Department of Psychiatry and Behavioral Sciences, BOX 3903, School of Medicine, Duke University, Durham, NC, USA.
Department of Psychiatry and Behavioral Sciences, BOX 3903, School of Medicine, Duke University, Durham, NC, USA; Department of Medicine, School of Medicine, Duke University, Durham, NC, USA; Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; Center for Child and Family Policy, Sanford School of Public Policy, Duke University, Durham, NC, USA.
Drug Alcohol Depend. 2017 Nov 1;180:311-318. doi: 10.1016/j.drugalcdep.2017.08.028. Epub 2017 Sep 14.
Available data suggest that medical marijuana users may have more mental health problems than recreational marijuana users. There is limited information about differences in behavioral health disorders and unmet treatment needs between medical and recreational marijuana users.
We compared past-year prevalence of behavioral health disorders and unmet treatment needs across three marijuana subgroups (recreational use only, medical use only, and both). Sex-stratified logistic regression was performed to determine their associations with marijuana use status. We analyzed data from adults (≥18 years) who used marijuana in the past year (N=15,440) from 2013 to 2014 National Surveys on Drug Use and Health.
Among 15,440 past-year marijuana users, 90.2% used recreational marijuana only, 6.2% used medical marijuana only, and 3.6% used both. Both users had the highest prevalence of behavioral health disorders and unmet treatment needs overall, with no significant sex differences. In the sex-specific logistic regression analysis, medical only users and both users showed somewhat different patterns of associations (reference group=recreational only users). Medical only users had decreased odds of alcohol or drug use disorders, and unmet need for alcohol or drug treatment among males and females. Additionally, female medical only users had decreased odds of opioid use disorder. Both users had increased odds of major depressive episode, hallucinogen use disorder, and unmet need for mental health services among males, and cocaine use disorder among females.
Different approaches tailored to individuals' sex and motives for marijuana use is needed for the prevention and treatment of behavioral health problems.
现有数据表明,医用大麻使用者可能比娱乐性大麻使用者有更多的心理健康问题。关于医用和娱乐用大麻使用者在行为健康障碍和未满足的治疗需求方面的差异,信息有限。
我们比较了三种大麻亚组(仅娱乐性使用、仅医用和两者兼有)过去一年行为健康障碍和未满足的治疗需求的流行率。采用性别分层逻辑回归来确定它们与大麻使用状况的关系。我们分析了 2013 年至 2014 年全国药物使用和健康调查中过去一年使用大麻的成年人(≥18 岁)的数据(N=15440)。
在 15440 名过去一年使用大麻的人中,90.2%仅使用娱乐性大麻,6.2%仅使用医用大麻,3.6%两者兼用。这两类使用者总体上具有最高的行为健康障碍和未满足的治疗需求的流行率,且无显著的性别差异。在性别特定的逻辑回归分析中,医用大麻使用者和两者兼用者表现出不同的关联模式(参考组=仅娱乐性使用)。医用大麻使用者在男性和女性中,酒精或药物使用障碍以及酒精或药物治疗的未满足需求的可能性降低。此外,女性医用大麻使用者中阿片类药物使用障碍的可能性降低。男性中,两者兼用者有更大的可能性出现重度抑郁发作、致幻剂使用障碍和未满足的心理健康服务需求,而女性中两者兼用者有更大的可能性出现可卡因使用障碍。
需要针对个人的性别和使用大麻的动机采取不同的方法,以预防和治疗行为健康问题。