Department of Health Education and Behavior, College of Health and Human Performance, Center for Addiction Research and Education, University of Florida.
Department of Psychology, College of Natural Sciences, Colorado State University.
J Consult Clin Psychol. 2019 Oct;87(10):859-871. doi: 10.1037/ccp0000431.
Marijuana and nonprescription opioids remain the two most commonly used illicit substances in the United States. They have commonalities, yet the use of both at the same time may have a greater impact on psychological and health outcomes. Research is needed to determine whether dual-use is associated with more negative outcomes than individual substance use.
We used the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC) Wave 1 (W1; N = 43,093), Wave 2 (W2; N = 34,653), and the more recent NESARC-III (N3; N = 36,171) to compare nonuse with use of marijuana, nonprescription opioids, or both. We examined perceived health, pain interference, pain-related medical conditions, psychiatric conditions, and suicidality.
Individual use and dual-use were more common in N3 than in W1. W1 dual-use and nonprescription opioid-only use predicted worse outcomes for most variables prospectively and cross-sectionally, including pain interference and poorer general health. Associations between marijuana-only use and outcomes were not as strong; however, marijuana was associated with depression and suicidal ideation.
Nonprescription opioid use is concerning with dual-use predicting poorer perceived health and pain interference with work 3 years later along with strong relationships to suicidality and psychiatric conditions. Marijuana and nonprescription opioid dual-use is a possible treatment target. Substance interventions may be enhanced by addressing alternative pain care; chronic conditions; and/or psychiatric comorbidity. Differences in outcomes between substance use and nonuse were smaller recently in N3, particularly for marijuana use only. This may be due to increased access decreasing differences between those using and not using these drugs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
大麻和非处方类阿片类药物仍然是美国最常使用的两种非法物质。它们有共同之处，但同时使用这两种物质可能对心理和健康结果产生更大的影响。需要研究以确定双重使用是否比单独使用某种物质会导致更多的负面结果。
我们使用了国家酒精和相关条件流行病学调查（NESARC）第 1 波（W1；N=43093）、第 2 波（W2；N=34653）和最近的 NESARC-III（N3；N=36171）来比较非使用者与大麻、非处方类阿片类药物或两者的使用者。我们检查了感知健康、疼痛干扰、与疼痛相关的医疗状况、精神疾病和自杀倾向。
与 W1 相比，N3 中的个体使用和双重使用更为常见。W1 中的双重使用和非处方类阿片类药物单独使用预测了大多数变量的前瞻性和横断面结果更差，包括疼痛干扰和更差的一般健康状况。大麻单独使用与结果的关联并不那么强；然而，大麻与抑郁和自杀意念有关。
非处方类阿片类药物的使用令人担忧，双重使用预测了 3 年后感知健康和疼痛干扰工作的情况更差，与自杀倾向和精神疾病有很强的关系。大麻和非处方类阿片类药物的双重使用可能是一个潜在的治疗目标。通过解决替代疼痛护理、慢性疾病和/或精神共病，可能会增强物质干预。在 N3 中，最近物质使用和不使用之间的结果差异较小，特别是对于单独使用大麻的情况。这可能是由于获得途径的增加减少了使用和不使用这些药物的人群之间的差异。（APA，所有权利保留）。
