Clem Selena N, Bigand Teresa L, Wilson Marian
College of Nursing, Washington State University, Spokane, Washington.
College of Nursing, Washington State University, Spokane, Washington.
Pain Manag Nurs. 2020 Feb;21(1):43-47. doi: 10.1016/j.pmn.2019.06.009. Epub 2019 Jul 30.
Cannabis has been linked to reduced opioid use, although reasons for cannabis use among adults prescribed opioids are unclear.
The purpose of this study was to determine whether motivations for cannabis use differ between adults prescribed opioids for persistent pain versus those receiving opioids as medication-assisted treatment for opioid use disorder.
A cross-sectional survey design was used.
Adults prescribed opioids for persistent pain (n = 104) or opioid use disorder (n = 139) were recruited from outpatient settings.
Data were collected on surveys asking about cannabis use and compared the two populations. A series of regression models examined population characteristics and cannabis use motivations using validated measures of the Marijuana Motives Measure scale.
More than half the sample (n = 122) reported current, daily cannabis use and 63% reported pain as a motivation for use. Adults with persistent pain were more likely to be older, female, and have higher levels of education (p < .05). Adults with opioid use disorder were more likely to report "enhancement" (p < .01) and relief of drug withdrawal symptoms (p < .001) as motivations for cannabis use. The most common reasons for cannabis use in both populations were social and recreational use and pain relief.
Both studied populations have unmet health needs motivating them to use cannabis and commonly use cannabis for pain. Persistent pain participants were less likely to use cannabis for euphoric effects or withdrawal purposes. Nurses should assess for cannabis use, provide education on known risks and benefits, and offer options for holistic symptom management.
大麻与阿片类药物使用减少有关，尽管开具阿片类药物的成年人使用大麻的原因尚不清楚。
本研究的目的是确定开具阿片类药物用于持续性疼痛的成年人与接受阿片类药物作为药物辅助治疗阿片类药物使用障碍的成年人之间，使用大麻的动机是否存在差异。
采用横断面调查设计。
从门诊环境中招募开具阿片类药物用于持续性疼痛（n = 104）或阿片类药物使用障碍（n = 139）的成年人。
通过调查收集有关大麻使用的数据，并比较这两个人群。一系列回归模型使用经过验证的大麻动机测量量表来检查人群特征和大麻使用动机。
超过一半的样本（n = 122）报告目前每天使用大麻，63%报告使用大麻的动机是疼痛。患有持续性疼痛的成年人更有可能年龄较大、为女性且受教育程度较高（p < 0.05）。患有阿片类药物使用障碍的成年人更有可能报告“增强”（p < 0.01）和缓解药物戒断症状（p < 0.001）作为使用大麻的动机。两个人群中使用大麻最常见的原因是社交和娱乐用途以及缓解疼痛。
两个研究人群都有未满足的健康需求促使他们使用大麻，并且通常使用大麻来缓解疼痛。患有持续性疼痛的参与者使用大麻产生欣快感或用于戒断目的的可能性较小。护士应评估大麻使用情况，提供有关已知风险和益处的教育，并提供整体症状管理的选择。
