队列物质使用对酒精和大麻使用及使用障碍各阶段转变可能性的影响：来自澳大利亚心理健康和幸福感全国调查的结果。
The impact of cohort substance use upon likelihood of transitioning through stages of alcohol and cannabis use and use disorder: Findings from the Australian National Survey on Mental Health and Wellbeing.
机构信息
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
Department of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institute of Health, Bethesda, USA.
出版信息
Drug Alcohol Rev. 2018 May;37(4):546-556. doi: 10.1111/dar.12679. Epub 2018 Mar 5.
INTRODUCTION AND AIMS
We used population-level Australian data to estimate prevalence, age of onset and speed of transitions across stages of alcohol and cannabis use, abuse and dependence, and remission from disorder, and consider the potential impacts that an individual's age cohort's level of substance use predicted transitions into and out of substance use.
DESIGN AND METHODS
Data on use, DSM-IV use disorders, and remission from these disorders were collected from participants (n = 8463) in the 2007 Australian National Survey of Mental Health and Wellbeing using the Composite International Diagnostic Interview.
RESULTS
Lifetime prevalence (95% confidence interval) of alcohol use, regular use, abuse and dependence were 94.1% (93.3-94.8%), 64.5% (62.9-66.2%), 18.7% (17.4-19.9%) and 4.0% (3.4-4.6%). Lifetime prevalence of cannabis use, abuse and dependence were 19.8% (18.6-20.9%), 4.4% (3.8-5.0%) and 1.9% (1.5-2.4%). Among those with the disorder, rates of remission from cannabis abuse, alcohol abuse, cannabis dependence and alcohol dependence were 90.5% (87.4-93.6%), 86.2% (83.8-88.7%), 79.6% (71.1-88.1%) and 53.8% (46.6-61.0%). Increases in the estimated proportion of people in the respondent's age cohort who used alcohol/cannabis as of a given age were significantly associated with most transitions from use through to remission beginning at the same age.
DISCUSSION AND CONCLUSIONS
Clear associations were documented between cohort-level prevalence of substance use and personal risk of subsequent transitions of individuals in the cohort from use to greater substance involvement. This relationship remained significant over and above associations involving the individual's age of initiation. These findings have important implications for our understanding of the causal pathways into and out of problematic substance use.
引言和目的
我们利用澳大利亚的人群水平数据，估算了酒精和大麻使用、滥用和依赖的各个阶段以及障碍缓解的流行率、发病年龄和转变速度，并考虑了个体年龄队列的物质使用水平对进入和退出物质使用的潜在影响。
设计和方法
使用复合国际诊断访谈从 2007 年澳大利亚国家心理健康和幸福感调查中的参与者（n=8463）收集了使用情况、DSM-IV 使用障碍和这些障碍的缓解数据。
结果
终生（95%置信区间）酒精使用、经常使用、滥用和依赖的流行率分别为 94.1%（93.3-94.8%）、64.5%（62.9-66.2%）、18.7%（17.4-19.9%）和 4.0%（3.4-4.6%）。终生大麻使用、滥用和依赖的流行率分别为 19.8%（18.6-20.9%）、4.4%（3.8-5.0%）和 1.9%（1.5-2.4%）。在患有该障碍的人群中，大麻滥用、酒精滥用、大麻依赖和酒精依赖的缓解率分别为 90.5%（87.4-93.6%）、86.2%（83.8-88.7%）、79.6%（71.1-88.1%）和 53.8%（46.6-61.0%）。在给定年龄，受访者年龄队列中使用酒精/大麻的人数估计比例增加与同一年龄开始从使用转变为缓解的大多数转变显著相关。
讨论和结论
在年龄队列层面上的物质使用流行率与队列中个人从使用到更严重物质使用的后续转变风险之间记录了明确的关联。这种关系在涉及个体起始年龄的关联之外仍然显著。这些发现对我们理解进入和退出问题性物质使用的因果途径具有重要意义。
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