与情绪变化的程度更大以及对大麻使用的负面影响的认识增加相关。

结论

监测禁欲方案可能有助于减少大麻使用、亚综合征性情绪困扰症状,并改变对大麻使用的看法。未来的预防和干预工作可能需要考虑针对奖励敏感性和冲动性,以及大麻使用、预期和情绪功能。

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