Department of Psychology, Iowa State University, 901 Stange Road, Ames, IA 50011-1041, USA.
Department of Psychiatry and Human Behavior, Center for Alcohol and Addiction Studies, Brown University, 121 South Main Street, Providence, RI 02903 USA.
Drug Alcohol Depend. 2019 Feb 1;195:186-192. doi: 10.1016/j.drugalcdep.2018.11.012. Epub 2018 Dec 17.
To determine if higher potency cannabis is associated with earlier progression to regular cannabis use, daily cannabis use, and cannabis use disorder symptom onset.
Data sources were the Michigan Longitudinal Study, an ongoing prospective, high-risk family study investigating the course and predictors for substance use disorders among youth beginning prior to school entry and time-parallel national average trends in delta-9-tetrahydrocannabinol (i.e., psychoactive compound in cannabis). The national average trends in delta-9-tetrahydrocannabinol were used to estimate potency level for the individual. Only cannabis users were included in analyses (n = 527).
Cox regression showed an increased risk of progression from cannabis initiation to cannabis use disorder symptom onset by 1.41 times (p < .001) for each unit increase in national average delta-9-tetrahydrocannabinol as compared to those not endorsing CUD symptom onset, adjusting for sex, regular use, and cohort effects. Accounting for regular use, individuals initiating cannabis at national average 4.9% delta-9-tetrahydrocannabinol were at 1.88 times (p = .012) higher risk for cannabis use disorder symptom onset within one year compared to those who did not endorse CUD symptom onset, while those initiating cannabis at national average 12.3% delta-9-tetrahydrocannabinol were at 4.85 times (p = .012) higher risk within one year.
This study provides prospective evidence suggesting higher potency cannabis, on average in the U.S., increases risk for onset of first cannabis use disorder symptom. Development of guidelines regarding cannabis potency is critical for reducing the costs associated with negative health outcomes.
确定高浓度大麻是否与更早进展为常规大麻使用、每日大麻使用和大麻使用障碍症状发作有关。
数据来源是密歇根纵向研究，这是一项正在进行的前瞻性、高风险家庭研究，调查了从入学前开始的青少年中物质使用障碍的发病过程和预测因素，以及同期全国范围内大麻中 δ-9-四氢大麻酚（即大麻中的精神活性化合物）的趋势。全国范围内 δ-9-四氢大麻酚的平均趋势用于估计个体的效力水平。仅包括大麻使用者进行分析（n=527）。
与未出现 CUD 症状发作的个体相比，Cox 回归显示，大麻起始后进展为大麻使用障碍症状发作的风险增加了 1.41 倍（p<0.001），这是由于全国平均 δ-9-四氢大麻酚增加了一个单位，调整了性别、常规使用和队列效应。考虑到常规使用，在全国平均 δ-9-四氢大麻酚含量为 4.9%的情况下开始使用大麻的个体，在一年内出现大麻使用障碍症状发作的风险比未出现 CUD 症状发作的个体高 1.88 倍（p=0.012），而在全国平均 δ-9-四氢大麻酚含量为 12.3%的情况下开始使用大麻的个体，在一年内出现大麻使用障碍症状发作的风险高 4.85 倍（p=0.012）。
这项研究提供了前瞻性证据，表明在美国，平均而言，高浓度大麻会增加首次出现大麻使用障碍症状的风险。制定有关大麻效力的指南对于降低与不良健康后果相关的成本至关重要。
