Drossel Claudia, Forchheimer Martin, Meade Michelle A
Eastern Michigan University, Department of Psychology, Ypsilanti, Michigan.
University of Michigan Health Center, Department of Physical Medicine and Rehabilitation, Ann Arbor, Michigan.
Top Spinal Cord Inj Rehabil. 2016 Winter;22(1):3-12. doi: 10.1310/sci2201-3.
People with spinal cord injury (SCI) are accessing cannabis for therapeutic purposes (CTP), the use of which has been legalized in more than 20 states. In the past, illicit marijuana use had positive correlations with other health risk behaviors. It is not known whether access to CTP has shifted patterns of use and altered health outcomes. To describe the self-reported patterns of CTP use among individuals with SCI and correlations with health behaviors and health indicators. Secondary analysis of data from a cross-sectional study involving community-dwelling individuals with chronic SCI and neurogenic bladder and bowel, at least 5 years post injury. Data were collected via structured interviews. 92.2% of the current sample ( = 244) lived in states that, at the time of the study, permitted the use of CTP. 22.5% reported using CTP at least monthly to relieve pain (70.4%) and spasticity (46.3%). Of those 54 participants, 52.7% were daily users. Whereas 23.0% of non-CTP users endorsed having prescriptions for at least one opioid-based medication, 38.1% of CTP users did so, suggesting that CTP use does not mitigate opioid use. Users were more likely to be single and live alone, report more bladder complications, and perceive their psychosocial functioning as more compromised than non-users. A relatively large percentage of individuals with chronic SCI appear to use CTP on a regular basis. Results suggest that they may be more vulnerable to complications and to risk factors for substance use disorders in SCI, such as social isolation. Although the generalizability of these findings is limited by the sampling strategies and the eligibility criteria of the larger study, CTP use should be assessed and considered when planning health interventions.
脊髓损伤（SCI）患者正在出于治疗目的使用大麻（CTP），在20多个州，这种使用已合法化。过去，非法使用大麻与其他健康风险行为呈正相关。目前尚不清楚获得治疗性大麻使用是否改变了使用模式并改善了健康状况。目的是描述脊髓损伤患者自我报告的治疗性大麻使用模式以及与健康行为和健康指标的相关性。对一项横断面研究的数据进行二次分析，该研究涉及社区居住的慢性脊髓损伤以及神经源性膀胱和肠道功能障碍患者，损伤后至少5年。通过结构化访谈收集数据。当前样本中的92.2%（n = 244）生活在研究时允许使用治疗性大麻的州。22.5%的人报告至少每月使用一次治疗性大麻以缓解疼痛（70.4%）和痉挛（46.3%）。在这54名参与者中，52.7%为每日使用者。非治疗性大麻使用者中有23.0%认可至少有一种阿片类药物的处方，而治疗性大麻使用者中有38.1%这样做，这表明使用治疗性大麻并不能减少阿片类药物的使用。与非使用者相比，使用者更可能单身且独居，报告更多膀胱并发症，并认为其心理社会功能受到更大损害。相当大比例的慢性脊髓损伤患者似乎经常使用治疗性大麻。结果表明，他们可能更容易出现并发症以及脊髓损伤中物质使用障碍的风险因素，如社会隔离。尽管这些发现的普遍性受到更大规模研究的抽样策略和纳入标准的限制，但在规划健康干预措施时，应评估并考虑治疗性大麻的使用情况。
