Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA; University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI, 48109, USA.
Addict Behav. 2018 Feb;77:166-171. doi: 10.1016/j.addbeh.2017.10.007. Epub 2017 Oct 12.
Chronic pain is the most common reason for medical cannabis certification. Data regarding alcohol use and risky drinking among medical cannabis patients with pain is largely unknown. Therefore, we examined the prevalence and correlates of alcohol use and risky drinking in this population.
Participants completed surveys regarding demographics, pain-related variables, anxiety, cannabis use, and past six-month alcohol consumption. Alcohol use groups were defined using the AUDIT-C [i.e., non-drinkers, low-risk drinkers, and high-risk drinkers (≥4 for men and ≥3 for women)] and compared on demographic characteristics, pain measures, anxiety, and cannabis use.
Overall, 42% (n=330/780) were non-drinkers, 32% (n=251/780) were low-risk drinkers, and 26% (n=199/780) were high-risk drinkers. Compared to non-drinkers, low- and high-risk drinkers were significantly younger whereas a larger proportion of low-risk drinkers reported being African-American compared to non- or high-risk drinkers. High-risk drinkers reported significantly lower pain severity/interference compared to the other groups; high-risk drinkers were also less likely to be on disability compared to other groups. A multinomial logistic regression showed that patients reporting lower pain severity and less disability had greater odds of being classified a high-risk drinker.
High-risk drinking appears common among medical cannabis patients. Future research should examine whether such use is concurrent or consecutive, and the relationship of such co-use patterns to consequences. Nevertheless, individuals treating patients reporting medical cannabis use for pain should consider alcohol consumption, with data needed regarding the efficacy of brief alcohol interventions among medical cannabis patients.
慢性疼痛是医学大麻认证的最常见原因。关于疼痛的医学大麻患者的酒精使用和危险饮酒的数据在很大程度上尚不清楚。因此，我们研究了该人群中酒精使用和危险饮酒的流行率和相关因素。
参与者完成了有关人口统计学，疼痛相关变量，焦虑，大麻使用和过去六个月酒精消耗的调查。使用 AUDIT-C 定义酒精使用组[即不饮酒者，低风险饮酒者和高风险饮酒者（男性≥4，女性≥3）]，并比较了人口统计学特征，疼痛指标，焦虑和大麻使用。
总体而言，42％（n=330/780）为非饮酒者，32％（n=251/780）为低风险饮酒者，26％（n=199/780）为高风险饮酒者。与非饮酒者相比，低风险和高风险饮酒者明显年轻，而低风险饮酒者中报告为非裔美国人的比例明显高于非饮酒者或高风险饮酒者。高风险饮酒者报告的疼痛严重程度/干扰明显低于其他组；与其他组相比，高风险饮酒者因残疾而报告的可能性也较低。多变量逻辑回归表明，报告疼痛严重程度较低和残疾程度较低的患者被归类为高风险饮酒者的可能性更大。
高风险饮酒在医学大麻患者中似乎很普遍。未来的研究应检查这种使用是同时发生还是连续发生的，以及这种共同使用模式与后果的关系。尽管如此，治疗报告因疼痛而使用医用大麻的患者的个人应考虑饮酒问题，还需要有关医用大麻患者中简短酒精干预措施的疗效的数据。
