College of Nursing, Washington State University, Spokane, WA, United States; Program of Excellence in Addictions Research, Washington State University, Spokane, WA, United States; Translational Addictions Research Center, Washington State University, Pullman, WA, United States.
Department of Psychology, Washington State University, Pullman, WA, United States.
Addict Behav. 2018 Feb;77:225-231. doi: 10.1016/j.addbeh.2017.10.012. Epub 2017 Oct 18.
Adults in Medication-Assisted Treatment (MAT) for opioid addiction are at risk for substance use relapse and opioid overdose. They often have high rates of cannabis use and comorbid symptoms of pain, depression, and anxiety. Low levels of self-efficacy (confidence that one can self-manage symptoms) are linked to higher symptom burdens and increased substance use. The effects of cannabis use on symptom management among adults with MAT are currently unclear. Therefore, the primary purpose of this study is to examine whether cannabis use moderates the relationships between pain and negative affect (i.e., depression and anxiety) and whether self-efficacy influences these interactions.
A total of 150 adults receiving MAT and attending one of two opioid treatment program clinics were administered a survey containing measures of pain, depression, anxiety, self-efficacy, and cannabis use.
Cannabis use frequency moderated the relationships between pain and depression as well as pain and anxiety. Specifically, as cannabis use frequency increased, the positive relationships between pain and depression and pain and anxiety grew stronger. However, cannabis use was no longer a significant moderator after controlling for self-efficacy.
Results suggest that cannabis use strengthens, rather than weakens, the relationships between pain and depression and pain and anxiety. These effects appear to be driven by decreased self-efficacy in cannabis users. It is important to understand how self-efficacy can be improved through symptom self-management interventions and whether self-efficacy can improve distressing symptoms for people in MAT.
接受药物辅助治疗（MAT）的成年阿片类药物成瘾者有物质使用复发和阿片类药物过量的风险。他们通常有很高的大麻使用率和疼痛、抑郁和焦虑的共病症状。自我效能感（相信自己可以自我管理症状的信心）水平较低与更高的症状负担和增加的物质使用有关。大麻使用对接受 MAT 的成年人的症状管理的影响目前尚不清楚。因此，本研究的主要目的是检验大麻使用是否调节了疼痛与负性情绪（即抑郁和焦虑）之间的关系，以及自我效能感是否影响这些相互作用。
共有 150 名接受 MAT 并参加两个阿片类药物治疗项目诊所之一的成年人接受了一项调查，该调查包含疼痛、抑郁、焦虑、自我效能感和大麻使用的测量。
大麻使用频率调节了疼痛与抑郁以及疼痛与焦虑之间的关系。具体来说，随着大麻使用频率的增加，疼痛与抑郁以及疼痛与焦虑之间的正相关关系变得更强。然而，在控制自我效能感后，大麻使用不再是一个显著的调节因素。
结果表明，大麻使用增强了疼痛与抑郁以及疼痛与焦虑之间的关系，而不是减弱了这些关系。这些影响似乎是由于大麻使用者自我效能感下降所致。了解自我效能感如何通过症状自我管理干预得到提高，以及自我效能感是否能改善接受 MAT 的人的痛苦症状，这一点很重要。
